Вы находитесь на странице: 1из 155

Haryana Hospital Information System (HIS)

Request for Proposal Volume 1


Haryana State Health Resource Centre (HSHRC)
Version 1.0

October 2013

Implementation of Hospital Information System (HIS)

Request for Proposal - Volume 1

This report (and any extract from it) may not be copied, paraphrased, reproduced, or distributed in any
manner or form, whether by photocopying, electronically, by internet, within another document or
otherwise, without the prior written permission of PricewaterhouseCoopers. Further, any quotation,
citation, or attribution of this publication, or any extract from it, is strictly prohibited without
PricewaterhouseCoopers prior written permission.

Haryana State Health Resource Centre confidential

Implementation of Hospital Information System (HIS)

Haryana State Health Resource Centre confidential

Request for Proposal - Volume 1

Implementation of Hospital Information System (HIS)

Request for Proposal - Volume 1

Table of Contents
1.

Introduction and Background ........................................ 11


1.1.

Project Objectives ..................................................................................................................... 12

1.2.

Summary of Issues and Challenges faced by Stakeholders ................................................ 12

1.2.1. Issues faced by Hospital Staff ................................................................................................. 12


1.2.2. Issues faced by Hospital Administrators .............................................................................. 13
1.2.3. Issues faced by Patients / Citizens ......................................................................................... 14
2.

State Profile ............................................................... 16

2.1.

Overview of Health Department and Medical Education................................................... 16

2.2.

Administrative Structure......................................................................................................... 21

2.3.

e-Governance in Health........................................................................................................... 22

3.

Scope of Work ............................................................ 25

3.1.

Project Requirements .............................................................................................................. 25

3.2.

Detailed Description of Activities .......................................................................................... 26

3.2.1. Supply, installation, configuration, customization, integration, of Hospital Information


System (HIS) together with the necessary database and other software ......................... 26
3.2.1.1. Inception Report: ..................................................................................................................... 26
3.2.1.2.

Detailed Requirements Gathering and Analysis: ......................................................... 26

3.2.1.3.

System Design................................................................................................................... 27

3.2.2. Implementation of HIS according to the reference architecture, performance metrics,


acceptance criterias and conformance to industry standards including its testing and
certification ............................................................................................................................... 28
3.2.3. Installation, configuration and commissioning of central servers for hosting the HIS
solution at Data Centre. Facilitate HSHRC in provisioning of redundant broadband
connectivity. Procurement Installation, configuration and commissioning of end user
computing infrastructure at the project locations comprising of all hardware, system
software, application software and any other software including necessary site
preparation of hospital facilities considered for implementation..................................... 29
3.2.4. Operation and Maintenance of the entire HIS Solution including Application, IT &
Non-IT infrastructure for a period of five years from the date of phase-1 Go-Live ........ 30
3.2.5. Change Management and Capacity Building including Training of users for effectively
using the system ....................................................................................................................... 31
3.2.6. Adherence to Implementation Plan and Project Governance Structure .......................... 31
Haryana State Health Resource Centre confidential

Implementation of Hospital Information System (HIS)

Request for Proposal - Volume 1

3.3.

Stakeholders Roles and Responsibilities .............................................................................. 31

3.4.

Documentation and Versioning ............................................................................................. 36

4.

Business Functions ...................................................... 38

4.1.

Business Requirements to be met by the System ................................................................ 38

4.2.

Functional Requirements........................................................................................................ 38

4.3.

Integration with external applications and systems ........................................................... 38

4.4.

Proposed Backend Components / Server Interactions ....................................................... 44

5.

Technical Requirement Specifications ............................ 47

5.1.

Application and other standards ............................................................................................ 47

5.2.

Compliance with Industry Standards .................................................................................... 48

5.3.

Performance Metrics................................................................................................................ 49

5.4.

Acceptance Criteria .................................................................................................................. 52

5.4.1. Security ...................................................................................................................................... 52


5.4.2. Backup and Recovery............................................................................................................... 52
5.4.3. Uptime and Performance ........................................................................................................ 52
5.4.4. IT Refresh Policy ...................................................................................................................... 53
5.4.5. Development / Customization Criteria ................................................................................. 53
5.4.6. Project Management and Plan ............................................................................................... 54
5.4.7. Version Control and Bug Fixing ............................................................................................. 54
5.4.8. Future Changes / Application Upgrades ............................................................................... 55
5.5.

Technology Reference Architecture ....................................................................................... 55

5.6.

Deployment Architecture ........................................................................................................ 58

5.7.

Testing Criteria ......................................................................................................................... 59

5.7.1. User Acceptance Testing (UAT) ............................................................................................. 60


5.7.2. Acceptance Test Design and Execution................................................................................. 60
5.7.3. Fault Correction........................................................................................................................ 60
5.8.

Hosting Criteria ........................................................................................................................ 61

5.9.

Data Loss Protection ................................................................................................................ 61

6.

Infrastructure Requirements ........................................ 63

6.1.

Proposed implementation / Network Architecture ............................................................. 63

6.2.

Virtualization and Cloud ......................................................................................................... 63

6.3.

Data Centre ............................................................................................................................... 63

Haryana State Health Resource Centre confidential

Implementation of Hospital Information System (HIS)

Request for Proposal - Volume 1

6.4.

Business Continuity ................................................................................................................. 66

6.5.

Network / Connectivity ......................................................................................................... 69

6.6.

Summary of proposed IT infrastructure at front end / client side .................................... 70

6.7.

Site Preparation requirements ............................................................................................... 72

7.

Operational Requirements ............................................ 73

7.1.

Performance Requirements .................................................................................................... 73

7.2.

Support Requirements ............................................................................................................ 73

7.3.

Infrastructure Operations and Maintenance ....................................................................... 75

7.4.

Warranty Support Services ..................................................................................................... 76

7.5.

Annual Maintenance Contract (AMC)................................................................................... 77

7.6.

Manpower for IT Support at all project locations................................................................ 77

7.7.

Helpdesk Support / Incident Management Services .......................................................... 78

7.8.

Facility Management Services ................................................................................................ 80

8.
8.1.
9.

Training Requirements ................................................ 82


Training and Change Management Requirement ............................................................... 82
Project Plan and Deliverables....................................... 84

9.1.

Implementation Schedule ....................................................................................................... 84

9.2.

Institutional Mechanism for Project Review and Monitoring ........................................... 88

9.3.

Risk Management..................................................................................................................... 90

10.

Annexure ................................................................... 93

10.1

Annexure 1_ Functional Requirement Specifications......................................................... 93

1.

HIS Web Portal ......................................................................................................................... 93

1.2.

Static Web Content .................................................................................................................. 93

2.

Public Reports / Statistics ....................................................................................................... 94

3.

HIS Core Application - Functional Components ................................................................. 94

3.1.

Information Components........................................................................................................ 94

3.2.

Search Component ................................................................................................................... 95

3.4.

Interface Component ............................................................................................................... 96

4.

Registration ............................................................................................................................... 97

5.

Helpdesk .................................................................................................................................... 99

6.

Billing ............................................................................................ Error! Bookmark not defined.

7.

OPD ............................................................................................................................................ 99

Haryana State Health Resource Centre confidential

Implementation of Hospital Information System (HIS)

Request for Proposal - Volume 1

8.

Emergency ............................................................................................................................... 101

9.

IPD (Admission, Transfer, Dischange) .................................... Error! Bookmark not defined.

10.

IPD (Wards Management) ........................................................ Error! Bookmark not defined.

11

Maternity Ward and Labor Room............................................. Error! Bookmark not defined.

12

Operation Theatre ....................................................................... Error! Bookmark not defined.

13

Medico-Legal Case/Report (MLC/MLR) ................................. Error! Bookmark not defined.

14.

Laboratory .................................................................................... Error! Bookmark not defined.

15.

Radiology ..................................................................................... Error! Bookmark not defined.

16.

Blood Bank ................................................................................... Error! Bookmark not defined.

17.

Birth Registration ........................................................................ Error! Bookmark not defined.

18.

Death Registration ...................................................................... Error! Bookmark not defined.

19.

Software Integration ................................................................... Error! Bookmark not defined.

20.

Pharmacy Management.............................................................. Error! Bookmark not defined.

21.

Equipment Management............................................................ Error! Bookmark not defined.

22.

Human Resource Management ................................................. Error! Bookmark not defined.

23.

Finance and Accounts ................................................................. Error! Bookmark not defined.

24.

Medical Record Department (MRD.......................................... Error! Bookmark not defined.

25.

Ambulance Services (including Referral Transport) .............. Error! Bookmark not defined.

26.

General Stores Management ....................................................... Error! Bookmark not defined.

27.

Document Management ............................................................. Error! Bookmark not defined.

28..

Content Management ................................................................. Error! Bookmark not defined.

29.

HIS Core Application Admin, Reporting and Audit Trail .. Error! Bookmark not defined.

29.1. Application Admin ...................................................................... Error! Bookmark not defined.


29.2. Authentication ............................................................................. Error! Bookmark not defined.
29.3.

Privilege Administration .......................................................... Error! Bookmark not defined.

29.4. User and Group Management ................................................... Error! Bookmark not defined.
29.5. Rights and Privilege Management ............................................ Error! Bookmark not defined.
29.6. Masters (Lists and Values) Management ................................ Error! Bookmark not defined.
29.7. Masters List Table ...................................................................... Error! Bookmark not defined.
30.

MIS Reporting ............................................................................. Error! Bookmark not defined.

31.

Audit Trail .................................................................................... Error! Bookmark not defined.

32.

User Log-in / Authentication Services ..................................... Error! Bookmark not defined.

Haryana State Health Resource Centre confidential

Implementation of Hospital Information System (HIS)

Request for Proposal - Volume 1

33.

Registration, Password Retrieval / Reset ................................ Error! Bookmark not defined.

34.

Search / Advanced Search.......................................................... Error! Bookmark not defined.

35.

Grievance Redressal / Feedback / Suggestions ...................... Error! Bookmark not defined.

34.

Personalized Dashboard ............................................................. Error! Bookmark not defined.

37.

Integration Services .................................................................... Error! Bookmark not defined.

38.

HIS Lite / Offline Application ................................................... Error! Bookmark not defined.

39.

Local HIS Lite Application dependencies ................................ Error! Bookmark not defined.

40.

Online Help/Reference with Search Option....................................................................... 143

10.2

Escalation Matrix ................................................................................................................... 148

10.3. HIS Core Application General Functionality Requirements ........................................ 146


10.4. Helpdesk Support / Incident Management Services .................................................... 14644
10.5

Annexure 2_ Present IT Infrastructure .............................................................................. 148

10.6

Annexure 3_ Indicative Bill of Material .......................................................................... 14846

10.7

Annexure 4_ List of Deployment Locations (FRUs) ..................................................... 15250

10.8

Annexure 5_ Indicative average number of Scans per Hospital per day ................... 15351

Haryana State Health Resource Centre confidential

Implementation of Hospital Information System (HIS)

Request for Proposal - Volume 1

Glossary
Abbreviation

Meaning

NISG

National Institute for Smart Government

HSHRC

Haryana State Health Resource Centre

HIS

Hospital Information System

H&FW

Health and Family Welfare

ME

Medical Education

PS

Principal Secretary

DG

Director General

VC

Vice Chancellor

HS

Health Services

MD

Managing Director

PMO

Principal Medical Officer

MS

Medical Superintendent

DH

District Hospital

SDH

Sub-district Hospital

CHC

Community Health Centre

PHC

Primary Health Centre

SMO / MO

Senior Medical Officer / Medical Officer

I/C

In-charge

Haryana State Health Resource Centre confidential

Implementation of Hospital Information System (HIS)

Abbreviation

Meaning

TPAA

Third Party Audit Agency

HSDC

Haryana State Data Centre

CR

Change Request

EQI

Equal Quarterly Instalments

Haryana State Health Resource Centre confidential

Request for Proposal - Volume 1

10

Implementation of Hospital Information System (HIS)

1. I ntroduction

and

Request for Proposal - Volume 1

B ackground

India has faced many serious challenges in Healthcare sector over the years; but there has been
considerable progress especially through various flagship policy and Programme initiatives,
across the nation. Evidently, these are not efficiently manageable without the assistance of IT
systems. An integrated approach to the implementation and use of IT systems is seen as a
potential game-changer, invaluable to all stakeholders involved in the provision of better,
efficient, effective and affordable healthcare services.
However, despite the improving health status of the Indian population, healthcare
infrastructure in India has a long way to go towards achieving high quality and efficient
healthcare delivery systems. In public healthcare, Information and Communications Technology
(ICT), when implemented judiciously, have the potential to reduce administrative costs, reduce
effort, reduce time to deliver service, and improve productivity of the Health Department and
hospitals across a state. Additionally, transparency of information available to the general public
as well administrators can be increased manifold through such initiatives. For any hospital
administrator it is very essential to know service availability of the resources i.e. people
(doctors/nurses/paramedics etc), facilities & equipment (x-rays, CT scan etc) and their supplies
(x-ray films, reagents etc) at any point of time. As non-availability of any one of these services
shall have a huge impact on the service delivery. Therefore it becomes very essential to bring in
effectiveness and quality in utilization of these resources. Therefore it is the ICT which can play
an important role in addressing the issues of efficiency, transparency, and reduction in
healthcare costs, service delivery time and errors; easy storage and portability of data / records,
as well as enable evidence based medical advice.
Many IT systems have been operating at the Centre and in States, providing valuable benefits,
experience and lessons. There is a need to achieve convergence amongst various IT systems in
the health sector to obtain reliable information for policy making, ensure efficient program and
service delivery as well as achieve breakthrough discoveries for diseases.
The Indian healthcare system has recently realized the potential of information and
communication technologies in completely transforming health care and service delivery at
hospitals. Health Information System (HIS) is one of the initiatives proposed by Haryana State
Health Resource Centre (HSHRC), under Health Department, Government of Haryana, that
aims at increasing the availability and accessibility of Healthcare services for the target
beneficiary as well as usage and sharing of timely and accurate health information within and
outside Haryana state, for the State and District administrators for quick decision making and
optimal utilization of resources. The project further aims at creating Information and
Communications Technology (ICT) based HIS in order to improve public health service delivery
mechanisms within the state through various Health institutions spread across the state.
Consequently, HSHRC appointed National Institute for Smart Government (NISG) to provide
required advisory support.

Haryana State Health Resource Centre confidential

11

Implementation of Hospital Information System (HIS)

1.1.

Request for Proposal - Volume 1

Project Objectives

The objective of this project is to implement a state of the art ICT enabled Hospital Information
System (HIS) in order to improve productivity of the State Health Department and the state
hospitals / health institutions, thereby improving public health services and bring
administrative efficiency in the entire healthcare system.
The state envisages meeting the following key objectives:
1. Unique ID patients and availability of EHR across all facilities in the State
2. Reduction in patient waiting time, efficient queue management
3. Aim of providing 100% service availability to patients
4. Simplification and automation of manual processes
5. Transparency and availability of information related to services
6. Efficient grievance redressal mechanism
7. Optimal utilization of infrastructure, equipments, facilities, HR , drugs & Consumables
8. Integration with external applications, programmes and schemes
9. Real-time reporting, efficient analytics and decision support

1.2.

Summary of Issues and Challenges faced by Stakeholders

The key issues and challenges being faced by various stakeholders have been analyzed during
the assessment of existing processes and functions. The following depicts the current scenario as
observed by the project team, which are the focus areas of HIS:

1.2.1.

Issues faced by Hospital Staff

a. Data Collection and Duplication


i.

Largely paper-based, time consuming and tedious

ii.

Copying, aggregating and reporting of same data across levels

iii.

Delays and errors in data entry

iv.

Most of the staff at ground level maintain multiple registers, often


capturing data for same fields at various points

v.

Sometimes they maintain multiple copies of some registers

Haryana State Health Resource Centre confidential

12

Implementation of Hospital Information System (HIS)

vi.

Request for Proposal - Volume 1

Data collection fatigue and loss of attention from main function service
provision

b. Data Reporting
i.

Numerous reports are prepared at the hospital level based on ground


level data capture and reports

ii.

Same data fields or subsets are reported for various schemes

iii.

Data transmission is a manual process until the data is finally entered in


an IT system

c. Capacity Building
i.

1.2.2.

Lack of Training and skills augmentation for hospital staff working at all
levels

Issues faced by Hospital Administrators

a. Reporting and Analytics


i.

Lack of timely, accurate information and analytic tools support for


decision making

ii.

Lack of alerts for timely action and policy correction

iii.

Lack of effective monitoring of schemes and related Project


management; to ensure corrective steps are taken in time

iv.

Use of data for planning, optimization of resources

v.

Wrong / duplicate data leading to erroneous reports

vi.

Frequent changes in the reporting formats with regard to the time and
effort taken to get used to new reporting formats

b. HR related
i.

