“A STUDY ON AUTOMATED HOSPITAL

MANAGEMENT SYSTEM”

SYNOPSIS OF THE THESIS

Under the Guidance of

“Dr. Shaifali Tripathi”

Dean- Faculty of Management

Mansarovar Global University

Bilkisganj, Sehore, MP

In Partial Fulfillment of the Requirements for the Degree of

“DOCTOR OF PHILOSOPHY IN MANAGEMENT”

DEPARTMENT OF MANAGEMENT

MANSAROVAR GLOBAL UNIVERSITY, MP

2023-2025

Submitted by

SAURABH ANAND THAWARANI

Enrollment No.: 2022MGU0087

 Dedicated to

My Loving Parents

&

Teachers
 Certificate by the Supervisor

Date:………………

This is to certify that the thesis entitled “A STUDY ON AUTOMATED HOSPITAL

MANAGEMENT SYSTEM”, submitted by SAURABH ANAND THAWARANI to
MANSAROVAR GLOBAL UNIVERSITY, MP, is a record of bona fide research work carried
out under my supervision and is worthy of consideration for the award of the degree of Doctor
of Philosophy of the University.

Signature of the Supervisor: ……………….

Name of the Supervisor: DR. SHAIFALI TRIPATHI, HOD, Department of Mgmt

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 Declaration by the Scholar

Date: ……………….

I, SAURABH ANAND THAWARANI declare that the thesis entitled “A STUDY ON

AUTOMATED HOSPITAL MANAGEMENT SYSTEM” is plagiarism-free as per UGC

norms and is being submitted by me for the award of Degree of Doctor of Philosophy in

“Business Management” is the record of work carried out by me under the guidance of DR.

SHAIFALI TRIPATHI, HOD, Department of Management and has not formed the basis for the

award of any degree, diploma, associate-ship, fellowship, titles in this or any other University

or other similar institutions of higher learning.

Date:……………… Signature of the Scholar: ……………………

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 Acknowledgment

First and foremost, I would like to express my sincere gratitude to Hon’ble Chancellor,

MANSAROVAR GLOBAL UNIVERSITY, MP , --------- and Hon’ble Vice Chancellor,

MANSAROVAR GLOBAL UNIVERSITY, MP , Prof. (Dr.) ------ for continuous support of

my research work.

My sincere thanks must go to the ------------, Pro Vice-Chancellor and Deputy Pro Vice-

Chancellor----- for continuous encouragement and guidance which helped me to complete this

dissertation.

I am grateful to the Dean Research, Prof. (Dr.) ----------- for his valuable inputs toward

improving my research work.

I would like to express my deepest gratitude to my supervisor, Dr. Shaifali Tripathi, Dean-

Faculty of Management, Mansarovar Global University, Bilkisganj, Sehore, MP, whose

sincerity and encouragement I will never forget. I have benefited greatly from his wealth of

knowledge and inspirational discussions during the course of my Ph.D. research work. I would

like to recognize the invaluable support of Prof. (Dr.) ---------------------------

My sincere thanks must also go to the members of my thesis advisory & DRC Dr. ----.

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I would like to thank Mr.------------, Librarian, Central Library & his team for extending

support in literature survey phase I & II. I am fortunate to have been a part of the

MANSAROVAR GLOBAL UNIVERSITY, MP. Thank you for the good learning experience.

I am thankful to all the faculty members & supporting staff of MANSAROVAR GLOBAL

UNIVERSITY, MP and to fellow colleagues & fellow research scholars for their continuous

moral support and help.

I am also thankful to all the Teachers & Students for molding my career to right path. And last

but not the least I am thankful to my Parents & family members without them I can’t imagine

anything, whether small or big achievement.

I have enlightened (post covid-19) with the fact that GOD is always with us. Thanks each &

everyone for supporting my research journey.

SAURABH ANAND THAWARANI

Date:

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 Table of Contents

Page No.

