Role of Databases in

Hospital Information
Management

Hospital Information Systems

The purpose of a hospital information system (HIS) is to
manage the information that health professionals need to
perform their jobs effectively and efficiently by managing
the Information Requirements given below:
1. Operational Requirements
up-to-date factual information
necessary for day to day tasks

2. Planning requirements
short- and long-term decisions about patient care
decisions about hospital management

3. Documentation Requirements
the maintenance of records
accreditation
legal record

The Friedman and Martin functional model

describes the following modules for an HIS
1. Core Systems

2.

patient scheduling
admission
discharge
admission-discharge-transfer (ADT)

Business and Financial Systems

payroll
accounts receivable

3.

Communications and Networking Systems

integration of all parts of the HIS
order entry & results reporting

4. Departmental-Management Systems
the needs of individual departments can be met
those subsystems can be useful in a macro-system

5. Medical-Documentation Systems
collecting, organizing, storing, and presenting
Quality Assurance (QA)

6. Medical Support Systems

assistance in interpreting data
issue alerts, provide advice

Medical databases serve a critical function in healthcare, including the areas of patient care,
administration, research and education. Accurate and comprehensive healthcare data are vitally
important for a variety of purposes. The data may be used for local assessments or evaluations
within a healthcare system, such as for specific outpatient conditions or inpatient hospital events.

Medical Databases
Pre-Electronic Database
Storage problems:
Huge number of files
needed
Problems with
storing
patients
records
manually
(paper based)

Handwritten notes messy

And hard to understand

Only one person

can access data at
the same time

Records go
missing

Medical Databases
Patients records now stored electronically
Data can be accessed by more than one medical
professional at the same time
No need to transport files (speed of data access)
Security
Latest information can be accessed from patients
bedside (example: results from blood tests)

Database Technologies
Used in Health Information
Systems

Clinical Data Repositories, Data

Warehouses,
and Data Marts

Many health care organizations, particularly those moving toward

electronic health records, develop clinical data repositories. Although
these databases can take different forms, in general the clinical data
repository is a large database that gets data from various data stores
within application systems across the organization.
There is generally a process by which data are cleaned before they
are moved from the source systems into the repository. Once the
clean data are in the repository, they can be used to produce reports
that integrate data from two or more data stores. In function, the
clinical data repository is generally a large relational database.

A data warehouse, however, is functionally different from a relational database. It is a type of large
database designed to support decision making in an organization. Traditionally, health care
organizations have collected data in a variety of online transactional processing (OLTP) systems,
such as the traditional relational database and clinical data repository. OLTP systems are well
suited for supporting the daily operations of a health care organization but less well suited for
decision support. Data stored in a typical OLTP system are always changing, making it difficult to
track trends over time, for example. The data warehouse, in contrast, is specifically designed for
decision support.

Data Mining
Data mining is another concept closely associated with
large databases such as clinical data repositories and
data warehouses. Data mining refers to a sophisticated
analysis tool that automatically discovers patterns
among data in a data store. Data mining is an advanced
form of decision support. Unlike passive query tools, the
data mining analysis tool does not require the user to
pose individual specific questions to the database.
Instead, this tool is programmed to look for and extract
patterns, trends, and rules.

A clinical decision support system

(CDSS)
A clinical decision support system (CDSS) is an
application that analyzes data to help healthcare
providers make clinical decisions. A CDSS is an
adaptation of the decision support system commonly
used to support business management.

NoSQL
A NoSQL database provides a mechanism for storage and
retrieval of data which is modeled in means other than
the tabular relations used in relational databases.
There is a current tendency of companies in the
healthcare industry including insurers, hospitals and
solutions providers are building applications on NoSQL
databases such as MongoDB and Apache CouchDB to
reduce costs, meet compliance standards and improve
healthcare outcomes.

MongoDB and Apache CouchDB are document-oriented data stores. These NoSQL databases are
widely considered as a solution for rising costs, changing regulations and complex technological
demands in Health Information Systems.

Hippocratic Database Technology

Hippocratic databases (HDBs) are a class of database systems that
accept responsibility for the privacy and security of information they
manage without impeding legitimate use and disclosure. HDBs ensure
that only authorized individuals have access to sensitive information
and that any disclosure of this information is for proper purposes.
They empower individuals to consent to specific uses and disclosures
of their information and to verify the enterprises compliance with its
privacy policies. HDBs also employ technical safeguards to ensure the
security of the information they manage. Further, they use advanced
information sharing and analytics to enable enterprises to gain
maximum value from information without compromising security or
individual privacy.