Systemic management of HR - shortage of doctors, specialists, and


other health personnel / hospital staff and contractual staffing

ii.

Lack of transparency and visibility in transfers/ postings of various staff

iii.

Recruitment and Performance Management

c. Infrastructure
i.

Utilization of equipments not optimal

Haryana State Health Resource Centre confidential

13

Implementation of Hospital Information System (HIS)

Request for Proposal - Volume 1

ii.

No monitoring of performance of facilities

iii.

Lack of timely availability of drugs, vaccines, and other consumables

iv.

Un reliable connectivity for IT systems

v.

Lack of Basic IT infrastructure facilities like computers, printers,


internet connectivity, power backups, application software, etc.

vi.

No specific IT support personnel / teams in any health facilities and


hence troubleshooting is time consuming

d. Capacity building
i.

Staff engaged in multiple activities (administrative and clinical), causing


inefficiencies in their core functions (mainly clinical)

ii.

Lack of adequate skills to usher in the changes necessary for effective


use of IT systems in operational set-up

e. Silos syndrome Convergence and re-use

1.2.3.

i.

Different IT based application systems have sprung up without effective


data sharing or data exchange mechanism; these application systems
have not followed any standards and hence such systems cannot interoperate and applications cant co-work when interconnected. This
means multiple rounds of common fields of data entry, as in respect of
demographic data; or inability to put to maximum use of data residing
in various systems which is not amenable to requirements of decision
makers, health care providers and patients.

ii.

The multi-purpose hospital staff / contractual staff have to do repeated


entry of same data, leading to fatigue at the cost of service provision.

Issues faced by Patients / Citizens

a. Long waiting time in queues for availing various services within hospital
premises
b. Lack of proper instructions to locate Labs, OPDs, Wards, etc.
c. Insufficient lab facilities including working equipments in comparison to number
of beds
d. Late admission / admission in different wards (like emergency or disaster ward)
due to limited number of beds

Haryana State Health Resource Centre confidential

14

Implementation of Hospital Information System (HIS)

Request for Proposal - Volume 1

e. Unhygienic conditions / Inadequate measures for sterilization to prevent hospital


acquired infection
f.

Inadequacy of health personnels to give health education to patients

g. Delayed response in cases of emergency in some cases

Haryana State Health Resource Centre confidential

15

Implementation of Hospital Information System (HIS)

Request for Proposal - Volume 1

2. S tate P rofile
Haryana Civil Medical Services is the government service in the department of health in
Haryana. Doctors are recruited by Haryana Government to work in various government
hospitals of Haryana state.

2.1.

Overview of Health Department and Medical Education

HEALTH DEPARTMENT: The health Department provides preventive, promotive and curative
services to all persons in Haryana.
The curative services include medical and surgical interventions at the various levels of Govt.
Hospitals in the outpatient or inpatient Departments. In addition it attends to all types of
medical and surgical emergencies which occur anywhere in the state through its wide network of
ambulances and emergency departments of hospitals including Medico-legal cases and Post
mortem. It also provides obstetric services (childbirth) services at all levels of care through the
maternity units in its various hospitals.
The treatment services include provisioning of free medicines and surgical consumables. These
involve a function of procurement of medicines, its storage, its quality testing and distribution to
various facilities across the state.
This also includes procurement, upkeep and retirement of various medical Equipments and
monitoring their utilization and servicing.
The preventive and promotive functions are carried out through large number of health
programs which are carried out by field level health functionaries across the state. Programs
cover both rural and urban areas. These include maternal health care, anemia control,
Immunization programs, provision of preventive health services to school children of primary
and adolescent age groups, programs to control communicable diseases like Dengue, Malaria,
TB, AIDS etc and non-communicable diseases like diabetes, Hypertension, Cancer etc and also
various types of mental illnesses.
In order to provide these services posting of specialists, doctors and paramedical staff is to me
made in a rationale manner so that gaps in services do not occur. Similarly planning of finances
and budget is made to ensure adequate and timely utilization of funds.
The Health Department comprises of the following hierarchy from state to the village level.

Haryana State Health Resource Centre confidential

16

Implementation of Hospital Information System (HIS)

Request for Proposal - Volume 1

State Government Level (Health Minister)


Principal Secretary Health

Principal Secretary Medical Education

State Hq Level
MD NRHM

DGHS

DG Ayush

ED HSHRC

DGHS Medical
Education

District Hq Level
Civil Surgeon

PMO (District Hospital)

Director Medical College

BLOCK/SMALL TOWN Senior Medical Officer (CHC/Gh)(poplulation 120000)


Hospital (30-75 Bedded)

Health Programme

Medical Officer PHC


Health Programme

Hospital (6 Beded)

Health Sub Centre


Health Progrrames

Delivery Room

Village Asha
Health Programmes
From every level from District and below the health department carries out Hospital based
curative services and outreach preventive community interventions.
1. Curative Services: The Government health hospital has the following structure and
functions.

Haryana State Health Resource Centre confidential

17

Implementation of Hospital Information System (HIS)

Request for Proposal - Volume 1

a. District Hospital / General Hospitals: Every district has a district hospital (except
Karnal) making it 20 district hospitals. In smaller towns there are General
Hospitals. The bed strength of these hospitals varies from 50 to 300 beds.
District Hospital
S. N

Name of Hospital

Number of Beds

1.

GH Ambala

200

2.

GH Bhiwani

300

3.

GH Faridabad

200

4.

GH Fatehabad

100

5.

GH Gurgaon

200

6.

GH Hisar

200

7.

GH Jind

100

8.

GH Jhajjar

100

9.

GH Kaithal

100

10.

GH Kurukshetra

100

11.

GH Karnal

200

12.

GH Mandikhera

50

13.

GH Narnaul

100

14.

GH Palwal

100

15.

GH Panchkula

150

16.

GH Panipat

100

17.

GH Rewari

100

Haryana State Health Resource Centre confidential

18

Implementation of Hospital Information System (HIS)

S. N

Name of Hospital

Request for Proposal - Volume 1

Number of Beds

18.

GH Rohtak

100

19.

GH Sonepat

100

20.

GH Sirsa

100

21.

GH Yamunanagar

50

General Hospital
S. N

Name of Hospital

Number of Beds

1.

GH Bahadurgarh

100

2.

GH Dabwali

60

3.

GH Gohana

50

4.

GH S10 Gurgaon

100

5.

GH Hansi

50

6.

GH Jagadhari

50

7.

GH Tohana

50

8.

GH Ambala cantt

75

9.

GH Naraingarh

50

10.

GH Siwani

25

11.

GH Bhawanikhera

50

12.

GH Loharu

50

Haryana State Health Resource Centre confidential

19

Implementation of Hospital Information System (HIS)

S. N

Name of Hospital

Request for Proposal - Volume 1

Number of Beds

13.

GH Dadri

50

14.

GH Ballabhgarh

50

15.

GH Sohana

50

16.

GH Haily mandi

25

17.

GH Hansi

50

18.

GH Adampur

50

19.

GH Beri

50

20.

GH Narwana

50

21.

GH Nilokheri

50

22.

GH Kosli

50

23.

GH Meham

50

24.

GH Samalkha

50

These hospitals provide individual citizens and would include Outdoor services,
inpatient services, Surgical services, Deliveries (caesarian or normal), Diagnostics
(Lab and Radiology) and Pharmacy Services.
b. Urban Health Centers: These are located in bigger towns for a population of
10000 to cover slum populations and underserved areas
c. Polyclinics and Dispensaries: Provide OPD and Obstetric services to population
in the HUDA sectors.
d. Community Health Centre(CHC): It caters to a rural population of 120000 and
has 4-7 doctors including specialists, though in Haryana very few CHCs have
specialists. It is also a First Referral Unit where cases are referred from lower

Haryana State Health Resource Centre confidential

20

Implementation of Hospital Information System (HIS)

Request for Proposal - Volume 1

health facilities. It has 24X7 ambulance facilities. It is a 30 bedded facility. There


are 110 CHCs in Haryana. Kalka is a CHC.
e. Primary Health Centre (PHC): It serves a rural population of 30000, and has two
medical Officers (Allopathic), one Dental Surgeon and one AYUSH doctor. It has
OPD facility, labor room, Minor OT, 6 in-patient beds, laboratory and a
pharmacy. It does not have X-ray unit eg Barwala is a PHC
f.

Health Sub-Centre: It caters to population of 5000 and there are 2 ANMs


(Nurses) who are trained in public health and the focus of their work is to provide
maternal services, child health services and family planning services.

g. ASHA: is a health worker recruited for a population of 1000 from the village
where she works and provides community health services. She is a first contact
with the public health system.
2. Preventive Services: These are provided by Sub-centers, PHCs and UHCs in rural and
urban areas through outreach health workers like ANMs, MPW (M) and ASHAs.

2.2. Administrative Structure


The state level organization comprises of the following administrative wings:
1. STATE HEALTH SOCIETY: The executive committee is headed by the Principal
Secretary Health and member secretary is the MD, NRHM. The NRHM was started in
2005 as a GOI sponsored programme for Health System strengthening, improve health
indicators, disease control and inter-sector convergence.
2. HEALTH DIRECTORATE: Headed by the DGHS is responsible for administrating the
public health system in the state.
3.

MEDICAL EDUCATION: Carries out function of Medical Education and provides


tertiary health care facilities. Currently there are 4 Govt. Medical Colleges in Haryana in
districts of
a. Rohtak
b. Sonepat
c. Mewat
d. Karnal

Haryana State Health Resource Centre confidential

21

Implementation of Hospital Information System (HIS)

Request for Proposal - Volume 1

The organization structure of the Health administration in state of Haryana is depicted in the
organization chart below.
PS (ME)

STATE

PS (H&FW)

HSHRC

DG (ME)

DG (HS)

DG (AYUSH)

MD (NRHM)

VC (Medical
University)

Director

Director

Deputy Director

Deputy Director

Director
(Medical
College)

PMO (DH)

Civil Surgeon

DISTRICT

Deputy Civil Surgeon

MS (DH)

MS (SDH)

SMO I/C (CHC)

1,20,000
Population

MO I/C (PHC)

30,000
Population

Health Sub-Centre
(ANM)

5,000
Population

2.3. e-Governance in Health


''ICT and Governance'' refers to the mechanisms and the challenge of devising them, allowing
ICT to enable decision making in Government and society to work together in ways that are
effective, credible, accountable and transparent. The Department has carried out various IT
initiatives such as Implementation of Mother and Child Tracking system (MCTS), for

Haryana State Health Resource Centre confidential

22

Implementation of Hospital Information System (HIS)

Request for Proposal - Volume 1

registration and tracking of Pregnant Mothers and children, SMS services, Immunization
Monitoring etc. Online status of blood availability website was developed & launched for all nine
blood banks of Faridabad. MedLEaPR (Medico Legal Examination and Post Mortem Reports)
System As per the directions of Honble High Court, MeDLEaPR software has been developed
with necessary security measures and access controls. MEDISC-MS, Medical Equipment and
Drug Inventory & Supply Chain Management System for NRHM Haryana has been initiated.
However most of these IT initiatives focus on just one or two health parameters and are
standalone initiatives with limited or no integration with backend automation systems. There is
a need to achieve convergence amongst various IT systems in the health sector to obtain reliable
information for policy making, ensure efficient program & service delivery and achieve
breakthrough discoveries for diseases.
Further in the context of Haryana state, changes are required in aiding the Governments ability
in decision making, health care and medical services management, procedural as well as medical
institutions vise, changes in accountability and the delegation of authority, transparency in
governance, administration, and the resulting loss of vested interest etc. Further changes are
required in improving the communication with citizens, redesigning processes and structures,
enhancing co-operation between governments health care institutions and managing
knowledge for support of complex administrative decisions. In light of the various challenges
being faced in the health sector / hospitals across the state of Haryana, the Hospital Information
System (HIS) project has been initiated by HSHRC, State Government of Haryana (GoH) to
provide a better interface of medical service delivery to citizen for which the government is
committed.
This HIS project aims at creating ICT based HIS to provide benefits to all stakeholders and
enable the state in improving the health delivery system across the state by,
1. Use of ICT to enhance the real time information gathering and reporting for monitoring
and decision making processes such as to manage performance of systems and facilities
2. Automation of the work flow wherever possible and removal of manual processes and /
or dependency on the human resources
3. Reducing patient waiting time; efficient queue management for availing facilities /
services. Real time access to information by the citizens like availability of beds, blood in
blood bank , etc. through multiple channels
4. Maintaining quality of services based on defined parameter of safety and accuracy for
decision
5. Ensuring 100% services and drug availability by automated reporting on availability of
health personals, equipment uptime, utilization, maintenance requirements and Drug
reorder levels for various health facilities.
6. Crisis Management in case of emergency and efficient referral management

Haryana State Health Resource Centre confidential

23

Implementation of Hospital Information System (HIS)

Request for Proposal - Volume 1

7. Developing a unique Electronic Health Record (EHR) across facilities, to record all
health events following a life cycle approach and all revisits, referrals etc. one person
one record.

Haryana State Health Resource Centre confidential

24

Implementation of Hospital Information System (HIS)

3. S cope

of

Request for Proposal - Volume 1

W ork

This chapter summarizes the overall scope of work that needs to be executed by the selected
Implementation Agency.
A Hospital information system (HIS) is envisaged to be a comprehensive,
integrated information system designed to manage overall functioning of a government
healthcare institution including patient care, hospital administration and the corresponding
service processing.

3.1.

Project Requirements

The RFP envisages the following components of work to be executed by a competent


Implementation Agency in order to fulfill the objectives of the proposed Hospital Information
System:
1. Supply, installation, configuration, customization, integration, of Hospital Information
System (HIS) together with the necessary database and other software
2. Implementation of HIS according to the reference architecture, performance metrics,
acceptance criterias and conformance to industry standards including its testing and
certification
3. Installation, configuration and commissioning of central servers for hosting the HIS
solution at Data Centre. Facilitate HSHRC in provisioning of redundant broadband
connectivity. Procurement Installation, configuration and commissioning of end user
computing infrastructure at the project locations comprising of all hardware, system
software, application software and any other software including necessary site
preparation of hospital facilities considered for implementation
Operation and Maintenance of the entire HIS Solution including Application, IT & NonIT infrastructure for a period of five years from the date of phase-1 Go-Live
4. Change Management and Capacity Building including Training of users for effectively
using the system
5. Adherence to Implementation Plan and Project Governance Structure

Haryana State Health Resource Centre confidential

25

Implementation of Hospital Information System (HIS)

Request for Proposal - Volume 1

3.2. Detailed Description of Activities


3.2.1.
Supply, installation, configuration, customization, integration, of
Hospital Information System (HIS) together with the necessary database
and other software
3.2.1.1.

Inception Report:
i.

The IA needs to prepare and submit a phase-wise Inception Report,


which will serve as the foundation document for all activities related to
phase of the project. Additionally, the Inception Report must cover the
risks the IA anticipates and the plans they propose towards mitigating
those risks

ii.

The Implementation Agency (IA) shall prepare an Integrated Project


Plan for the entire project that covers detailed tasks which are intended
to be performed, as part of the project

iii.

The acceptance of the Inception Report by HSHRC is necessary before


proceeding to the next stage of the project

3.2.1.2.

Detailed Requirements Gathering and Analysis:


i.

The envisaged high-level functional requirement for the key processes


has been provided in Annexure 1 of this RFP

ii.

The IA must map the Functional Requirements to the proposed HIS


solution and analyze the existing gaps between the Functional
Requirements and the functionalities provided by the application
software. The IA should identify the customization requirements for the
implementation

iii.

The IA shall conduct a comprehensive requirement analysis of the


system, infrastructure and training needs in discussion with all the
stakeholders (HSHRC or its representatives).

iv.

Activities conducted as part of this task will result in the project


deliverable Haryana HIS Software Requirement Specifications (SRS)
report, Bill of Material (BOM), Site preparation requirements and
Training Needs Analysis (TNA) report, which shall detail the
requirements of the complete solution and implementation
requirements up to the last possible detail

Haryana State Health Resource Centre confidential

26

Implementation of Hospital Information System (HIS)

3.2.1.3.

Request for Proposal - Volume 1

System Design
i.

Having conducted a comprehensive analysis of the requirements for


HIS solution, build a complete audit trail of all transactions (for e.g.
add, update and delete) using transaction log reports, so that errors in
data, intentional or otherwise, can be traced and reversed. The most
appropriate level of security commensurate with the value to that
function for which it is deployed must be chosen. Access Controls must
be provided to ensure that the databases are not tampered with or
modified by the system operators. Implement data security to allow for
changes in technology and business needs. Based on the requirements
analysis conducted above, the IA must develop a comprehensive
solution for HIS. The IA would need to prepare system architecture,
Solution Architecture, Hardware Deployment Architecture, Network
Design, Security Architecture etc. for the HIS system and other design
documents for the HIS project. The Architecture document should give
the complete architecture of the proposed HIS systems

ii.