Certificate by Supervisor ii

Declaration by Candidate iii

Acknowledgment iv

Table of Contents vi

Abstract xi

Keywords x

List of Figures xi

List of Tables xii

Abbreviations xvi

Notations and Symbols/Nomenclatures xvii

Chapter 1 Introduction 1

1.1 Introduction 1

1.1.1 2

1.1.2 3

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 1.1.3 5

1.1.4 13

1.2 Survey of Literature 15

1.2.1 Research Gap 44

1.3 Research Methodology 45

1.3.1 Areas to be investigated 46

1.3.2 Problem Identification 46

1.3.3 Motivation 47

1.3.4 Objectives 47

1.3.5 Research Hypotheses 48

1.3.6 Research Design 53

1.3.7 Research Approach 55

1.3.8 Research Strategy 55

1.3.9 Quantitative and Qualitative Research 56

1.3.10 Pilot Study 56

1.3.11 Sampling Plan 57

1.3.few Scaling 58

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 1.3.13 Sources of Data Collection 58

1.3.14 Reliability & Validity 60

1.3.15 Statistical Analysis of Data 61

1.3.few Analysis of Variance (ANOVA) 63

1.4 Organization of the Thesis 64

Chapter 2 Background of the Research 66

2.1 66

2.2 67

2.3 73

2.4 74

2.4.1 75

2.4.2 76

Chapter 3 Data Analysis & Interpretations 93

3.1 Analysis on 95

3.2 114

3.3 130

Chapter 4 Findings & Discussions 144

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 4.1 144

4.2 148

4.3 152

Chapter 5 Conclusion and Scope of Future Work few0

5.1 Conclusion few0

5.2 Objective Wise Conclusion few3

5.3 Suggestions few7

5.4 Challenges few9

5.5 Contribution to Future Research 170

5.6 Limitations 171

Appendix – Questionnaire xviii

Bibliography xxiii

List of Publications xxxviii

Plagiarism Report Certificate lii

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 Chapter 1

Introduction

“A STUDY ON AUTOMATED HOSPITAL MANAGEMENT SYSTEM”

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1. INTRODUCTION

1.1 Hospital Management System

According to Toussaint (2015), hospitals can’t improve without better management systems.

In Toussaint’s perspective, management is a significant part of today’s cost and quality crisis

in health care. The reason why suitable hospital needs and appropriate medical management

must be present to deliver applicable healthcare facilities.

According to Agnes (2011), there must be a planned approach towards work. Thus, the

activities within the hospital must be well-planned and organized. In line with this,

researchers found that the level of accuracy in handling hospital information must be done

accordingly and accurately. Conclusively, the errors are not completely eliminated, but they

are reduced. Hospital Management System is powerful, flexible, and easy to use and is

designed and developed to deliver real conceivable benefits to hospitals. Prasanth and Sailaja

(2014) stated that the hospital management system is to computerize the front office

management which deals with the collection of patient information, diagnosis details, and

even the billing details. The researchers found out that the computerization of hospital

management systems has become a necessity and has become the new standard. By

implementing this technology adoption, the researchers also found out that the need for easy

access to patient information and history is significantly increasing.

A hospital management operation is an institution for medical care that provides patient

treatment by technical staff and outfit. Generally, automated medical staff operations are

funded by the public sector, medical associations (for-profit or nonprofit), health insurance

companies or charities, including finances by direct charitable donations. Historically, still,

automated medical staff operations were frequently innovated. And funded by religious

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orders or charitable individualities and leaders. Ultramodern automated medical staff

operation is largely staffed by professional medical staff, surgeons, and nurses Automated

medical staff operation is distinguished by their power, compass of services, and whether

they're tutoring automated medical staff operation with academic confederations. Automated

medical staff operations may be operated as personal (for-profit) businesses, possessed either

by pots or individualities similar to the medical staff or may be voluntary - possessed by non-

profit pots, religious associations, or operated by central, state, or Megacity governments.

Voluntary and non-profit automated medical staff operations are generally governed by a

board of trustees, named from among community business and communal leaders, who serve

without pay to oversee hospital management operation operations.

1.1.1 Community

Hospital management staff utmost community automated medical staff operation offer

exigency services as well as a range of outpatient and inpatient medical and surgical services.

Community hospital management staffs, where most people admit are, are generally small,

with fifty to five hundred beds. This automated medical staff operation typically give quality

care for routine medical and surgical problems. Some community automated medical staff

operation is nonprofit pots, supported by original backing.

These include automated medical staff operations supported by religious, collaborative, or

osteopathic associations. In the 1990s, figures of not-for-profit community automated

medical staff operations have converted their power status, getting personal automated

medical staff operations that are possessed and operated on a for-profit base by pots. These

automated medical staff operations have joined investor-possessed spots because they need

fresh fiscal coffers to maintain their actuality in a decreasingly competitive assiduity.

