Hospital Management

Hospital is an institution of health care. Generally many doctors of different specialties are associated with the hospital. The hospital has a large no. of sections which have to work in a synchronized manner for effective performance. 

Advances in software technology and internet have provided a valuable tool for better management of hospital, which is a very complex organization. Even though the hospital has unique name and image many a times the patients are attracted to the hospital based on the expertise of the doctors. There is a close relationship and information exchange between doctors and patients. The taste reports are studied by doctors and they prescribe the medicine after physical check up of the patients. The feedback of the treatment is very valuable in deciding efficiency of diagnosis and medicines. 

I had an occasion to visit hospitals in Houston, and was very impressed by the infrastructural facilities, care and respect given to patients and methodic documentation and superb coordination in various activities. Hospital does't look like hospital but as a five star hotel. Reception rooms are specious, sofas for seating arrangement, wall paintings, reading journals,books, toys and computers for children. The admission clerks work on computers connected by intranet for data entry and retrival. There is minimal use of paper document, patients are provided with pagers to alert the appointment. Patients can fix up the appointments by phone, search and receive reports on net. All hospitals are interconnected for sharing and transferring data of analysis reports, dignosis and medical advise. The patients have full right to question and probe the health service quality. 

All this makes the cost of health care very high and health insurance companies provide the health cover.These health care insurance companies insist on detailed documentation of all the information so that they can access the medical bill payments to the patients. There is a dearth of manpower in hospitals in advanced countries for necessary documentation, which has given rise to medical transcription business in India.There is no constraint on finance availability for medical research but what they lack is the availability of factual data of symptoms and patient response to medication for variety of cases.

In India, private speciality hospitals, polyclinics have been established in large number. But the hospital management is still far from providing basic facilities and care of patients. There is heavy reliance on paper work and job of maintaining test reports is delegated to patients. There is no central intranet and knowlege store, data compilation is absent. The documentation is rarely done and generally restricted to bill payments and test reports. Even the test reports are generally given to the patients and no record is kept of medicines prescribed and diagnosis. Individual doctors keep certain information recorded for their personal use but very few doctors use computers to manage patient records and rely on their experience. As such this information and knowlge asset remains with doctor and is not transferred to the hospital knowledge database. This creates a condition that the hospital depends totally on the current medical experts and staff appointed and suffers a loss if a good experience doctors leaves the hospital.

In many hospitals there are junior doctors or medical students who do not have the expert knowledge or the experience to handle complex cases nor do they get information from the hospital about the case histories of similar patients.In civil hospitals, the well known doctors from the city often work on honorary basis but that information does not add any repute or knowledge database to the hospital as there is no compilation or processing of information.In an ideal hospital, software program shall include knowledge management aspect along with accounts, inventory, salaries, maintenance and other administrative activities.

The cost of developing such comprehensive software may seem to be high it is amust for any hospital. Indirectly this creates a very useful knowledge base for the medical profession and helps to retain and exchange the image of hospitals. Even the new doctors joining the hospital can get benefited by the information stored in the hospital database. Such a requirement is considered unnecessary and is neglected while planning the hospital project. It should be remembered however, that such a software system shall work like a brain of the hospital. Developing all other organs but neglecting brain would result in unorganized, aimless and temporal functioning of the hospital. The software should have multi-user facility with computers of different sections being served from a central processor server with a responsible person as overall in charge of computer system. The website connected to the central processor of intranet but hosted on remote server shall be an added advantage as it would provide a showcase to the general public and there patients staying at distant places about the general facilities, expertise and administrative capabilities of the hospital. It could also help the doctors to give advice or study the test reports even remotely at any time. This would ensure availability of doctors certain even beyond hospital timings and for the outdoor patients.

If the knowledge database of the hospital is properly created processed and transformed in learning modules, it can serve as a practical guide to students studying medical courses. Suitable distance education programs can be developed by the hospital and it can issue certificates acting as an educational institute. This would give additional financial resources and enhance the image and prestige of the hospital.
The hospitals in India should transform themselves into responsible heath care facilities, proper development and compilation of medical data through use of intranet connected to central database and interactive website for communication with patients, experts and other hospitals. This will not only improve medical services, it could build a valuable asset of vast knowledge base as number of patients and variety of diseases handled by these hospitals is many times compared to advanced countries. Foreign manufacturers of medicines can sponsor research projects and provide substancial financial support for betterment of health services in India.