The IA must ensure that granularity is built in the HIS application


modules, sub modules and individual functionalities so that these
functionalities can be enabled or disabled through the application
admin as per applicability in different health institutions across the
State

iii.

The IA shall be entirely responsible for the architecture of the system


implemented to satisfy all features, functions, security etc. as described
in this document including system sizing. The IA should ensure that the
approved architecture should not restrict any scalability or
enhancement in future

iv.

The HIS design must be such as to require the minimal installation, if at


all, at the users end, besides the Internet Browser. The HIS system
should be able to support all latest common browsers (like Internet
explorer, Mozilla, Chrome etc.)

v.

The IA shall consider users inputs when they are finalizing all design
components including user interfaces, mode of data entry, storage and
retrieval, outputs reports, queries and the application design as a whole

vi.

The solution must possess easy-to-use user interfaces, able to perform


tasks with minimum of clicks, maximum select options and provide
suitable short-cuts wherever possible.

vii.

The IA shall deploy a dedicated team experienced in customization;


deployment and/ or integration of proposed HIS Solution. This is
important to ensure that future upgrades, enhancements and bug fixes
are not impacted. Every custom development must be documented in

Haryana State Health Resource Centre confidential

27

Implementation of Hospital Information System (HIS)

Request for Proposal - Volume 1

detail and the code / script should be properly annotated with


comments.
viii.

The IA shall configure the specific HIS modules, third party bolt-on
applications (if any), development of interfaces wherever and whenever
necessary.

ix.

The IA shall ensure that the proposed HIS provides adequate


interfacing mechanisms (both at the application and data level) with a
view to integrate future applications, wherever required.

x.

The IA shall create and manage all necessary master files for the
proposed HIS.

Note:
1. The IA shall be responsible for designing and developing the a lighter
version of HIS core application which can operate and store
transactional data in offline mode
2. Reference to complete Business Functions are described in chapter 4
of this RFP. The functional requirements are provided as annexure 1
of this RFP

3.2.2. Implementation of HIS according to the reference architecture,


performance metrics, acceptance criterias and conformance to industry
standards including its testing and certification
3.2.2.1. Compliance to Standards
a. The IA shall ensure bilingual support and other standard formats for display,
calculate and transmit data
b. The IA must ensure that the HIS technology components adhere to flexibility,
interoperability, usability, availability, manageability, security and integration
standards
c. The IA shall ensure adherence to all relevant e-gov standards defined by
Government of India (GoI) from time to time

Haryana State Health Resource Centre confidential

28

Implementation of Hospital Information System (HIS)

Request for Proposal - Volume 1

3.2.2.2. Reference Architecture


The IA shall ensure that the solution and technology architecture of the HIS application
is designed to meet the RFP requirements as described in Chapter 5 of this RFP

3.2.2.3. Deployment Architecture


The IA shall ensure the deployment of management and monitoring tools like Project
Management, Application Performance Monitoring, version control (software as well as
document), bugs tracking tools. The IA shall facilitate HSHRC in deployment of servers
and commissioning of core HIS application and HIS Lite application at the data center
and end-user environment respectively. The deployment of HIS application shall follow
and comply to the contemporary principles of Information Security Management System
(ISMS) i.e. ISO 27001

3.2.2.4. Testing and Hosting


a. The IA shall conduct all tests as a part of standard Software Testing Life Cycle
(STLC)
b. The IA shall facilitate HSHRC or its nominated agencies to conduct a User
Acceptance Testing, Application Security testing (vulnerability testing and
penetration testing) and Infrastructure Security
c. The IA shall host the HIS solution at the facility finalized by HSHRC

Note: The detailed technical requirements specifications with respect to standards,


deployment architecture, testing and hosting is provided in Chapter 5 of this RFP.

3.2.3. Installation, configuration and commissioning of central servers for


hosting the HIS solution at Data Centre. Facilitate HSHRC in provisioning
of redundant broadband connectivity. Procurement Installation,
configuration and commissioning of end user computing infrastructure at
the project locations comprising of all hardware, system software,
application software and any other software including necessary site
preparation of hospital facilities considered for implementation
a. The IA shall be responsible for Installation, configuration and commissioning of
central servers for hosting the HIS solution at Data Centre.

b. The IA shall be responsible for facilitation HSHRC in provisioning of redundant


broadband connectivity at the project locations
Haryana State Health Resource Centre confidential

29

Implementation of Hospital Information System (HIS)

Request for Proposal - Volume 1

c. The IA shall be responsible for Procurement Installation, configuration and


commissioning of end user computing infrastructure at the project locations
comprising of all hardware, system software, application software and any other
software including necessary site preparation of hospital facilities considered for
implementation

Note: The detailed infrastructure requirements are provided in Chapter 6 of this RFP

3.2.4. Operation and Maintenance of the entire HIS Solution including


Application, IT & Non-IT infrastructure for a period of five years from the
date of phase-1 Go-Live
a. On successful completion of the phase-wise implementation, the IA must extend
Post Implementation Support (including warranty) till the end of contractual
period
b. The IA must also deploy a minimum of one resource each at District Hospital and
Medical College, to provide handholding support to the users at these locations
according to the implementation schedule
c. The IA must provide a centralized Helpdesk and Incident Management Support
from the Phase-2 Go- live till end of contractual period
d. During the operational and maintenance support, the IA should:
i.

Ensure that all necessary measures are taken for the smooth operation
of the HIS system

ii.

Ensure that designated personnel from HSHRC support team are duly
prepared and groomed in a progressive manner so as to operate the
system on their own, with a view to eventually takeover operations at
the end of contractual term

iii.

Ensure that all necessary know-how is transferred to HSHRC support


team in an effective manner to facilitate a smooth transition. The
transition plan will need to be agreed between the IA and HSHRC

iv.

Ensure adherence to baseline performance SLA matrix as defined in


volume III of this RFP

Note: The detailed operational requirements are provided in Chapter 7 of this volume
of the RFP

Haryana State Health Resource Centre confidential

30

Implementation of Hospital Information System (HIS)

Request for Proposal - Volume 1

3.2.5. Change Management and Capacity Building including Training of users for
effectively using the system
a. The IA shall impart training to hospital staff and other key stakeholders on the
usage and maintenance of the HIS application
b. HSHRC has come out with an indicative list of training modules and user groups.
Please refer Chapter 8 of this volume of RFP for details.
c. The IA shall provide a change management plan to HSHRC which addresses the
various aspects of capacity building and training
d. The IA shall propose different training modules for different user profiles at
appropriate timelines
e. The IA shall provide such additional training as they deem necessary in order to
ensure that the training imparted is comprehensive, complete and meets the
Service Level Agreement as mentioned in the RFP
f.

The IA must also prepare Training Modules/content to enable the users for selflearning. Please refer Chapter 8 of this volume of RFP for details

g. The training material prepared will be owned by the HSHRC

3.2.6 Adherence to Project Plan And Deliverables


a. The IA must ensure phase wise implementation of HIS solution at different
project locations as defined in the RFP
b. The IA must strictly adhere to the project timelines as specified in the RFP.
c. The IA must ensure that all the project deliverables are complied with in time.
d. The IA shall adhere to roles and responsibilities as defined in the RFP but not
limited to with respect to design, development/customization, implementation as
well as operations and maintenance of HIS solution across all project locations in
the State.
e. The IA must conform to the defined institutional mechanism for project review
and monitoring including risk management during the entire contractual period
f.

The IA shall maintain all documentation related to HIS project including


software artifacts with adequate traceability matrix and version control.

3.3. Stakeholders Roles and Responsibilities


A clear definition of the roles and responsibilities of all the stakeholders in a project establishes
transparency, accountability, manageability and efficiency in the project.
Haryana State Health Resource Centre confidential

31

Implementation of Hospital Information System (HIS)

Request for Proposal - Volume 1

Following will be the key stakeholders involved during the implementation phase of the HIS
project:
1. DGHS/HSHRC: As owner of the Project, the role of DGHS/HSHRC in the successful
implementation of the project includes discharging the following responsibilities:
a. Frame and Issue Guidelines to the State Administration for implementation of
project during the Pilot and State-wide roll out
b. Setting up of a State Project Committee (SPC) for overseeing the implementation
of the Project
c. Provide technical assistance to the State for effective implementation of the
project
d. Organizational capacity building initiatives
e. Defining service levels for identified services, ensuring service level adherence,
implementation and sustainability of the project and subsequent state wide
rollout
f.

Driver for policy, regulatory and other relevant changes

g. Providing State Financial Support as per the project report


h. Support to the Implementation Agency (IA) with respect to Infrastructure setup
i.

Take an appropriate decision on the mode and degree of integration of HIS


application with the other Government Schemes and existing physical, digital and
institutional infrastructure of various Government Departments, as required

j.

Decide upon the State wide rollout based upon common software, approach and
financial model following the completion of the pilot project

k. Provide commitment and support to bring-in the process changes


l.

Work closely with the implementation agency (software) to undertake the field
work, comprehend the requirements, document the observations, oversee
preparation of roadmap, develop/customize application as per proposed reengineered processes, etc.

m. Help build capacity for the Hospital staff and executive resources of Health
administration so that they can work closely with the technical solution provider
for developing / customizing the software, and implement the technical solution
as required
n. To manage, supervise and implement backend computerization of Hospitals with
long term vision of Health Department of the State
o. Coordinate, manage & monitor the receipt and utilization of financial support
Haryana State Health Resource Centre confidential

32

Implementation of Hospital Information System (HIS)

Request for Proposal - Volume 1

p. Coordinate and facilitate interactions between the project implementation


partners/other stakeholders, State Government Departments, and Central
Administration, as necessary
q. Central Project Team - The Central Project team will be headed by the nominated
Project Director. It will consist of the Officials of HSHRC and the Program
Management Unit. This team will be the nodal point for this project and will be
responsible for making key decisions, policy matters, vendor evaluation and
monitoring the overall direction of the project. The Committee will play a major
role in successful implementation of the project at the field level
r. Any breach or misuse of Hospital infrastructure other than entitled ones, should
be an obligation to DGHS/HSHRC and Hospital Administrators also
s. The change requests, if any, should be carried out by the IA as per pre defined
Change Control Procedure. The project committee or HSHRC will provide the
requirements for the change requests and decide the penalty for non-compliance
as mentioned in the Service Levels for Change Requests. The decision of HSHRC
will be final and binding on the IA
t.

Ensure that there is no unauthorized access at any of the restricted areas defined
by the IA at any of the Hospital facilities / location, without prior information
and without maintaining a proper log

2. Project Management Unit / Team: The Project Management team shall work with
DGHS/HSHRC and the Selected IA on day-to-day management of the project. The
responsibilities of Project Management Team will include but not be limited to the
following:
a. Prepare the Project Reports and proposal vetting
b. Provide project management services
c. Support DGHS/HSHRC in monitoring the implementation of the project
d. Provide continuity (from the concept stage) during implementation of the project
e. Provide support to the Hospitals and its field units in their discussions with the
selected IA
f.

Provide guidance and clarifications to the selected IA

g. Project management, monitoring and evaluation after selection of the IA to


ensure adherence to the project timelines and requirements
h. Periodic SLA monitoring of the system deployed by the IA

Haryana State Health Resource Centre confidential

33

Implementation of Hospital Information System (HIS)

Request for Proposal - Volume 1

i.

Periodic review of project plans and progress and advise DGHS/HSHRC and the
Hospital Teams

j.

Track project issues and risks and advise HSHRC on mitigation measures

k. Review of software requirement specifications, system design, hardware


sizing/Scrutiny of deliverables for their compliance with Scope specifications
l.

Review content, methodology and other documentation for user training

m. Provide support to DGHS/HSHRC and the selected IA in the change


management initiatives and training programs
n. Review and
monitor data digitization / migration plans and their
implementation, if any
o. Review the technical documentation provided by the selected IA and ensuring
that it conforms to the standards
p. Support DGHS/HSHRC in acceptance testing and certification
q. Organize weekly/fortnightly review meetings to review functionality issues and
progress of project. The frequency of meetings will be intimated by the Project
Management Team in consideration of requirements of the project. The project
management team would prepare the minutes of the review meetings mentioning
the issues discussed, decisions taken on them and appropriate level at which
these require being resolved
r. Support DGHS/HSHRC in popularizing the project initiatives through a media
plan for encouraging citizen, and other users to access the various channels for
availing services
s. Inspection of the entire infrastructure (UPS, switches, Server, other facility
requirements etc.) provided by the IA twice a year at all the specified locations
and provide reports for corrective actions wherever gaps are observed
t.

Periodic inspection of back-ups, storage, DMS, and other systems, at least twice a
year

u. Physical monitoring of data centers in Hospitals and report to HSHRC


v. Validation and approval of configuration and monitoring parameters

3. Implementing Agency: The detailed scope of work and responsibilities for the
selected IA are discussed in earlier sections of this document. In addition to these roles
and responsibilities, the responsibilities of the selected IA will include but will not be
limited to the following:

Haryana State Health Resource Centre confidential

34

Implementation of Hospital Information System (HIS)

Request for Proposal - Volume 1

a. Designing System Requirement Specification (SRS), and other technical


documents / reports
b. Development of UAT procedures and test cases
c. Conduct User Training
d. Rollout in various locations, first during pilot phase and then across the state as
decided by DGHS/HSHRC
e. Interface with external applications and delivery channels for to and fro seamless
flow of data / information
f.

Develop the Application Software based on the requirements specified

g. Procure and Implement the Infrastructure (Software and Hardware) for the
project as per specified requirements
h. Configure the solution to facilitate access to the application from all the identified
locations / users
i.

Provide application software and IT infrastructure maintenance support, as


decided by DGHS/HSHRC

j.

Work in close coordination with HSHRC, Project Management Team and other
stakeholders for this project; and provide periodic reports

k. Carry out the activities as indicated in the contract agreement and submit all the
mentioned deliverables within the stipulated time-frame
l.

Ensure that the time lines will be adhered to and take necessary actions to
mitigate any slippage in timelines and risks envisaged. Communicate with
HSHRC accordingly

m. Ensure compliance with the project SLAs


n. Submit hardcopies and softcopies of all the deliverables other than source code to
HSHRC as per timelines specified in contract agreement. Application Code may
be shared as Soft Copy only
o. All the recommendations mentioned as a result of IT Security Review,
Architecture Review, code review etc. must be implemented by the IA. IA must
highlight the issues with appropriate facts and figures to suggest an alternative
but equally viable solution and implementation plan as applicable
p. It is a necessary requirement that the IA should implement a version control tool
to record each and every version of the software application release, as well as
ensure that all security measures are in place to secure the data, code or
functionality and nothing is changed after UAT phase

Haryana State Health Resource Centre confidential

35

Implementation of Hospital Information System (HIS)

Request for Proposal - Volume 1

q. Any change notified to HSHRC from the UAT phase till deployment on the
production environment will be treated as breach of contract and HSHRC will
take all necessary action within its jurisdiction, even leading to termination of
contract
r. The change requests should be carried out as per the defined Change Request
Procedure and directions of HSHRC
s. Conduct detail survey of all locations across the state and assess the hardware,
networking devices, software, any other infrastructure components and prepare a
comprehensive inventory list before Go- Live
t.