Investor-possessed, acquire not-for-profit automated medical staff operation to make case

grounded share, expand their provider networks, and access new medical care cases. Tutoring
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Hospital management staff operations are those community and tertiary automated medical

staff operations combined with medical seminaries, nursing seminaries, or confederated-

health professions training programs. Tutoring automated medical staff operation are the

primary spot for training new medical staff where interns and resider work under the

supervision of educated medical staff. Non-tutoring automated medical staff operation may

maintain confederations with medical seminaries and some also serve as spots for nursing

and confederated-health professions scholars as well as medical staff- in- training. Utmost

tutoring hospital management staffs, which give clinical training for medical scholars and

other medical staff professionals, are combined with a medical academy and may have

several hundred beds. Numerous of the medical staff on staff at the hospital management

operation also hold tutoring positions at the university combined with the hospital

management operation.

In addition to tutoring medical staff-in-training at the bedsides of the cases. Cases in tutoring

automated medical staff operation understand that they may be examined by medical scholars

and resider in addition to their primary" attending" medical staff. One advantage of carrying

care at a university-combined tutoring hospital management operation is the occasion to

admit treatment from largely good medical staff with access to the most advanced technology

and outfit. A disadvantage is the vexation and irruption of sequestration that may be affected

from multiple examinations performed by residers and scholars. When compared with lower

community hospital management staff, some tutoring automated medical staff operations

have reports for being veritably impersonal; still, cases with complex, unusual, or delicate

judgments generally profit from the presence of conceded medical experts and further

comprehensive coffers available at these installations. Tutoring hospital management

operation combines backing to cases with tutoring to medical scholars and nurses and

frequently is linked to a medical academy, nursing academy or university.

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1.1.2 Public Automated Hospital

Public automated medical staff operations are possessed and operated by central, state, and

Megacity governments. Numerous have a continuing tradition of minding for the poor.

They're generally located in the inner metropolises and are frequently in precarious fiscal

situations because numerous of their cases are unfit to pay for services. The central

government matches the countries' donations to give a certain minimum position of available

content, and the countries may offer fresh services at their expenditure.

1.1.3 General Automated Hospital Management

This is the stylish type of hospital management operation; it’s set up to deal with numerous

Kinds of conditions and injuries and typically has an exigency department to deal with

immediate and critical pitfalls to health.

1.1.4 Quarter Hospital Management Operation.

This is the major medical care installation in with region, with large figures of beds for

ferocious care and long-term care; and specialized installations for surgery, plastic surgery,

parturition, and bioassay laboratories. Technical Hospital management operation. It is a

special type of hospital management operation meant for a particular case like trauma centres,

recuperation hospital management staff, children's hospital management staff, seniors'(senior)

hospital management staff, and automated medical staff operation for dealing with specific

medical requirements similar as psychiatric problems, certain complaint orders similar as

cardiac, ferocious care unit, neurology, cancer centre, and obstetrics and gynaecology,

oncology, or Orthopedic problems. Conventions a medical installation lower than a hospital

management operation is generally called a clinic and frequently is run by a government

agency for health services or a private corporation of medical staff (in nations where private

practice is allowed). Conventions generally give only inpatient services.

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1.1.5 Problems of the Home-made System

1) Lack of immediate reclamation

2) The information is veritably delicate to recoup and to find particular information

3) To find out about the case’s history, the stoner has to go through colourful registers.

This results in vexation and a waste of time.

1.1.6 Problem of the Manual System

a) Lack of immediate retrieval: -

b) The information is very difficult to retrieve and to find particular information e.g. -

c) To find out about the patient’s history, the user has to go through various registers.

This results in inconvenience and waste of time.

d) Lack of immediate information storage:

e) The information generated by various transactions takes time and effort to store them.

f) Error-prone manual calculation:

g) Manual calculations are error-prone and take a lot of time, this may result in incorrect

information. For example, the calculation of a patient’s bill based on various treatments.

h) Preparation of accurate and prompt reports:

i) This becomes a difficult task as business intelligence is difficult; this is due to a lack

of information collation (ability to put information)

1.2 Automated Hospital Management at Glance

According to Kaelber et al., (2008), patients, policymakers, providers, payers, employers, and

others have an increasing interest in using personal health records (PHRs) to improve

healthcare costs, quality, and efficiency. They stated that many healthcare information

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technology vendors and healthcare providers already have the tools available to PHRs to their

customers and patients. For example, an estimated 50 million patients see healthcare

providers who use the EPIC EHR (Electronic Health Record) software system. The

researchers concluded that to achieve this improvement, an upgrade of the hospital

management was necessary. Previous reviews of research on electronic health record (EHR)

data quality have not focused on the need for quality measurement. Chan et al., (2010)

reviewed empirical studies of EHR data quality, with an emphasis on data attributes relevant

to quality measurement. They stated that many of the 35 studies reviewed examined multiple

aspects of data quality. 60% per cent evaluated data accuracy, 57% data completeness, and

23% data comparability.

