Hospital Management System: Admissions, Wards, Pharmacy and the Final Bill

A clinic deals with a patient for twenty minutes. A hospital deals with one for days, across wards, a pharmacy, a laboratory, an operating theatre and several doctors — and at the end has to produce a single bill that includes all of it. That is the problem a hospital management system exists to solve. For outpatient work on its own, see clinic management software.

One patient, one record

Every patient gets one number at first registration and keeps it for life. Each visit or admission hangs from that number, so a doctor can see earlier admissions, test results and medicines without sending for a file. Duplicate registrations are the first thing to guard against: search by phone number and CNIC before creating a new patient.

Admission and beds

• Admission records the consultant, the ward, the bed, the room category and whether the patient is private or on a panel.
• Bed status shows every bed as occupied, vacant, being cleaned or reserved, so admissions staff do not phone the ward to ask.
• Transfers from ward to ICU or between room categories change the daily charge from that moment.
• Advance payments are recorded against the admission and shown against the running bill.
• Expected discharge lets the ward and the admissions desk plan the next patient.

Orders: where treatment becomes charges

During a stay, doctors order medicines, tests and procedures. In a paper hospital each order is a slip that travels to a department, and the charge reaches the bill only if someone remembers to send it to accounts. In a system, the order is entered once on the ward. The pharmacy or lab sees it, carries it out, and the charge posts to the patient's bill at that moment.

Pharmacy and laboratory

• Medicines are issued to a patient against an order, by batch, so stock falls and the bill rises together.
• Expiry dates are tracked, and near-expiry stock is listed before it becomes a loss.
• Returned medicines go back into stock and come off the bill.
• Lab tests are received, the sample is tracked, and the result is entered against the patient's record.
• Results are released to the ward when verified, and are available at the next visit.
• Walk-in pharmacy and lab customers are billed at a counter from the same stock and test list.

These two departments are usually where money leaks, because they often run on separate software or on paper. Bringing them into the same system as the wards does more for the final bill than any other step.

The bill at discharge

The practical result is that a patient's family can be told the running total on any day, and discharge does not wait for accounts to gather slips from four departments.

Panel and insurance patients

Many patients are paid for by an employer or an insurer. Each panel has its own rate list, its own rules on what is covered and often an approval step before a procedure. The system needs a rate list per panel, the approval recorded against the admission, and a bill split between what the panel pays and what the patient pays. Panel receivables then need following up like any other credit customer.

Access and privacy

Medical records are confidential, and a hospital has many more users than a clinic. A cashier needs the bill but not the diagnosis; a nurse needs the orders but not the hospital's revenue. Every user should see only what their role requires, and opening or changing a record should leave a trace. Roles and permissions in business software explains how to design this, and business software security basics covers backups and access.

The order to build it in

Each phase is usable by itself, which is why phased ERP implementation suits hospitals better than switching everything on one morning. If your discharge bills are still assembled from slips, tell us how a patient's charges reach accounts today. Our ERP and business systems are built one department at a time.