While proposing the exact number of PCs and other auxiliary components,
taking into consideration the re-usage of existing hardware, ensure that any
device or hardware component which is equal to or more than four years old is
totally discarded. All the devices and hardware components which are less than
four years old are upgraded as required. All the devices & hardware components
which are less than one year old and which are in perfect working condition is
accounted in the final sizing

3.4. Documentation and Versioning


The IA must ensure that complete documentation of HIS Project is provided with
comprehensive user manuals, and adhere to standard methodologies in software development
as per ISO standard and/or CMM models. The following documents are the minimum
requirements:
1. System Requirement Specifications and Solution Design Document
2. Traceability Matrix document
3. Communication Plan listing all stakeholders in the project, defining their roles and
responsibilities
4. All Architecture documents, Design documents and, testing and deployment manuals,
non-functional requirements etc.
5. Quality Assurance Plan (not methodology) stating the planned actions to ensure
satisfactory delivery conforming to functional and technical requirements of HIS project
6. Interface Control Document, documenting the interface characteristics of one or more
systems and any previously documented information together with any agreements
between interface owners.
7. Test Plan containing information on the software test environment to be used for
independent testing, the test cases to be performed, and the overall testing schedule.
This includes, schedule, resources, tools, procedures, environment definition, test cases,
and software test results
Haryana State Health Resource Centre confidential

36

Implementation of Hospital Information System (HIS)

Request for Proposal - Volume 1

8. Operations Manual providing instructions for installing the application, troubleshooting,


interpreting message logs, and FAQs (Frequently Asked Questions)
9. User Manual (online or downloadable content) providing detailed instructions in the
form of a narrative on how to use the software. In addition, it shall describe how to
access, submit inputs to, and interpret outputs from the application
10. A data dictionary listing out all the data elements shall be prepared
11. Minutes of Meeting, Agenda, Proceedings and tracking of decisions during the entire
implementation period
12. All the documents including, but not limited to the above shall be submitted to HSHRC
for sign-off

Haryana State Health Resource Centre confidential

37

Implementation of Hospital Information System (HIS)

Request for Proposal - Volume 1

4. B usiness F unctions
4.1.

Business Requirements to be met by the System

The HIS system to be deployed by the Implementation Agency should be able to deliver at
minimum the services listed below. The Implementation Agency shall implement all the
necessary functional, technical, operational and other supporting requirements to meet these
services. The application would have a
A. Patient perspective as depicted by figure 1
B. Administrator Perspective as depicted by figure 2

4.2. Functional Requirements


Haryana Hospital information System (HIS) is proposed to be one core, automated, scalable and
integrated software application, deployed centrally at Data Centre (DC) in the state of Haryana,
having a Web Portal interface accessible through DC and Intranet core Application interface
accessible to all hospital staff accessible through LAN / Intranet. The entire application is
envisaged to be deployed as per Centralized Model in Star Architecture connected to the
centralized DC, later scaled up to Mesh Architecture where individual health institutions can be
connected with other along with the central DC.
The Application will be hosted in DC, customized and enabled for various requirements of
individual hospitals according to the type of facility. This shall be achieved through the master
maintenance of modules and functionalities, through Admin module wherein the authorized
resource will be able to enable or disable the different functionalities based on Role Based
Access Control (RBAC) and individual hospital requirements, but the application shall work on a
common architecture, configuration and functional modules. Each of the hospital / health
institution across the state will be connected to the core central application hosted at DC
through SWAN as per defined project implementation plan.
The core modular, fully integrated and automated software application for the Haryana Hospital
Information System (HIS), will have interface for various types of Users and applications. It is
envisaged that the core application should have decoupled but integrated core database, though
there may be logical partitioning for effective data retrieval and storage. In addition to the
above, it is also proposed that the entire application architecture will have a Business Logic
layer and a Data Access Layer to support the efficient data handling between the Application
Layer and the Database Layer. The application and its functionalities should be granular and
modular enough for the administrators to enable or disable any particular function of HIS at any
health institution in Haryana, at any given time, as per their requirement, through Application
Admin interface, without the need for a developer / code level change / custom UI change.
The core application should have HIS modules, along with other automated user friendly
features. It is a necessary requirement that the application should have complete integration
Haryana State Health Resource Centre confidential

38

Implementation of Hospital Information System (HIS)

Request for Proposal - Volume 1

between different modules and an efficient data sharing mechanism so that each module can
showcase complete automated workflow functionality for a seamless backend processing. It is
necessary that all the technical documents, with versions, traceability matrix and updates, are
maintained by the IA as per standard Software Development Life Cycle (SDLC) and submitted to
HSHRC as per agreed milestones and timelines without fail.It is proposed that the integrated
core HIS application shall have following 3 accessibility views:
1. HIS Web Portal 2. HIS Core application with 3. Backend support services
The diagram below provides a view of the proposed functional architecture, distinctly
identifying various functions:
FIGURE 1
Hospital Information System

HIS Web
Portal

HIS Core
Application

Static Web
Content
Public Reports
/ Statistics

4
Application
Admin

11

6
MIS
Reports

HIS Backend
Support

Patient
Administratio
n Services
Patient
Clinical
Services
Non-Clinical
Support
Services

Audit Trail

Personalized
Dashboard

8
User Log-in
/
Authenticat
ion Services

12

Basic Human
Resource
Management
Basic Finance
and Accounts
Assests and
Equipement
Management
Inventory
Control
Record Room
Document
Management
Content
Management

Registratio
n, Password
Retrieval /
Reset

Integration
Services
13
HIS Lite /
Offline
Application
14
Business
Analytics

10
Search /
Advanced
Search

Grievance
Redressal /
Feedback /
Suggestions

Helpdesk support / Incident


Management
Audio Visual Training / Online Help

Haryana State Health Resource Centre confidential

39

Implementation of Hospital Information System (HIS)

Request for Proposal - Volume 1

List of Functional Components of proposed HIS solution:

The sections below


enumerate each of the functional components of the proposed HIS solution, as shown above:

4.2.1.

HIS Web Portal

4.2.1.1.

Static Web Content

4.2.1.2.

Public Reports / Statistics

4.2.2.

HIS Core Application

4.2.2.1.

Patient Administration Services (PAS)

4.2.2.2.

Patient Clinical Services (PCS)

4.2.2.3.

Non-Clinical Support Services

4.2.3.

HIS Backend Support

4.2.3.1.

Basic Human Resource Management

4.2.3.2.

Basic Finance and Accounts

4.2.3.3.

Asset and Equipment Management

4.2.3.4.

Store and sub store Management

4.2.3.5.

Record Room

4.2.3.6.

Document Management

4.2.4.

Application Admin

4.2.5.

MIS Reporting

4.2.6.

Audit Trail

4.2.7.

User Log-in / Authentication Services

4.2.8.

Registration, Password Retrieval / Reset

4.2.9.

Search / Advanced Search

4.2.10.

Grievance Redressal / Feedback / Suggestions

4.2.11.

Personalized Dashboard

FIGURE 2
Haryana State Health Resource Centre confidential

40

Implementation of Hospital Information System (HIS)

Request for Proposal - Volume 1

The overall envisaged view of HIS for Hospital Administrators is depicted below:
Effectiveness & Quality

Utilization

Service Availability

PEOPLE

Roster

FACILITIES &
EQUIPMENT

Maintenance
& Upkeep

SUPPLIES

Integration with
external systems

Supply Chain

STATEWIDE HOSPITAL NETWORK


DEFINITION

4.3 Integration with external applications and systems:


HIS Core Application is envisaged to be a completely automated and integrated
software application which is going to be used by not only internal Hospital users
but also the state and district level decision makers as well as patients / citizens
in future, to obtain various services provided by the Hospital / network of
Hospitals
It is believed that the true sense of automation will only be achieved if the system
is capable enough to exchange data / information to and from other external
systems or departmental applications. It is proposed that a standard mechanism
of data exchange be built and implemented by the IA to cater to any external
systems requirement so that the impact on the HIS core application is minimal
due to any external changes
The system shall enable integration / data exchange to and from any external
application / database which will happen only through a Middleware or an API
by using a standard data exchange protocol through a secure channel
It is proposed that a data integration layer / Middleware to be created for
exchange of data between HIS Core application and other external applications.
The interface with these Systems will enable capture of relevant field wise details
between the applications

Haryana State Health Resource Centre confidential

41

Implementation of Hospital Information System (HIS)

Request for Proposal - Volume 1

The overview of the interfacing scenario is shown in the figure below:

HIS Core Application

External systems

MIDDLE WARE

HIS Core Application will prepare the


messages / datasets in XML / XBRL
based on the triggers and schedules.
Incase of transactions, system will
prepare databases in XML / XBRL as
and when transactions are recorded in the
system.
System will put all messages and XML /
XBRL formats in SFTP location
identified by State Authorities / HSHRC.
The system will pick up the data from
external application through middleware
and update the same in their own
database(s)

The middleware deployed between HIS


and the external application will read
these messages and XML / XBRL data
continuously and pull it in their
application database.
The external application will send the
acknowledgement to HIS Core application
after successful incorporation.
External application will also send an
update to HIS Core application in case of
any failure in data exchange (Failure
Status)
Similarly, the external application
Middleware will prepare all the messages
in XML / XBRL formats that need to be
passed onto the HIS Core application.

It is envisaged that all of these applications shall have seamless integration for
data exchange through a common data integration layer / Middleware. The data
exchange may happen in standard format, especially XML or XBRL through
Secure File Transfer Protocol (SFTP) location. The integration layer will be based
on business rules, defined in form of Triggers or Schedules.
The overall process flow for data exchange may be represented as follows:
i.

The HIS Core application will prepare all the messages / datasets in
XML or XBRL formats based on the triggers & schedules, as required by
the external applications

ii.

System will put all these messages and XML or XBRL formats at a
predefined Secure File Transfer Protocol (SFTP) location. These SFTP
locations would be generally identified by HSHRC

iii.

The Middleware deployed between the external applications and HIS


core application will read these XML or XBRL data continuously and
will pull it into their application database. The data would be processed
and inserted in their own database as required

iv.

The external applications will then send the acknowledgement to HIS


Core application after successful incorporation

Haryana State Health Resource Centre confidential

42

Implementation of Hospital Information System (HIS)

Request for Proposal - Volume 1

v.

External applications will also send an update to HIS Core application


in case of any failure in data exchange (Failure Status)

vi.

Similarly, the External application will prepare all the messages in XML
or XBRL formats that need to be passed onto the HIS Core application
and deposit at the specified Middleware

vii.

The HIS Core application will pick up that data from external
application through Middleware and update the same in their own
database(s) after due processing, including adequate checks and
balances, thus synchronizing the databases

Integration with SMS Gateway


Integration with Mobile / Handheld Devices
Integration with SSDG, State Portal, NSDG, National Portal and MSDG

4.2.13 HIS Lite / Offline Application


HIS Core applications and types (Local HIS Lite Application)
S. No.

Applications

Application Type

HIS Core Applications


Support Services

Portal

Centralized Application

Document Management System

Centralized Application

Content Management System

Centralized Application

Grievance Redressal

Local/ Centralized Application

Financial Management
Accounting

Human Resource Management

Centralized Application

Asset
and
Management

Centralized Application

Inventory Control

and

and

Equipment

Haryana State Health Resource Centre confidential

Local/ Centralized Application

Local/Centralized Application

Centralized Application

43

Implementation of Hospital Information System (HIS)

4.4

Request for Proposal - Volume 1

S. No.

Applications

Application Type

10

Record Management

Local Application

11

Analytics and BI

Centralized Application

Proposed Backend Components / Server Interactions

Apart from the various functional modules and additional functionalities mentioned above, it is
proposed that the application would be supported by backend components / servers / databases.
The indicative components to be considered as part of the proposed solution and their logical
interaction to support the overall automated system environment are mentioned below.
Application and Web Server
Application Server will form the middle tier and the HIS core application would be hosted on it.
Application server would take care of the necessary workflow, accessible through Intranet, and
the web server would be required for interfacing with the Hospitals and external users via web
browser through Internet. The business logic layer will coordinate the application, process
commands, make logical decisions and evaluations, and perform calculations. It also moves and
processes data between the two surrounding layers.
Document Repository Server
All the documents like scanned physical files, invoices, receipts and the any other supporting
documents during the course of any treatment or hospital administrative work should be stored
in this server with proper indexing and integration with other servers. The digital documents
generated through the automated HIS system should also be stored and linked to the core
database.
Database Server
HIS Application integrated with a core database will act as decoupled but yet single data storage.
Since this data is centralized and is very critical, it should be load balanced and clustered to
ensure high availability and reliability. The data would be stored on the storage server.
SLA Database Server
It is expected that the SLA monitoring tool, such as EMS, should be deployed by the IA for
monitoring the defined SLAs. This tool should be deployed in the DC and should be integrated
with all the system components.

Haryana State Health Resource Centre confidential

44

Implementation of Hospital Information System (HIS)

Request for Proposal - Volume 1

It is envisaged that the SLA database should be separate from the main HIS database which will
record all the readings captured by the system on the performance parameters. The system
should automatically feed the information on the performance parameters to SLA dashboard,
which should be available to Administrators as per their pre-defined roles and responsibilities,
mapped to their rights / privileges in the system.
The system should also allow generation of MIS reports, as required by the Administrators. The
system should retrieve the data from the SLA database and generate these reports as per the
defined Reporting functionality (Reporting Module). For details on the Reporting
functionalities, please refer to Section 4.2.5 and Annexure 1of the RFP.
Further the advanced analytics and BI should also generate required outputs and feed the SLA
dashboards of Administrators for faster decision making
User Authentication Server
User authentication server, a directory service should store all the user account details and
passwords, along with other verification credentials in a central database. It should allow the
administrators to manage user identities, credentials, information protection, system and other
application settings. This is specifically proposed for the internal Hospital staff using HIS
application. Database of the Patients is proposed to be kept separate but completely integrated
with other servers.
Patient Database
In the view of huge number of Patients records being stored through HIS application, it is
proposed that the Patient data should be kept separate but fully integrated with other databases.
All the demographic information, registration details etc. as well as index of the documents /
reports etc. are proposed to be stored here for ready reference and retrieved through the HIS
core application.
Note: It is proposed that the provision of UID should be available in the system wherever
applicable, in particular where Patient data is being stored. It is mandatory for the IA to
integrate HIS core application with UIDAI, as and when it is operational, and enable
capturing of the UID details for all Patients in future.
Reporting Server
Reporting Server can be used to prepare and deliver a variety of reports, majorly MIS reports.
Users can generate fixed and custom reports through the HIS core application that interfaces
with the Reporting Server. Integration with advanced analytics is also proposed so that
analytical reports should also be available for HIS users in real time for decision making
purposes.
External interfaces / databases
It is envisaged that the HIS core application will need to interact with other applications /
specific databases, either for intelligence purpose or for information / data sharing. It is
Haryana State Health Resource Centre confidential

45

Implementation of Hospital Information System (HIS)

Request for Proposal - Volume 1

proposed that the HIS core application will share the data with any of the other applications /
databases through an Enterprise Service Bus. The necessary data mapping and formats for
data exchange will have to be developed by the IA in consultation with HSHRC and owner of
external applications / databases.
State MIS Users
The HIS application is envisaged to provide higher state officials and other health department
officials / administrators the capability to view customized MIS reports / advanced analytics /
DSS, accessible through Internet and HIS Web Portal. The IA is required to develop and
implement the necessary features in the application.

Haryana State Health Resource Centre confidential

46

Implementation of Hospital Information System (HIS)

Request for Proposal - Volume 1

5 T echnical R equirement S pecifications


Application Solution must be web enabled, built on enterprise application platforms with
sufficient flexibility for customization based on HSHRCs needs. The proposed HIS solution
must use standard relational database.
1. Language Support: All functionalities must be provided with bilingual support i.e. in
English and Hindi language. All the screens and templates should be in English. Where
required, screen shall support Devnagri script. In addition application shall support
Unicode formats for text editing, file name, data storage.
2. Dates: All functionality MUST properly display, calculate, and transmit date data, in
21st-Century date data (DDMMYYYY) format.

5.1

Application and other standards

This section details the various Information Technology (IT) related standards that are to be
considered while developing the HIS solution. The below mentioned components need to be
taken care of while developing the technology components on HIS Solution:
1. Platform Flexibility
a. Web-centric, multi-tier architecture shall be used
b. Open Standards and Interoperability shall be considered
c. XML / XBRL based standard shall be used wherever applicable
d. Compliance to SOA and Web-services

2. Interoperability
a. Usage of standard APIs
b. Service-oriented architecture (SOA) based
c. Support for multiple industry standard databases with ODBC, JDBC and Unicode
compliance

3. Usability
a. Applications should comply with Guidelines for Indian Government Websites
Haryana State Health Resource Centre confidential

47

Implementation of Hospital Information System (HIS)

5.2

Request for Proposal - Volume 1

Compliance with Industry Standards

The Solution shall be based on and compliant with industry standards (their latest versions as
on date) wherever applicable. This will apply to all the aspects of solution including but not
limited to design, development, security, installation, and testing. There are many standards
that are indicated throughout this volume as well as summarized below. However the list below
is just for reference and is not to be treated as exhaustive.
Information access/ transfer protocols

SOAP, HTTP/HTTPS

Interoperability

Web Services, Open standards

Information Security

System to be ISO27001 compliant

Operational integrity & security


management

System to be ISO17799 compliant

IT Infrastructure management

ITIL / EITM specifications

Service Management

ISO 20000specifications

Project Documentation

IEEE/ISO specifications for documentation

Internet Protocol

IPv6 ready equipments

Medical standards

DICOM 3.0 Compliant

Imaging

Picture Archiving & Communications System


(PACS)

Interoperability standard for exchange


of electronic health information

Seamless handling of inbound and outbound HL7


messages from any system that has similar
capabilities

HIS Application

Web enabled application

Universal standard for identifying


medical laboratory observations

LOINC Coding

Disease Classification

ICD-10 coding

Haryana State Health Resource Centre confidential

48

Implementation of Hospital Information System (HIS)

Request for Proposal - Volume 1

Clinical Healthcare Terminology

SNOMED-CT Coding (when available)

Investigations

Investigations coding, Results coding

Equipment compatibility

All equipments will be used with international


bench-marks that are workable in India

HIS Solution Standards


The system shall adhere to all the IT standards published by the Department of Electronics &
Information Technology, Government of India (www.deity.gov.in) and other applicable medical
standards listed in the table above.