1.3 Electronic Medical Record System

According to Park et al., (2008), the use of an electronic medical record system for

mandatory reporting of drug hypersensitivity reactions has been shown to improve the

management of patients in the university hospital in Korea. The researchers found out that the

report rate of past DHSRs (drug hypersensitivity reactions) was greatly increased and the

estimated incidence of new events decreased under the new system. The occurrence rate of

new DHSRs during hospitalization, which was caused by the repeated administration of the

agents previously suspected as culprit drugs enormously, decreased from 15% in the previous

system to 1% in the new system. The researchers concluded based on the study that the

mandatory reporting system for past DHSRs and the supervision by allergy specialists appear

to be important in improving the management of patients with drug hypersensitivity and in

preventing the occurrence of DHSRs in a general hospital.

According to Blumenthal and Tavenner (2010), the widespread use of electronic health

records (EHRs) in the United States is inevitable. EHRs will improve caregivers' decisions

and patients' outcomes. Once patients experience the benefits of this technology, they will
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demand nothing less from their providers. Hundreds of thousands of physicians have already

seen these benefits in their clinical practice.

According to Wager et al., (2014) physicians and staff indicated that the EMR system has

changed not only how they manage patient records but also how they communicate with each

other, provide patient care services, and perform job responsibilities. The EMR is also

perceived by its users to have an impact on practice costs. Although in most practices

physicians and staff were unaware of actual expenses and cost savings associated with the

EMR, those in practices that have eliminated duplicate paper-based systems believe they

have realized cost savings.

According to Shachak (2009), the use of EMR exerts both positive and negative impacts on

physician–patient relationships. The negative impacts can be overcome by some simple

means as well as better designs of EMR systems and medical education interventions.

Physicians’ everyday practices of integrating EMR use into the clinical encounter as well as

better design of EMR systems and EMR and communication training may facilitate PDC in

computerized settings. Shachak used a qualitative, grounded theory ‐like approach to analyze

the data.

According to Lau et al., (20few) currently, there is limited positive EMR impact in the

physician's office. To improve EMR success one needs to draw on the lessons from previous

studies such as those in this review. They included 27 controlled and few descriptive studies

and examined six areas: prescribing support, disease management, clinical documentation,

work practice, preventive care, and patient-physician interaction. Overall, 22/43 studies

(51.2%) and 50/109 individual measures (45.9%) showed positive impacts, 18.6% of studies

and 18.3% of measures had negative impacts, while the remaining had no effect. Forty-eight

distinct factors were identified that influenced EMR success. Several lessons learned were

repeated across studies: (a) having robust EMR features that support clinical use; (b)
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redesigning EMR-supported work practices for optimal fit; (c) demonstrating value for

money; (d) having realistic expectations on implementation; and (e) engaging patients in the

process. In conducting their study, they had three practising physicians (MP, JB, and CP) on

the review team to assist in study selection and synthesis to ensure the relevance of their

findings. One researcher searched two online databases -Ovid MEDLINE® and CINAHL®

in early 2010 using search strategies prepared with the assistance of a medical librarian.

The search covered combinations of concepts for electronic medical records, office practice,

physician and impact. Lau and his group limited their search to English articles published in

the last decade as they were more likely to be relevant than those from earlier periods (from

2000 to 2009). After removing duplicates from the combined MEDLINE® and CINAHL®

searches one reviewer did the preliminary screening of all citations. Full-text review of the

articles was done by two teams of two reviewers (one researcher and one physician per team).

The third physician (MP) was the tie-breaker. The final article selection for analysis was done

by consensus. Corresponding authors of original articles were contacted to verify the setting

if needed. In conclusion, the researchers found that several important themes emerged. The

organizational context in which the system is implemented is important. Effective leadership,

the presence of a system champion, the availability of technical training and support, and

adequate resources are essential elements to the success of the EMR (electronic medical

records). The researchers also found out that the physicians who use electronic health records

believe such systems improve the quality of care and are generally satisfied with the systems.