5.3

Performance Metrics

Some of the key considerations that the implementation agency should aim for while designing
the deployment architecture is to ensure that the HIS project meets SLA requirements,
standards, specifications and performance prescribed, by ensuring that the following are
associated with clear, quantifiable metrics for accountability:
1. Performance
2. Availability
3. Security
4. Manageability
5. Scalability
6. Inter-operability & Integration
7. Standards and protocols

The solution must be designed to meet all functional, non-functional and management
requirements as mentioned in the document. Some of the key acceptance criteria are defined in
the table below.

Haryana State Health Resource Centre confidential

49

Implementation of Hospital Information System (HIS)

#
1.

Request for Proposal - Volume 1

Requirements
Performance - The system should provide fast and steady response times (Quality
of Service). The maximum user response time should be less than 3 seconds over
WAN and less than 1 second over LAN, for the next screen to appear or the existing
screen to refresh for submission of data. The speed and efficiency of the system
should not be affected with growing volumes, especially during search operations,
reporting, MIS, online processes and batch processes.
The system should be operational with good response time using low band width in
the hospital of about 32Kb per user, especially for LAN and internet users.
The system should support high variance in frequency as the volumes are not
expected to be constant and may be subjected to variances in user behavior due to
festivals, seasons, economic state of the country, regulatory changes, behavior of
intermediaries, etc.

2.

High Availability All the components of Haryana HIS must provide adequate
redundancy to ensure high availability of the HIS applications. The systems shall be
designed for 24x7 operations and meet all SLA requirements. Designing for
availability assumes that the systems will fail, and therefore the systems must be
configured to recover from component or server failures with minimum application
outage. All the components of HIS should support SNMP protocol for the effective
monitoring and management.
Haryana HIS should be available for 99.95% of the planned uptime. The accepted
planned downtime should not be more than 60 minutes per month (2 alternate
Sundays in a month at around midnight). The IA needs to indicate the critical
components in the system and indicate the plans for fail-over mechanisms.

3.

Security The implementation of HIS components for each of the project


locations should comply with the standard guidelines of Information Security
Management System (ISMS). The IA is expected to implement ISO 27001 for the
project and should formulate standard security policy and procedures applicable for
each of the entities separately.

4.

Manageability (Version Control and Management) The proposed System


must have versioning features to track and document and process revisions made. A
tool may be used for version control. The admin control of the tool will always
remain with HSHRC.

5.

Scalability All components of the HIS must support scalability to provide


continuous growth to meet the requirements and demand of Haryana HIS. A
scalable system is one that can handle increasing number of requests without
adversely affecting the response time and throughput of the system. HIS solution
should support vertical scalability (the growth within one operating environment)
and horizontal scalability (leveraging multiple systems to work together in parallel)
by the use of load balancers and High available servers. A scalable HIS solution

Haryana State Health Resource Centre confidential

50

Implementation of Hospital Information System (HIS)

Request for Proposal - Volume 1

Requirements
shall easily be expanded or upgraded on-demand. Scalability is important because
new proposed components shall constantly be deployed.
Expected number of users of the web-based system during the first year is
approximately 200 users, second year this shall grow to approximately 1000 users,
third year these shall grow to approximately 2000 users. Year on Year growth for
no. of web users beyond third year is expected to grow at 10% per annum.
Expected number of concurrent web-based year wise users shall be around 60%
with another buffer of 15% of the provisioning.

6.

Inter-operability - The entire system with all subsystems should be interoperable


and must seamlessly integrate with other legacy applications and the applications
being developed / already developed by Government of India as well as
Government of Haryana for similar purposes. Operating systems and storage
technologies from several suppliers must interact well with each other. These
systems should support the open architecture solutions such as XML, LDAP, SOAP,
etc. where information/ data can be ported to any system, whenever desired.

7.

Access and Interface The systems must be user-friendly, intuitive and


equipped with help / support facilities.

8.

Server Based Computing The computing architecture must be Server based.


The applications will reside in the servers and will be accessed to the users through
other Browser based computing facility / technology.

9.

Application Client The clients should be supported on latest versions of all


popular browsers such as Internet Explorer, Chrome, Netscape, Mozilla Firefox, etc.
It should also be multi channel, compatible to web as well as mobile / handheld
devices.

10. Source codes Please refer to Article VII, Intellectual Property clause mentioned
in volume III of the RFP
11. The system should be web 3.0 compliant to ensure the HIS application works on
various platforms, browsers and resolution.

Haryana State Health Resource Centre confidential

51

Implementation of Hospital Information System (HIS)

5.4

Request for Proposal - Volume 1

Acceptance Criteria

5.4.1 Security
The IA must take rigorous provisions to prevent unauthorized alteration or damage to
HIS application, and all related applications and databases. The IA must describe in
detail all measures to be taken, including the use of security infrastructure including
end-point security, Security Policy and Procedures for each project location, applicability
of the policies and security controls for physical, communication, assets, software
licenses, equipment security etc. as per the ISMS procedures. IA shall provide basic level
of security by providing the end users with username and password to access the
applications. IA shall deploy the application only after it has undergone User Acceptance
Testing (UAT) and is security audited by the Haryana State Information Security
Management Office (ISMO) for vulnerability assessment (VA) and penetration testing
(PT). However IA shall undertake and conduct all sorts of testing and follow a standard
Software Testing Life Cycle approach (STLC) before deployment of application in a
production environment in addition to assessment and certification through the ISMO.
Content Management Software that is part of the portal shall be restricted to specific IP
sources. Additional layer of security shall be provided to sensitive applications by
deploying these behind Application Firewall.
The Governance Framework established for the project shall ascertain what all measured
risks that needs to be accepted; however IA shall at each such occurrence/incident be
responsible for providing resolution in terms of correction, prevention and remediation
throughout the project tenure.

5.4.2 Backup and Recovery


The IA must provide and successfully test backup and recovery capabilities for the HIS
application and related databases deployed at Data Center. The IA must describe this
functionality, the frequency of backup and provide reports to HSHRC. It is a must, that
the facility to conduct such tests/audits should be provided to HSHRC or any other
nominated agency on behalf of HSHRC for audit purposes, as and when required. At
each hospital facility, IA shall be responsible for data storage, backup and recovery
measure that will be taken at individual facility separately.

5.4.3 Uptime and Performance


The HSHRC shall provide sufficient hardware (servers, storage, security & monitoring
infrastructure) and network capacity for the centralized infrastructure deployed at the
Data Center on the basis of solution proposed by the IA. Therefore IA must provide in
their technical proposal all details w.r.t sizing and specifications (throughput, IOPS,
compute capacity, cores, processors, MIPS, bandwidth requirements etc.) for each of the
solution components that are required to ensure that all application functionality,
including data access, file downloads, and online transactions, is performed within
commercially acceptable response times and as per the defined SLAs. The IA must state

Haryana State Health Resource Centre confidential

52

Implementation of Hospital Information System (HIS)

Request for Proposal - Volume 1

the capacity that will be required for each of the application and what tools and
techniques will be required to continuously monitor application performance.

5.4.4 IT Refresh Policy


The IA shall follow the guiding principles for Refresh / Replace policy of HIS solution
components that are given below, which would be valid for the entire contract duration:
a. The IA must replace / refresh the components during those instances which may
have an impact on the overall performance and accordingly may trigger SLA
breach.
b. No End of Sale/End of Service/ End of Support/ user-end equipment /
component should be bought by the IA (OEM must certify that the proposed
user-end equipment is not End of Support and the certificate must be submitted
to HSHRC after every procurement). Once End of Support is announced,
transition strategy must be defined by the IA so that all replacements happens at
least 6 months before End of Support.
c. When handing over infrastructure and other components for this project, at end
of contract period, IA must ensure that no equipment or component is having
End of Support for a period less than one year.

5.4.5 Development / Customization Criteria


In order to achieve the high level of stability and robustness of the application, the
system development life cycle must be carried out using industry standards best
practices and adopting the security constraints for access and control rights. The various
modules / application should have a common Exception Manager to handle any kind of
exception arising due to internal / external factors. This will help ease of application
maintenance and enhancements. Similarly the modules/ application should be
supported by the Session and Transaction Manager for the completeness of the
requests.
The software application must be developed / customized in a suitable environment as
agreed in the discussions with HSHRC. The IA must justify the choice of development
environment. The application must be developed / customized and hosted utilizing
industry standard with commercially available tools. The IA must list all tools to be used
to develop, customize and maintain the application, as well as the hosting platform,
hardware and software, and seek prior approval of HSHRC. IA shall propose and setup a
dedicated Development / Customization environment and provide remote monitoring
access to HSHRC for the same.
It is proposed that the customization of HIS core application may be allowed to take
place outside HSHRC / Government premises; however, it is proposed that for all the
ongoing up gradation / enhancements and maintenance activities needs to be done
Haryana State Health Resource Centre confidential

53

Implementation of Hospital Information System (HIS)

Request for Proposal - Volume 1

within the development environment set up by the IA within pre-decided premises only.
The IA must comply with all the IT and admin requirements as defined by HSHRC.
Note: In case the State Authorities / HSHRC agrees to continue ongoing upgradation /
enhancements and maintenance activities from outside location, the IA needs to define the
environment and provide necessary controls / access for adequate monitoring to authorized
officials.
The IA must take all reasonable care to protect the integrity of the software application
during development / customization. Use of a version and library control tool is
required. The IA must describe the development environment to be used and tools
deployed for maintaining the version control of the software application. The access
control of the version control tool must be provided to HSHRC or any agency nominated
by HSHRC for periodic review of logs and Audit of the entire development process.

5.4.6 Project Management and Plan


The IA must provide an experienced Delivery Manager to
development/customization of the application and serve as primary point
HSHRC. The IA must follow an established Project Management
conforming to the best practices of the Project Management Institute.
describe the methodology to be used.

oversee the
of contact for
methodology
The IA must

Within one week of award of contract, the IA must provide HSHRC an Inception Report
including a detailed Project Plan for the development / customization of the application
along with the Performance Management System (PMS) tool. This Project Plan must
include the Project Charter, a work breakdown structure showing all proposed
milestones and deliverables, and a listing of all project issues and risks. Additionally the
IA will also be required to submit the detailed CVs of all resources being deployed for
providing services to HSHRC and also the Resource Plotting sheet as per project plan.
The IA must provide weekly status reports to HSHRC during the development effort as
well as the entire project implementation and maintenance phase, for the entire contract
period. These reports must be submitted by close of business each Monday and reflect
status against the Project Plan as of close of business the previous Friday. Any
falsification of these status reports or failure to inform HSHRC of issues impacting the
deliverables or timeframe of the project may result in imposition of adequate penalty /
action by HSHRC.

5.4.7 Version Control and Bug Fixing


The IA must make any modifications necessary for the duration of the contract to ensure
that the system is compatible with current and supported versions and releases of the
relevant operating system and other system software with all relevant documentation. It
is a mandatory requirement that all relevant documentation be created, updated and
maintained throughout the contract duration. The IA will also ensure that proper track of

Haryana State Health Resource Centre confidential

54

Implementation of Hospital Information System (HIS)

Request for Proposal - Volume 1

all bugs are maintained and are fixed as per various tests conducted on the application. It
is desirable that the IA maintains a bug tracking tool for the purpose.

5.4.8 Future Changes / Application Upgrades


From time to time, changes in work process, legislations, policies, etc. may necessitate
changes in the HIS application. The IA must make any and all such changes for the
duration of the contract as defined in the Change Control procedure. When provided
the specifications of the change required, IA must submit an estimate of work effort and
cost for the change, as defined in the Change Control Life Cycle to HSHRC for
approval.
Note: The Change Control Life cycle needs to be discussed and agreed with HSHRC upon
selection of the IA and contract signing

5.5

Technology Reference Architecture

The proposed overall solution framework for HIS is presented in this section, depicting the
overall Logical application structure showcasing the inter-relationships between different
layers.
The 3-tier architecture (also referred to as multi-tier or N-tier architecture) has been proposed
for the Application Solution. It is required that all the automated modules to be developed by IA
should be complying with DeitY, GoI standards and guidelines. This would enable ease of
interoperability and also be significantly more economical for the Haryana Health Department.
It is recommended that IA should opt for Service Oriented Architecture (SOA) for implementing
HIS application modules.
The indicative layers in the proposed application architecture are shown below:

Haryana State Health Resource Centre confidential

55

Web Browser

Front Window / CHCs /


PHCs

Citizens / Patients

Mobile devices

Kiosk

Email

Other stakeholders

SMS

Service
Delivery
Channels

State / District Administrators

Hospital Internal Users

Request for Proposal - Volume 1

Users

Implementation of Hospital Information System (HIS)

Service Helpdesk

Internet and Intranet

Mobility

Helpdesk / Call Center

HIS Data and Analytics Engine

Healthcare Management (360 degree Patient


view)

Dashboarding | MIS Reporting

Common Services

INTEGRATION LAYER

Patient Care
Services

Diagnostic and other


Para Clinical services

Communication Services
Mailing | Notification | SMS | IVR

Ancillary and
Support Services

Portal Data
Stores

Administrative
Services

ODS

Application
Admin

Common Master Data

Process Management
Payment
Services

Audit trail

Central
User
Repository

Business Rules | Process


Manager | Process Monitoring

Financial
Accounting

Other support
services

Content &
Document
Management
Data Store

Servers Application Server, Web


Server, Content Server, Database
Server, SAN Storage, FTP Server,
Email Server, Mobility Server

Third Party Service


Provider ( UIDAI etc)

Functional
Data Stores

Authenticati
on Services

Analytics | Fraud Management

Business
Enablers

Content/ Document Management

Search / Advanced Search

HIS Service
and Process Insights Layer
Gateway

Workflow Management

Functional
Modules

Centralized
Authentication
Gateway
Web Service
Security
Application specific
authentication &
authorization model

Enabling Applications

Common
Service
Centers

Database
Security

Forms | Web Services | Other


interfaces

National / state
Schemes

Infrastructure Security

Mobile Interface /
Downloadable Apps

HIS Core Application

State Portal

Compliance, Regulations & Policies,


Architecture Principles, Interoperability Standards, Data & Metadata Standards

(HIS Web Portal |

Other Public Sector


Gateways

HISs Integrated Web Presence

Data Store & Infrastructure


Platform

eService Interface

SECURITY
SERVICE

eService
Delivery
Interface

Interface
Services

The description of various layers shown in the diagram above is given below:
The User Layer: This layer forms the internal Hospital users accessing the applications over
Internet or Intranet. Role based access would be defined for the internal users for having
accessibility to the respective application modules, and MIS / DSS which would be accessed by
higher authorities which would help them in decision making as well as at various levels.
Integrated database structure would ensure a one point stop search available to all the units.
The Application Layer represents all the functional modules, i.e. core, supporting and
backend support modules of HIS, along with the additional modules proposed for the Hospitals.
These modules will communicate by sharing of data with one another, or by coordinating an
activity between two or more services as per integrated workflows. Users can easily access
solution components having an interface with single sign-on, identity Management (IDM)
facility provided by the Light-weight e-Governance Interconnect (LeGIT) framework either
through Internet or through Intranet.
The Business Logic Layer: All the processes and functionalities within the HIS core
application would be guided by Business Rules and Logics. The rules engines will cater to the
Haryana State Health Resource Centre confidential

56

Implementation of Hospital Information System (HIS)

Request for Proposal - Volume 1

requirements of each individual functional module at the Application layer and also help in
interacting with the modular databases / data tables.
The Data Access Layer: The Data Access layer is envisaged to contain the Metadata and
also cache of frequently used raw data. This layer will closely interact with the Masters to
control how the data flows to individual databases / tables and also how efficiently it is
retrieved.
The Data Layer: The overall solution would be based on a centralized architecture
comprising of centrally located databases at the Data Centre as central repository. The District
Hospitals and Medical Colleges shall have minimum one server each required for operating the
application in offline mode with all necessary data of that particular facility, which will enable
capturing of data from standalone applications at those places (when the connectivity with
central repository is lost or intermittent). This approach would cater to the functionalities of all
the key processes and functions performed at all other locations and would also allow the users
to have access to the central repository for comprehensive information as and when required.
The data storage, backup and recovery measure will be taken at individual hospital facility as
indicated above.
Networking: The overall networking solution would be based on a combination of SWAN as a
primary connectivity and broadband connectivity to be provisioned by IA, ensuring optimum
uptime at all the desired locations.
The Service Delivery Layer represents the different modes/media of service delivery, which
would be used for availing/accessing the services of HIS. Services would be primarily provided
through system accessed over the specified network. This will also authenticate the different
users through their credentials and control the access to various modules / functionalities in the
system as per rights granted to them.
The IA shall choose the technology such that:
1. It can help Hospitals (HIS functions) respond more quickly and cost-effectively to
changing environment conditions / demands from the general public requiring health
care services.
2. It shall promote reuse at the macro (service) level rather than micro (classes) level. It can
also simplify interconnection to - and usage of - existing IT (legacy) assets, if any.
3. It shall also support the principles of good design: Granularity, interoperability,
modularity and scalability.
4. The issues related to performance, manageability, etc. shall be well addressed and
system shall provide a more manageable system which is less dependent on human
resources.

Note:
Haryana State Health Resource Centre confidential

57

Implementation of Hospital Information System (HIS)

Request for Proposal - Volume 1

1. The architecture proposed by the IA should include but not be limited to these layers
and modules. This is an indicative solution and logical Architecture. The IA should
carry out a detailed study to develop the exact Solution and Technology Architecture
for proposed HIS considering DeitY, GoI standards and guidelines.
2. The figure above only depicts the key identified layers and the various modules of each
of the layers, however this is only indicative and not exhaustive. The IA needs to
develop a detailed application architecture and database design / schema to cover all
the requirements and functionalities as described in this report. All the technical design
documents along with architecture and DB design reports as submitted by the IA will
be reviewed and approved by HSHRC. The decision of HSHRC will be final and binding
on all parties in such matters.

5.6

Deployment Architecture

The logical deployment diagram is represented below:

Internet

Intranet

State MIS
Users

Patients

Hospitals

Core Router

Core Router
Gateway
Antivirus

Core Switch External Core Switch


Firewall
IDS/IPS

Internal
Firewall

FTP
Server

Web Server

Load
balancer

Core
Switch

IDS/IPS
SMS
Gateway

SAN storage

LDAP
Server

Certificate
Server

Database
Server Farm

SAN Switch

Switch

Haryana State Health Resource Centre confidential

Application Application EMS


Server
Server
Server

Backup
Server

58

Implementation of Hospital Information System (HIS)

Request for Proposal - Volume 1

Note: The above diagrams are only indicative and do not necessarily represent the physical
servers. The functional / logical interactions of the various servers may remain the same;
however the actual technical design and implementation would be done by the IA and shared
with HSHRC for approval. Also, the overall implementation is proposed to be centralized, with
core application being hosted at DC and all other locations (i.e. District Hospitals and Medical
Colleges) are proposed to access the application through SWAN.

5.7

Testing Criteria

A thorough testing is proposed for the HIS application and its modules, as per standard process
defined hereunder. HSHRC requires thorough and well-managed test methodology to be
conducted. The bidder must build up an overall plan for testing and acceptance of system, in
which specific methods and steps should be clearly indicated and approved by HSHRC. The IA
is required to incorporate all suggestions / feedback provided after the elaborate testing of the
HIS application, within a pre defined, mutually agreed timeline.
The Implementation Agency must undertake the following:
1. Outline the methodology that will be used for testing the system
2. Define the various levels or types of testing that will be performed for system
3. Provide necessary checklist/documentation that will be required for testing the system
4. Describe any technique that will be used for testing the system
5. Describe how the testing methodology will confirm to requirements of each of the
functionalities.
6. Indicate how one will demonstrate to HSHRC that all applications installed in the system
have been tested
Competent Authority from HSHRC shall issue application security audit certificate to
Implementation Agency after successful installation
The IA shall conduct various type of testing on the new build/package before releasing it for
deployment on the production environment according to standard Software Testing Life Cycle
(STLC). These tests shall include unit testing, system testing, security testing, stress testing,
reliability testing, performance testing, audit trail, multi-user capability, volume test, system
integration testing, compatibility and configuration testing, GUI testing etc.
The test documentation shall include test procedures, test data and test results should be
documented. Errors detected during testing should be logged, classified, reviewed, and resolved
prior to release of the software. Software error data that is collected and analyzed during a
development/customization life cycle may be used to determine the suitability of the software

Haryana State Health Resource Centre confidential

59

Implementation of Hospital Information System (HIS)

Request for Proposal - Volume 1

product for release and installation. Test reports should comply with the requirements of the
corresponding test plans.
The acceptance tests must demonstrate that the Implementation Agency has met each and every
requirement specified in the RFP and has delivered an effective operational system.

5.7.1 User Acceptance Testing (UAT)


HSHRC will form different user groups which shall be headed by a competent officer
appointed by HSHRC for the purpose of UAT. These user groups would test the
application for the functionality, reliability and all other related tests. Once the users are
completely satisfied with the application, Implementation Agency should take a formal
sign off from the competent officer appointed by HSHRC for acceptance of each module.
Based on the sign off and user feedback, HSHRC with the assistance of Project
Management Unit (PMU) or any other nominated agency would issue UAT certification
to the Implementation Agency for that particular module/ sub-module. In addition to
conducting a UAT testing, HSHRC through the ISMO shall conduct an application
security audit including vulnerability assessment and penetration testing.

5.7.2

Acceptance Test Design and Execution


All the acceptance test criteria shall be specified by Implementation Agency and finalized
under the technical guidance of Project Management Unit and the user representative
authorized by the HSHRC. The test criteria should be comprehensive to address all
aspects of testing the new systems. Extensive testing would be carried out by the User
Representatives with technical support from Project Management Unit (PMU).

5.7.3 Fault Correction


The Implementation Agency will be responsible for correcting all faults found during the
acceptance process at no extra cost to HSHRC. The Governance Framework established
for the project shall ascertain what all measured risks that needs to be accepted; however
IA shall at each such occurrence/incident be responsible for providing resolution in
terms of correction, prevention and remediation throughout the project tenure.
HSHRC will undertake an exercise of application security audit of the HIS solution
through ISMO, as soon as the IA declares the completion of system implementation.
The Governance Framework along with the ISMO shall establish appropriate processes
for notifying the IA of any deviations from the norms, standards or guidelines at the
earliest instance, after noticing the same, to enable the IA to take corrective action. Such
an involvement and guidance by the agencies shall not, however absolve the IA of the
fundamental responsibility of designing, developing/customization, installing, testing,
and commissioning the various components of the HIS Solution to deliver the services in
conformity with the RFP, SLA and the agreement. All changes suggested by the ISMO
shall be implemented by the IA upon acceptance and approval by the HSHRC.

Haryana State Health Resource Centre confidential

60

Implementation of Hospital Information System (HIS)

5.8

Request for Proposal - Volume 1

Hosting Criteria

The IA must work with HSHRC to provide a detailed deployment plan, including but not limited
to, orderly processing of inventory, application version control, and load all application
materials, assignment of user rights and security, and verification of correct functionality. The
IA must present a deployment plan to HSHRC for their approval by the beginning of the test
period. It is necessary that the application is hosted in DC and a Lite version of HIS core
application be deployed at District hospitals and Medical Colleges as per the Implementation
Schedule along with the necessary itemization of all hardware and/or software, as well as any
and all ancillary requirements.
The HIS application must be made available on a 24x7 basis, with scheduled down time as
mentioned in the SLA parameter, including both planned and unplanned outage. The IA must
state how the availability is to be provided, including all measures such as mirrored servers. The
IA must show the ability to report availability to HSHRC on a monthly basis, and must indicate
how availability is to be verified.
The HIS application must meet the standards for web accessibility. All web pages, static or
dynamically generated, must comply as outlined in the World Wide Web Consortium (W3C)
Web Content Accessibility Guidelines. The IA must test the HIS application with an available
accessibility monitor, and with a leading accessibility tool. A test report should be submitted as a
part of relevant documentary proof.

5.9

Data Loss Protection

The selected IA will need to implement comprehensive solutions with centralized workflow
capabilities, integrated policies, and customized reporting, in order to manage Data Loss and
protect sensitive data. They will also need to provide HSHRC with a modular DLP program that
offers capabilities across three main vectors: data at rest, data in motion, and data at endpoints.

Haryana State Health Resource Centre confidential

61

Implementation of Hospital Information System (HIS)

Request for Proposal - Volume 1

Where the standard DLP mechanism is shown above, the IA needs to propose adequate solution
and define protocols to cater to requirements of data prevention within the system implemented
at each project location with HIS Lite version along with the end-point security and at the Data
Center, and incorporates the same as part of entire solution design. The IA shall provide HSHRC
with the DLP policy and statement of applicability for each aspect of the network, storage and
end point according to the scope of work defined in the RFP. This is a mandatory requirement.

Haryana State Health Resource Centre confidential

62

Implementation of Hospital Information System (HIS)

Request for Proposal - Volume 1

6 I nfrastructure R equirements
The HIS application is required to be available on Centralized architecture and therefore it is
mandatory that the application is accessible over a common network. The subsequent sections
in this chapter provide the details of respective Infrastructure requirements for smooth
functioning of the HIS application.

6.1

Proposed implementation / Network Architecture

The following are proposed in terms of overall IT infrastructure setup for the proposed
implementation. First is the deployment of HIS Lite application at District Hospitals and
Medical Colleges and deployment of centralized core HIS application at the Data Center. A
detailed IT infrastructure design should be prepared by the IA which would be reviewed and
approved by HSHRC. The bidders are required to provide in their proposal the Bill of Quantities
(BOQ) including the numbers and work out detailed configuration/specification and type of
servers and other hardware, software components that are required under the proposed
technology solution HSHRC shall make provisions for deployment of servers and other required
components as per detailed design and specifications drawn out by the IA. IA is expected to
provide compliance to all the components of BOQ and include un-priced Bill of Material along
with technical proposal.

6.2

Virtualization and Cloud

It is proposed that the entire HIS infrastructure should be virtualized for optimum
infrastructure utilization and performance. Once the entire IT system is mature enough, the
infrastructure may then be scaled up to Private Cloud. This can be also applicable to all hospital
infrastructures for HIS application and both can be integrated for virtualization. However, in
case of extreme situations where the existing infrastructure even after making a Private Cloud
is found to be insufficient, the usage of other Cloud infrastructure may be allowed to manage
the additional load, however the decision of HSHRC will be final and binding on all parties in all
such matters.

6.3

Data Centre

Data Center for Haryana HIS project shall be provisioned as a service by the Data Center Service
Provider i.e. by HARTRON on behalf of the HSHRC. The IA is required to host the HIS
application and services on the server infrastructure at the facility of DC service provider. The
DC shall comply with the Tier-III standards and TIA-942 norms. HSHRC has provided the
Quality of Service (QoS) indicators and other performance parameters adequately in advance for
the IA to study and make out detailed specifications for the same. The specifications must be
futuristic with atleast a five year horizon to start with and recommended servers for
provisioning shall be on a managed services model from HARTRON/HSHRC. The centralized
compute infrastructure should be able to accommodate any scaling up requirements
necessitated in future. Based on the recommendations, HSHRC shall make provisions through
Haryana State Health Resource Centre confidential

63

Implementation of Hospital Information System (HIS)

Request for Proposal - Volume 1

HARTRON such that commissioning of servers for deployment of HIS core application and thus
the implementation plan does not suffer. The following are the suggested/desirable features for
the HIS core database to provide optimum performance and scalability on demand and facilitate
quick data response:
1. High Availability
2. Scalability
3. Data Security
4. Automatic Workload Management
5. Access Control
6. High Performance

The IA should assess, design and deploy the components in identified Data Centre either in the
ACTIVE-ACTIVE or ACTIVE-PASSIVE mode in order to meet the project requirements. The IA
should deploy and host the application in the Data Centre for the purpose of backup also. The
IA in mutual consultations with the HSHRC shall identify and ensure that only critical data is
backed up at the DC. Additionally it is proposed that the backup procedure at the DR site would
be near real time, till such time the DR Site is set up/ready for commissioning.
If for any reason, there is a delay in any deliverable that is due to Data Center services and or
Network service provider, the IA shall not be penalized..
IA shall provide the following for the Data Center: proposed DC scope for the IA has been
broadly divided into following categories:
1. All Application and System Software including various system tools as per RFP
requirements
2. The IA shall supply, install, configure and manage the antivirus solution hosted at DC
meant for the client infrastructure including desktops and servers, outside the DC but on
the Haryana SWAN network
3. System Operations & Maintenance Services - Undertake all operations and maintenance
services of all the components being procured and installed to ensure that overall uptime
commitment of 99.95%
4. Backup / Restore Services Design and implement the shared backup and restore
components and provide backup and restore services to the Hospitals.
5. Storage Services - Design, and implement the shared storage components and provide
storage administration and management services to the users in the Hospitals.

Haryana State Health Resource Centre confidential

64

Implementation of Hospital Information System (HIS)

Request for Proposal - Volume 1

6. OS and Database support services - Provide administration, patches upgrade and update
management services for OS and Database to the Hospitals.
7. IA must provide in their technical proposal all details w.r.t sizing and specifications
(throughput, IOPS, compute capacity, cores, processors, MIPS, bandwidth requirements
etc.) for each of the solution components that are required to ensure that all application
functionality, including data access, file downloads, and online transactions, is
performed within commercially acceptable response times and as per the defined SLAs.
8. The IA must state the capacity that will be required for each of the application and what
tools and techniques will be required to continuously monitor application performance.

There shall be no compromise with respect to the functionality and performance expected of
each of the above components and appropriate care has to be exercised, while finalizing the
device/component specifications and drawing up the final BOM, about scalability, security,
performance, availability and manageability. One more factor to be taken care of here would be
the compatibility of all these components with each other and with respect to the overall
solution deployment.
The sizing should be carried out keeping in mind the peak load requirements, during which, a
rapid growth in the transaction volumes occurs. Infrastructure should be pooled together,
optimally utilized and enabled in virtualization mode so that benefits such as agility, dynamic
and elastic resource allocation can be implemented.
All the applications should be enabled in Virtualization mode making planning in such a way
that peak resource requirements of different applications fall at different times so that resources
of applications with lean requirements can be diverted elastically to applications whose peak
time has occurred.
Infrastructure services provided by Data Center Service Provider
1. All Server hardware (compute infrastructure)
2. Racks and rack space
3. Building Monitoring System
4. Access control, Physical security & surveillance
5. Power Supply, UPS Backup & Generator
6. Precision AC
7. Fire Prevention System
8. Router for terminating traffic coming from internet
9. Router for terminating traffic coming from intranet over MPLS
Haryana State Health Resource Centre confidential

65

Implementation of Hospital Information System (HIS)

Request for Proposal - Volume 1

10. Core Switch and other layer 2 switches for LAN


11. Core information security equipment like Firewall, IPS, IDS
12. Network Termination facility for the Network Service Providers
13. Remote Support Services in case of any physical intervention are required
14. Availability and performance reports of the shared resources provided by Data Center
Service Provider will be made available by Data Center Service Provider on periodic
basis. The shared resources that Data Center will be using shall be monitored by Data
Center EMS are Routers, Switches, Firewall, IDS, IPS, Storage Solution, Backup Servers
and other Non-IT infrastructure components like AC, UPS and Generator on
weekly/monthly or as and when HSHRC requires it. DC EMS may also be required to
monitor MPLS links connectivity to hospital locations
15. Provision for Remote access to IA for monitoring the application performance to be
commissioned by IA
16. SAN storage / software with SAN switch
17. Backup Solution (including servers and software)
18. Vault for keeping DAT drives

6.4

Business Continuity

Disaster recovery will be a subset of business continuity. While business continuity will involve
planning for keeping all aspects of a business functioning in the midst of disruptive events,
disaster recovery will focus on the IT or technology systems that will support business functions.
In case of Disaster, the prioritization of services that shall be available and accessible to the HIS
users shall include static web services, clinical modules, supporting modules and reporting/
basic MIS only. The decision to change the prioritization of services shall solely lie with HSHRC.
HARTRON in mutual consultations with the HSHRC and its IA shall design the Business
Continuity solution in a manner that the Recovery Time Objective (RTO) of 4 hours and
Recovery Point Objective (RPO) of 2 hours is achieved. System should be designed to remove all
single point failures. Appropriate redundancy shall be built to all critical components to provide
the ability to recover from failures. HARTRON along with Data Center Service Provider shall
perform various tests including network, server, security, local failover tests to verify the
availability of the services in case of component/location failures.
IA is also expected to detail out in its technical proposal and provide a comprehensive BCP
solution for all the entities including but not limited to the PHCs, CHCs, District Hospital and
Medical College in addition to non-availability of the Data Centre facility. The IA in its technical
proposal bring out clearly the scenarios (instance/trigger points) and level at which the DR is
Haryana State Health Resource Centre confidential

66

Implementation of Hospital Information System (HIS)

Request for Proposal - Volume 1

activated, details on the complete process prior to declaration of disaster, communication


interventions and mode as to which services shall be available at the time of failure, roles and
responsibilities of the IA and HSHRC at the time of implementing BCP measures. The IA is
expected to plan and conduct regular half yearly failover drills throughout the project tenure.
The damage caused by either Natural or Man-made can make the data centre non-functional for
several minutes to months depending upon the magnitude of damage. Since the data centre is
going to be a repository of essential Hospital data and services hence utmost care needs to be
taken to ensure that adequate measures have been taken to ensure minimal data loss and
minimum time is lost in restoration of services.
It is in this context that the data centre team has to be sensitive to this issue and ensure that
adequate measures are taken by the Health Department / HSHRC for ensuring business
continuity depending upon the impact assessment analysis.
Some of the possible scenarios (not an exhaustive list) that are envisaged in the RFP, IA is
expected to provide in its technical proposal the probable solution and may identify scenarios
other than the ones that are mentioned below:
Infrastruct
ure
Provisione
d under DC

Partial Disaster at the Prime


Site

Application
Server

Applicati
on Server
Crashed
Down

Primary
Site is
completely
Down

Data Base
Server

Database
Server
Crashed
Down

Primary
Site is
completely
Down

Web Server

Web
Server
Crashed
Down

Primary
Site is
completely
Down

Scenario

Solution

Full Disaster at the prime site

Scenario

Solution

Directory
Server
Antivirus

Haryana State Health Resource Centre confidential

67

Implementation of Hospital Information System (HIS)

Infrastruct
ure
Provisione
d under DC

Request for Proposal - Volume 1

Partial Disaster at the Prime


Site
Scenario

Solution

Full Disaster at the prime site

Scenario

Solution

Server
Network
Component
s
(Including
Core
Network
and
Security
Component
s)

Netwo
rk/
Securit
y
Compo
nent
Down

Primary
Site is
completel
y Down

The above explained solution scenarios can only be met if adequate Control Measures have
been taken at every step while operating the Data Centre. The control measures are steps or
mechanisms that can reduce or eliminate various threats for organizations. Different types of
measures can be included in BCP. Disaster Recovery is a subset of a larger process known as
Business Continuity Planning and should include planning for resumption of applications, data,
hardware, communications (such as networking) and other IT infrastructure. A business
continuity plan (BCP) must be designed by the IA that will include planning for non-IT related
aspects such as key personnel, facilities, and crisis communication and reputation protection.