1.3.1 Design and Implementation of Hospital Management System

According to Liu (20few), the problem of design and implementation of hospital

management systems is of great importance in modern hospitals. Liu stated that the system

must be made of several parts such as: marking cards, registration, medical treatment, drug

information management, pharmacy dispensing, emergency, data dictionary maintenance,

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database backup, report printing and so on. Seven function modules are to be considered,

including Emergency Register Management, Price Making, Charge, Nurse Station

Management, Report Printing, Pharmacy Dispensing, and Data Dictionary Maintenance.

Based on the above design, the system can provide high-quality treatments and good services

for patients and their families.

According to Ren et al., (2017) hospital information system is considered as one of the most

important branches of Medical Informatics by the International academic community, with

the essence of integrating all the hospital departments into a large information network to

facilitate the whole hospital system. Given the issue of “difficult to be hospitalized” in China,

a set of safe, stable and easy-to-handle bed resource management information systems was

developed by the Hospital Information Department (HID) using PowerBuilder, the MVC

model and the Oracle database. This system improved the efficiency of bed resource

management, enabled interdisciplinary collaboration across departments, and significantly

reduced the average hospital stay of patients.

1.4 Healthcare Information Systems

With the increasing applications of electronic medical record systems, many hospitals have

accumulated rich clinical data in the format of distribution and heterogeneity (Cai et al.,

2014). To efficiently fulfil the integration, the Linked Data Model is extended and used to

design a method for personal electronic medical data searching and integration.

Personal electronic healthcare records are constructed through a linked information net. The

prototype demonstrates that the proposed method is effective and efficient. The ability of

external investigators to reproduce published scientific findings is critical for the evaluation

and validation of health research by the wider community (Hemingway et al., 2017). With the

complexity, volume and variety of electronic health records made available for research

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steadily increasing, it is critical to ensure that findings from such data are reproducible and

replicable by researchers.

According to Tarride et al., (2011), the introduction of health information technology (HIT)

into the medication management process holds the promise of reducing adverse drug events

(ADEs), increasing the efficiency of care delivery, improving the quality of care, reducing

costs, and saving money over the longer term.

However, even if these technologies are effective, they are complex and expensive to acquire,

implement, and maintain.

Electronic systems that collect, process, or exchange health information about patients and

formal caregivers; medication management information technology that was integrated with

at least one HIT system that processed patient-specific information and provided advice to

the healthcare provider or patient or dealt with transmission or order communication between

pharmacist and clinical prescriber. Any article that included an economic component was

tagged and underwent further screening. For this review, full and partial economic

evaluations were eligible for inclusion. A full economic evaluation is the comparative

analysis of alternative courses of action in terms of both costs and consequences, and these

were further classified into one of three categories: (1) cost-effectiveness analysis; (2) cost-

utility analysis; and (3) cost-benefit analysis.

Following the January 2010 earthquake in Haiti, the Israel Defense Force Medical Corps

dispatched a field hospital unit (Levy 2010). A specially tailored information technology

solution was deployed within the hospital. The solution included a hospital administration

system as well as a complete electronic medical record. A lightweight picture archiving and

communication system was also deployed. During 10 days of operation, the system registered

1111 patients.

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The network and system up times were more than 99.9%. Patient movements within the

hospital were noted, and an online command dashboard screen was generated. Patient care

was delivered using the electronic medical record. Digital radiographs were acquired and

transmitted to stations throughout the hospital. The system helped to introduce order in an

otherwise chaotic situation and enabled adequate utilization of scarce medical resources by

continually gathering information, analyzing it, and presenting it to the decision-making

command level.

The establishment of electronic medical records promoted the adequacy of medical treatment

and facilitated continuity of care. This experience in Haiti supports the feasibility of

deploying information technologies within a field hospital operation. Disaster response teams

and agencies are encouraged to consider the use of information technology as part of their

contingency plans.

The information system was designed to meet two primary objectives. The first was to serve

as an administrative platform for the field hospital and to enable hospital command to make

informed operational decisions, based on real-time accurate information. The second was to

enable advanced case management at the individual patient level by establishing an electronic

medical record. The solution scheme had to include a means of distributing digital

radiographs throughout the hospital because of the introduction of a computerized

radiography machine as part of the hospital's standard equipment.

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