Haryana State Health Resource Centre confidential

68

Implementation of Hospital Information System (HIS)

6.5

Request for Proposal - Volume 1

Network / Connectivity

The proposed Network Connectivity between various hospitals of Haryana, as part of this
project is given in the diagram below:
Data Centre Site

10 Mbps (P&S)
DC Internet Router
MPLS LL
SWAN
DC Intranet Router

SWAN MPLS CLOUD 1


Primary Connectivity

Secondary
Broadband
Link

Internet

Secondary Connectivity
Broadband

Primary
Link
Primary Link
Primary
Link

Secondary
link

Primary Link
Secondary
Link

Online Patients

Legend

Sub-District
Medical College (4)
Hospital (10) Community Health
District Hospital (20)
Centres (11)

Primary Health
Centres (10)

Primary
Leased Line
Link
Secondary
Broadband
Link

The primary connectivity for all the hospitals connecting to the centralized application hosted at
Data Center in all the cases shall be through Haryana State Wide Area Network (SWAN). The
SWAN services in Haryana State are provided through BSNL. The primary connectivity shall be
provided using a dedicated MPLS leased line. The last mile connectivity to the hospital facility
from the SWAN point-of-presence (POP) in each district shall be provisioned by SWAN provider
in the State. This shall also include the end-user termination equipment and networking
components such as routers etc.
The IA is expected to build network level redundancy through broadband connection from a
different service provider. The network should have high availability switches. The network
should enable easy and effective operations and maintenance. The networking devices including
routers, switches shall be procured with sufficient number of ports for addressing the required
bandwidth. The router/switch may be chassis based with adequate number of free slots for
additional ports in the future.

Haryana State Health Resource Centre confidential

69

Implementation of Hospital Information System (HIS)

Request for Proposal - Volume 1

Hospital Network connectivity

S.
No

Network
Link

N1

N2

Locations/Connectivity

The Medical College, District


Hospital, Community Health
Centers and Primary Health
Center hospitals shall be
connected using a primary
connection of dedicated leased
line (MPLS) over SWAN.

Internet Connectivity for Data


Center through Internet
Gateway

Bandwidth Size
(Indicative)

Service
provisioning by

Primary MPLS leased


line links

Primary
connectivity
provided through
SWAN

Redundant
broadband links of 2
Mbps each for all
hospitals terminating
as a single
consolidated pipe at
DC.

DC Network, 10
Mbps Leased Line
link

Secondary
connectivity from
broadband service
provider for
redundancy , to be
provisioned by the
IA

SWAN

The above is an indicative bandwidth requirement for hospital connectivity, which will have to
be studied and finalized by the IA in consultation with HSHRC during SRS stage. The leased line
links for hospital locations shall be provided from primary (SWAN) and secondary sources
(provisioning to be facilitated by IA), as indicated in table above. These will be simultaneously
available for use. HSHRC reserves its right to make IA increase the bandwidth provided on
different network segments if the desired service quality is not being achieved because of any
limitation on account of bandwidth and IA will have to fulfill such a request within an agreed
timeframe.

6.6

Summary of proposed IT infrastructure at front end / client side

The physical space for workstations will be provided by the respective Hospitals at each location.
IA shall procure the entire infrastructure required at these locations. The no. of Hospital Users
(sanctioned staff strength)/ employees should be provided with PCs to cater to the requirements
of HIS and to achieve the complete automation status.
At each such location the following shall be carried out, but not limited to:

Haryana State Health Resource Centre confidential

70

Implementation of Hospital Information System (HIS)

Request for Proposal - Volume 1

1. Supply of hardware (servers at Medical Colleges and District Hospitals and desktop for
all hospital locations), software, networking equipments, UPS to all the location as per
the requirements
2. Installation, Testing and Commissioning of UPS
3. Physical Installation of Desktops, Multi Function Device, peripherals etc. as required
4. Operating System Installation and Configuration
5. Installation of Antivirus and other support software if any
6. Configuring the security at the desktops, switches and broadband connection routers
7. Network and browser Configuration
8. Test accessibility and functionality of HIS application from the desktops
9. Ensuring all the systems required are supplied, installed, configured, tested and
commissioned and declaring the site to be operational
10. Implement a Central Management policy for Hospital employees PCs to prevent Virus
attacks

The required number of PCs and other peripheral components is provided in Annexure 3 for
reference. These are indicative and should not be considered as exhaustive. The IA is required to
provide the exact details, as per requirement and based on detailed infrastructure survey.
It is proposed that the IA should make adequate provisions for making the entire Nodes
operational i.e. all additional infrastructure requirements should be covered in that without the
Hospital going into specifics of hardware and other networking components requirements. One
node will comprise of the PCs and all its accessories, like LAN connections, UPS facility, Internet
connectivity, power backup, etc. It is envisaged that this will also take care of any additional PC
over and above the stated PC requirement numbers in future.
The envisaged year on year growth for each location has been determined as 5%, all these users
will need to be provided Desktop as applicable and connected through LAN at each location and
WAN to the central HIS application at SDC. This has to be factored in the overall calculation by
the IA; however the procurement and installation should be done in phased manner as per
directions from DGHS/HSHRC.
The IA needs to conduct a detailed survey to assess the existing hardware and networking
components. While proposing the exact number of PCs and other auxiliary components, taking
into consideration the re-usage of existing hardware, the IA has to ensure that any device or
hardware component which is equal to or more than three years old has to be totally discarded.
All the devices and hardware components which are less than three years old need to be

Haryana State Health Resource Centre confidential

71

Implementation of Hospital Information System (HIS)

Request for Proposal - Volume 1

upgraded as required. All the devices and hardware components, which are less than one year
old and which are in perfect working condition needs to be accounted in the final sizing.
It is also proposed that the entire management of computer resources, licenses, support and
security software management, upgrades, etc. will be managed centrally. The IA needs to deploy
adequate mechanisms to monitor the usage of licensed applications / software and other related
computer resources remotely and should be able to dynamically manage the optimum utilization
of resources in consultation with HSHRC. E.g. if any particular user machine has been provided
with a licensed software which he doesnt need them as part of his daily routine work, then the
IA should be able to remotely remove the application suite and assign it to someone who needs
it as part of their job responsibility, hence saving on license cost.
It is a mandatory requirement that UPS should be installed at all locations as per required
power backup needs, taking into consideration the already exiting and operational UPS.
The IA needs to submit the completion certificate for all the installations done, as per
requirement of HSHRC

6.7

Site Preparation requirements

The IA is expected to prepare the client sites for setting up the necessary client site
infrastructure. Successful site preparation in all Hospitals of Haryana will be done as follows,
but not limited to:
1. Provision of Local area network (LAN cables, LAN ports,) etc.
2. Provision of interconnectivity between building blocks of the hospital (e.g. OFC, Wifi
etc.)
3. Ensure adequate power points in adequate numbers with proper power back up facility,
including UPS
4. Adequate earthing and electric cabling as required at each location / node
5. Minor Civil works required for the Server room and UPS room

The physical space / premises will be provided by the individual Hospitals at respective
locations. IA shall procure and establish the required infrastructure and setup the facility for
smooth functioning of the HIS at each location state-wide.

Haryana State Health Resource Centre confidential

72

Implementation of Hospital Information System (HIS)

Request for Proposal - Volume 1

7 O perational R equirements
7.1.

Performance Requirements

The number of users and approximate concurrency figures are given in section 5.4 of this RFP
volume. Actual requirement of users / module will be ascertained by IA during implementation.
1. The average application response time(s), application availability and other performance
parameters are given in the SLAs of Volume-III of this RFP.
2. The application software should be designed to cater to this load without any
degradation of performance as explained above.
3. The database schema and design should be capable of handling current and future loads.
4. System should be upwardly scalable in the event of increased usage of the system or new
business requirements.
5. The IA shall provide comprehensive report every month on the performance of the
server side infrastructure
6. HSHRC may with prior notice audit such measurements to their satisfaction.

7.2. Support Requirements


The IA shall provide Operation and maintenance (O&M) support to HSHRC for 5 years from the
date of complete Go-Live of the application. The O&M should continue till the end of the
contract i.e. for 5 years after successful implementation of the all the modules of HIS as
prescribed in the implementation schedule. The IA will provide on-site support post
implementation support for Five Years after acceptance of Phase-I Go-Live.
The support will address all user level queries, fixing bugs, enhancements, changes to
configurations, customizations, patch updates, upgrades, database administration, security etc.
During Post Go- Live support, the IA will conduct the Stabilization Test for the HIS solution as
defined in this document. The Operation & Maintenance of the Overall System Solution (including
but not limited to Hardware, System Software, Application Software and other Infrastructure) shall
be for a period of 5 Years from Phase-I Go-Live.
A. Operation & Maintenance of Application Software and infrastructure for a period of
5 years from Go-Live
1. Compliance to the Functional & Technical Requirements
2. Compliance to SLA

Haryana State Health Resource Centre confidential

73

Implementation of Hospital Information System (HIS)

Request for Proposal - Volume 1

3. Application Software Maintenance, Problem identification and Resolution


4. Software Change & Version Control as per industry standards
5. IT Infrastructure Operations and Maintenance as per Standards for a period of 5 years
from Go-Live.
6. Other infrastructure operations and maintenance in compliance to Service Level
specified in RFP for a period of 5 Years from Phase-I Go-Live

B. Ensure the following from OEM for the equipment supplied:


1. Commitment of support for spares and services for a period of 5 years from the date of
Supply from OEM
2. System administration and database administration of application for 5 years from GoLive
3. Customize and implement a proper SLA monitoring tool in consultation with Project
Operations Committee (POC) and Project Monitoring Unit (PMU) for SLA Monitoring
during O&M Phase
4. Provisioning of Application Software, Hardware, and Networking etc. for integration of
any intervention with application during Operation and Maintenance Phase

As part of Post-Implementation services, the Implementation Agency shall undertake the


following:
1. Annual Technical Support for Five years
a. For Application Software
b. For Application Server / Web Server
c. For Server Hardware Supplied under this project

At the end of each quarter during O & M phase:


1. Updated system design documents, specifications,
2. Latest source code, application deployment files, configuration files for entire solution
3. Updated user manuals, administration manuals, training manuals etc.

Haryana State Health Resource Centre confidential

74

Implementation of Hospital Information System (HIS)

Request for Proposal - Volume 1

7.3. Infrastructure Operations and Maintenance


The IA will provide 24x7 operation and maintenance services for the contract period. The scope
of the services for overall Physical and IT infrastructure management as per ITIL framework
during this period shall include 365x24x7 Monitoring, Maintenance, Operations and
Management of the entire Data Centre and DR site (once it is operational) along with providing
Helpdesk services.
The scope of work during the operations phase is divided into seven areas which are mentioned
below:
1. System Administration, Maintenance and Management Services
2. Network Management Services
3. Storage Administration and Management Services
4. IT Security Administration Services as per ISO 27001 and ISO 20000 compliance
5. Backup and Restoration Services
6. Physical Infrastructure Management and Maintenance Services

The physical infrastructure management and maintenance services shall include, but not limited
to, the following:
1. Proactive and reactive maintenance, repair and replacement of defective components (IT
and Non-IT/ Hardware and Software).
2. The IA shall have to stock and provide adequate onsite and offsite spare parts and spare
component to ensure that the uptime commitment as per SLA is met. To provide this
service it is important for the IA to have back to back arrangement with the OEMs. The
IA needs to provide a copy of the service level agreement signed with the respective
OEMs.
3. Component that is reported to be down on a given date should be either fully repaired or
replaced by temporary substitute (of equivalent configuration) within the time frame
indicated in the Service Level Agreement (SLA). In case the IA fails to meet the above
standards of maintenance, there will be a penalty as specified in the SLA.
4. The IA shall also maintain records of all maintenance of the system and shall maintain a
logbook on-site that may be inspected by State Authorities / HSHRC or any nominated
agency by HSHRC at any time during the contract period.

Haryana State Health Resource Centre confidential

75

Implementation of Hospital Information System (HIS)

Request for Proposal - Volume 1

Note: The IA shall provide the MIS reports for all the devices installed in the mini Data Centre,
DC and DR site, if operational, in a prescribed format and media as mutually agreed with
HSHRC on a periodic basis. Whenever required by HSHRC, IA should be able to provide
additional reports in a pre-specified format. These formats may be discussed and agreed at the
time of finalization of contract.

7.4. Warranty Support Services


As part of the warranty services it is proposed that the IA shall provide:
1. A comprehensive warranty support and on-site free service warranty for the entire
contract period from the date of Go Live. IA shall obtain the minimum of five year
product warranty and five year onsite free service warranty on all licensed software,
computer hardware and peripherals, networking and other equipment. IA shall also be
responsible for infrastructure maintenance of all the locations.
2. IA shall provide the comprehensive manufacturer's warranty in respect of proper design,
quality and workmanship of all hardware, equipment, accessories etc. covered in the
scope. IA must warrant all hardware, equipment, accessories, spare parts, and software
etc. procured and implemented against any manufacturing defects during the warranty
period.
3. IA shall provide the performance warranty in respect of performance of the installed
hardware and software to meet the performance requirements and service levels.
4. IA should upgrade Application Software/ any licensed software / Database to latest
versions of system software for application and database servers as required.
5. IA is responsible for sizing and procuring the necessary hardware and software licenses
as per the performance requirements. During the warranty period IA shall replace or
augment or procure higher-level new equipment or additional licenses at no additional
cost to the Hospitals in case the procured hardware or software is not adequate to meet
the service levels. All licenses are required to be procured in the name of the government
only.
6. Mean Time between Failures (MTBF) - If during contract period, any equipment
has a hardware failure on four or more occasions in a period of less than three months
or six times in a period of less than twelve months, it shall be replaced by equivalent or
higher-level new equipment by the IA at no cost to the Hospitals. For any delay in
making available the replacement and repaired equipments for inspection, delivery of
equipments or for commissioning of the systems or for acceptance tests / checks on per
site basis, State Authorities / HSHRC reserve the right to charge a penalty.
7. During the warranty period IA shall maintain the systems and repair / replace, at no
additional charge to the Hospitals, all defective components that are brought to the IA's
notice at the installed sites.
8. The IA shall as far as possible ensure that the equipment is repaired at site.
Haryana State Health Resource Centre confidential

76

Implementation of Hospital Information System (HIS)

Request for Proposal - Volume 1

9. Warranty should not become void, if Hospitals buys, any other supplemental hardware
from a third party and installs it within these machines under intimation to the IA. The
entire responsibility for providing onsite support and getting services from OEM for all
such procurements by the Hospitals will remain with IA.
10. The IA shall carry out Preventive Maintenance (PM), including cleaning of interior
and exterior, of all hardware and testing for virus etc., if any, and should maintain proper
records at each site for such PM. Failure to carry out such PM will be a breach of
warranty and the warranty period will be extended by the period of delay in PM.
11. IA shall monitor warranties to check adherence to preventive and repair maintenance
terms and conditions of all equipments and components.
12. The IA shall ensure that the warranty complies with the agreed Technical Standards,
Security Requirements, Operating Procedures, and Recovery Procedures, as defined by
Government.
13. IA shall have to stock and provide adequate onsite and offsite spare parts and
spare component to ensure that the uptime commitment as per SLA is met.
14. Any component that is reported to be down on a given date should be either fully
repaired or replaced by temporary substitute (of equivalent configuration) within the
time frame indicated in the Service Level Agreement (SLA).
15. The IA shall develop and maintain an inventory database to include the registered
hardware warranties.

7.5. Annual Maintenance Contract (AMC)


1. The IA shall monitor OEM warranties to check adherence to preventive and repair
maintenance terms and conditions.
2. The IA shall ensure repair and replacement of hardware after the problem has occurred.
The IA shall as far as possible repair the equipment

7.6. Manpower for IT Support at all project locations


It is proposed that atleast 1 resource should be deployed at each District Hospital and Medical
College, who will manage the support services at the district as well as all locations under it, as
and when needed. This resource should be supported by additional staff of atleast 9 resources
who would manage the IT support services, handholding, incident management, etc. at all
locations related to that district. This additional manpower of 9 resources should be deployed in
Phase 2 of the project. In subsequent phase of implementation the support manpower should

Haryana State Health Resource Centre confidential

77

Implementation of Hospital Information System (HIS)

Request for Proposal - Volume 1

increase to minimum of 55 resources including the one point contact at District hospitals and
Medical College.
Note: This is indicative manpower requirement to manage the IT support services at all
locations within the project scope. However the IA may suggest an appropriate model with
adequate resources deployed phase wise but not more than proposed manpower as stated
above at any given point of time.

7.7.

Helpdesk Support / Incident Management Services

The help desk service will serve as a single point of contact for all ICT related incidents,
information and service requests as well as grievance redressal. The service will provide a Single
Point of Contact (SPOC) and also resolution and tracking status of incidents.
The scope of work will include:
1. Facility for providing any kind of assistance to all internal as well as external Users
regarding general information related to healthcare services, facilities, timings, fees, etc,
along with information related to automated modules / workflow in the application,
interpretation of any errors, functionalities and usage, etc.
2. Facility for reporting issues / problems with the IT infrastructure.
3. Should operate from 8AM to 8PM on every business day i.e. 6 days a week; if necessary it
should be also available on Holidays as per prior information and demand. The term
Holiday would include all public / government holidays as well as weekends.
4. Should also operate during late hours on demand; if necessary. The term late hours
would mean time period of 8PM of current day to 8AM of the next day, on all working
days and Sundays.
5. To provide a service desk facility and to set up all necessary channels for reporting issues
to help desk. The incident reporting channels will be the following:
a. Specific E-Mail account
b. Toll Free Phone Numbers
c. HIS Web Portal / HIS Application
d. SMS (expandable feature)
6. To implement a call logging system in line with the severity levels as mentioned in the
SLA.

Haryana State Health Resource Centre confidential

78

Implementation of Hospital Information System (HIS)

Request for Proposal - Volume 1

The indicative call process is described below:

Supervisor

Helpdesk Executives

Toll free number, Web Portal,


Application,
e-Mail, SMS
Helpdesk Server

Hospital User

Patient

The Helpdesk is envisaged to undertake the following activities:


1. Log issues / complaints / Grievances related to Application, IT infrastructure, BioMedical Infrastructure, Data Centre, IT systems at client locations, grievances related to
services availability and quality etc., as under different categories and issue an ID
number against the issue / complaint / Grievance
2. Assign severity level to each issue / complaint / Grievance
3. Track each issue / complaint / Grievance to resolution
4. Escalate the issues / complaints / Grievances, to State Authorities if necessary as per the
escalation matrix defined in discussion with HSHRC.
5. Provide feedback and resolution to the callers.
6. Follow up on the collection of reports, revisit and recording general feedback /
complaints on the services provided in the hospital facility.

The services must be available in atleast two languages, viz. Hindi and English. A call at the
helpdesk will be defined as successful registration of the call and a complaint ticket is generated
in the system, or successful dissemination of information sought by a User. All calls will be
monitored as per the call logs generated from the system. It is also proposed that the issue /

Haryana State Health Resource Centre confidential

79

Implementation of Hospital Information System (HIS)

Request for Proposal - Volume 1

complaint / Grievance statistics should be analyzed and also a knowledge base, based on
frequently asked questions to aid the users, should be created in the long run.
Note: It is proposed that initially there will only be a Helpdesk counter at individual Hospitals,
with couple of parallel lines of Toll free number and an Operator. The operator will be
responsible for handling the calls, assisting the Patients who visit the operator in person,
providing general information on facilities, services, procedures, timings etc., and recording
the incidents / complaints / grievances in the system. Later on, the entire system will matured
to a centralized Helpdesk / Incident Management centre.
The resources for IT support and the Helpdesk / Incident Management services may be
responsible for both and Facility Management as well, to optimize the deployed manpower.
However the IA need to ascertain the exact requirement and model of operations for providing
adequate support services for these two categories.

7.8. Facility Management Services


Facility Management Services should be provided by the IA for all IT, non IT and other items /
services being used by Hospitals for 5 years with the following objectives and envisaged
outcomes that the IA has to ensure throughout the contract period:
1. Establish effective and efficient Infrastructure monitoring and management practices to
ensure reliability, availability, quality of services and security of the Information systems
2. Help Hospitals to focus on the core business activities, service delivery to citizens and
administration
3. Help Hospitals in freeing from the problems relating to overall administration,
infrastructure, resources, security as well as performance management
4. Exploit maximum benefit for the HIS out of the EMS tools being deployed, in terms of
reduced response time and productivity of the users and thereby utilizing the investment
for better services to the Hospitals
5. Incorporate/adhere the security guidelines issued by the State authorities / HSHRC
during the course of the contract
6. Ensure compliance to the audits and the observations of regulatory bodies
7. Ensure innovative use of available technology to effectively by improving response time
and productivity for the business of the Hospitals
8. Provide effective IT infrastructure, Applications support and management tools
9. Enhance reliability and security of Information Systems through centralized
management of IT Infrastructure adopting the necessary measures and practices like:

Haryana State Health Resource Centre confidential

80

Implementation of Hospital Information System (HIS)

Request for Proposal - Volume 1

a. Dynamic Scalability
b. Centralized and Simplified Management
c. Improved quality of Data storage and retrieval
d. No risk of data loss
e. Higher availability of systems and data - 24x7x365
f.

Better management of security and access control

g. Guaranteed Service Levels leading efficiency in processes and functions


h. Reduced administrative burden for the Hospitals by avoiding necessity of vendor
management, addressing the technical issues surrounding the IT Infrastructure
i.

Efficient and effective management of Information Security related Health care


issues across Haryana

j.

Availability of IT Infrastructure on Demand (Virtualization)

k. Aggregation and optimal Utilization of IT Infrastructure (Hardware, Storage,


Networking and Software) and Management Resources

Haryana State Health Resource Centre confidential

81

Implementation of Hospital Information System (HIS)

Request for Proposal - Volume 1

8 T raining R equirements
8.1. Training and Change Management Requirements
The IA shall provide training to the application users to efficiently use the system. IA shall
conduct training after implementation of the HIS Application and Training will be provided by
the selected IA to the Users within each Hospital / Health institution of Haryana.
The selected IA must assume the following responsibilities:
1. The IA shall provide training to the Hospital Administrators and workforce in two to
three batches per day for a specified duration / working days. However, the training days
can be revised by the Change Management Team or HSHRC, based on requirement.
2. It is proposed that the Hospital Users and Administrators would be divided in the
following groups:
Band

Users

Group 1

State and District Level Administrators, CMO, PMO, etc.

Group 2

Doctors, Nurses, Paramedics, and other Technicians / Departmental incharge, various operations staff of the Health institutions

Group 3

Operators, System Administrators, IT support staff, application and database


management teams, etc. that are part of hospital staff

3. The IA needs to conduct a Training Needs Analysis (TNA) and impart Training to the
Users as per Groups provided above, according to their needs and requirements. Based
on the TNA, a training curriculum will need to be evolved and proposed. The indicative
Training Modules and Training plan are enlisted below:
#

Training Module

Indicative number of Group


Days

Frequency / year

1.

Sensitization / Orientation

2 days

Once

2.

Basic Computing Training

2 days

Twice

Haryana State Health Resource Centre confidential

82

Implementation of Hospital Information System (HIS)

Request for Proposal - Volume 1

3.

Process Training

3 days

Once

4.

Specialized Computer /
Module Training

5 days

Twice

5.

HIS Application Training

2 days - Application

Quarterly

3-5 days - Specific


Modules

4. It would be the IAs responsibility to set up the entire Infrastructure helpful in providing
successful training to all Hospital staff and Health Administrators like, computer,
network, LCD projector, printed course material and Utility Software CDs( optional) etc.
5. The schedule and the training material such as audio-visual, self-based/ computer based
training for imparting training shall be developed by the IA in consultation with the
Change Management Team at HSHRC and proper correspondence and acceptance needs
to be taken from HSHRC also. The IA shall prepare the training material in consultative
mode
6. In case of modifications either in the Training Plans or substitutions of the regular
trainers, proper correspondence with the Change Management Team shall be made.
7. Training program shall be continuously monitored by the representatives of both the
Change Management Team and HSHRC so as to ensure quality standards of the
Training. It is the responsibility of the IA to prepare a feedback mechanism (i.e., printed
feedback forms) and get it filled by the participating batch and submits the same on a
regular basis to the Change Management Team.
8. The IA shall provide audio-video content based multimedia software as training
material. The IA shall install and train the application users using the same. It is the
responsibility of the IA to prepare documents including User manuals, technical
manuals, installation manual, and administration manuals, and provide the same to the
Change Management team. The Change Management team needs to provide the
necessary inputs for preparing the training material.
9. Reinforcement training is to be provided when applicable.
10. Evaluation of participants and effectiveness of training methodology must be proposed
and approved by nodal officer.
Note: The plan and proposal related to this section will be evaluated as part of bid
response.

Haryana State Health Resource Centre confidential

83

Implementation of Hospital Information System (HIS)

Request for Proposal - Volume 1

9 P roject P lan And D eliverables


In order to overcome the critical issues, impairing the functioning of Hospitals during the
project implementation, it is proposed that HSHRC, Government of Haryana, would appoint a
Single Point Contact Agency, which would be responsible for handling all the hardware,
software, networking, logistics, Helpdesk support and any other requirement as per stated
scope, on turnkey basis, for the entire tenure of contract. A contract agreement clearly defining
the scope of work and other terms of engagement should be finalized and signed by all
concerned stakeholders.

9.1.

Implementation Schedule

Following is the indicative timeline for different phases proposed for the IA to carry out
implementation activities. The timelines are calculated from the time of award of contract.
1. Phase 1: Phase 1 will include implementation of HIS in DC along with 1 District
Hospital (Panchkula), including one attached hospitals within the district namely 1 CHC
and 1 PHC. Additionally 1 Medical College is also proposed to be implemented during the
pilot phase. The implementation is proposed to be completed in 6 months time with
stabilization period of 3 months. Total implementation time - T to T + 9 + 3 = T + 12
months
2. Phase 2: Phase 2 will include implementation of HIS in 6 District Hospitals, , including
all the remaining attached hospitals within the pilot district Hospital (Panchkula)
namely 1 CHC and 9 PHCs. In addition, 2 other Medical colleges are also proposed to be
implemented during this phase. The implementation is proposed to be completed in 6
months time. Total implementation time - T + 12 to T + 18 = T + 18 months
3. Phase 3: Phase 3 will include implementation of HIS in rest of the 13 District Hospitals,
and 1 Medical college. This phase will also include rest of the First Referral Units (FRUs)
which have not been covered in above two phases. Please refer to Annexure 4 for the list
of FRUs covered under the project scope. The implementation is proposed to be
completed in 6 months time. Total implementation time - T + 18 to T + 24 = T + 24
months

Note: HSHRC may expand the gamut of services and include other modules as well. However
the final decision will be taken later on and currently they are not included in the scope of
work for the IA. All decisions taken by HSHRC will be final and binding on all parties.
Various activities within each phase of the project implementation cycle are also envisaged. It is
proposed that the IA should conduct a thorough assessment of the requirements, existing

Haryana State Health Resource Centre confidential

84

Implementation of Hospital Information System (HIS)

Request for Proposal - Volume 1

infrastructure, and site preparation requirements at the start of each phase. The reports should
be submitted to HSHRC for review and approval, which will form the milestones for that phase.
It must be noted that these are only indicative timelines and milestones, and the IA is expected
to submit a detailed project plan and resource allocation plan to HSHRC at the time of award of
contract, without which the contract agreement will not be considered as valid.
The tentative timelines and deliverables for the pilot phase are listed below:
Activity

Timelines
(Weeks)

Deliverables

Stage I Design and Development


Project Initiation and
Team Mobilization

Inception Report including Detailed Project


Plan, Detailed Resource Profile and Resource
allocation plan. Also deployment of Project
Management Tool

Requirements Analysis
and Design

T + 10

System Design Report, Technical Design


Document, Software Requirement Specifications
Report

Development and Coding

T + 28

Architecture and DB design Report, Deployment


Plan

Testing and UAT

T + 36

Test Data, Test Reports, UAT Sign-off Certificate

Stage II Commissioning and Go-Live


Site preparation
requirements and plan

T+8

Site preparation plan and design, Bill of Material

Procurement, Installation
of Hardware and
Networking components

T + 24

Procurement Reports, Invoices and related


warranty information

Application Training and


Handholding Support

T + 28

Training and Change Management report,


Training Schedule / Plan, Satisfactory Training
Completion Feedback Report

Commissioning and Go-

T + 36

Certificate of successful commissioning

Haryana State Health Resource Centre confidential

85

Implementation of Hospital Information System (HIS)

Activity

Request for Proposal - Volume 1

Timelines
(Weeks)

Deliverables

T + 48

Logs, Issue tracker, Deployment logs

Live
Stabilization period

Stage III Operations, Maintenance and Warranty Support for 5 years


Operations, Maintenance
and Warranty support for
period of 5 years

5 years after
48 weeks i.e.
Go-Live

Monitoring Framework, Escalation Reports,


MIS reports with details of Operations,
Maintenance / Support / Warranty Activities
carried out.

Note: The percentage payment for completion of any milestone will only be released to the IA
if the deliverable has been duly accepted and signed-off by HSHRC. The IA must ensure that
the deliverables mentioned above are completed as per industry defined quality standards for
smooth sign-off process on completion of each milestone.
The tentative timelines and deliverables for the 2nd phase are listed below:
Activity

Timelines
(Weeks)

Deliverables

Stage I Design and Development


Phase Initiation and Team
Mobilization

T + 48

Detailed Project Plan, Detailed Resource Profile


and Resource allocation plan

Requirements for
phase wise
functionality

T + 50 (3
Months)

Requirement gathering for phase wise


functionality

Configuration &
customization

T + 50 (3
Months)

Configuration and customization

Testing and UAT

T + 62 (3
Months)

Test Data, Test Reports, UAT Sign-off Certificate

Stage II Commissioning and Go-Live

Haryana State Health Resource Centre confidential

86

Implementation of Hospital Information System (HIS)

Request for Proposal - Volume 1

Activity

Timelines
(Weeks)

Deliverables

Site preparation
requirements and plan

T + 60 (2.5
Months)

Site preparation plan and design, Bill of Material

Procurement, Installation
of Hardware and
Networking components

T + 68 (2
Months)

Procurement Reports, Invoices and related


warranty information

Application Training and


Handholding Support

T + 68 (2
Months)

Training and Change Management report,


Training Schedule / Plan, Satisfactory Training
Completion Feedback Report

Commissioning and GoLive

T + 76 (2
Months)

Certificate of successful commissioning

Stage III Operations, Maintenance and Warranty Support


Operations, Maintenance
and Warranty support

4.5 years after


76 weeks i.e.
Go-Live

Monitoring Framework, Escalation Reports,


MIS reports with details of Operations,
Maintenance / Support / Warranty Activities
carried out.

The third phase will follow the similar schedule as mentioned above for phase 2
Note:
1. The bidder is expected to propose and detail out an implementation plan in its technical
proposal according to the tentative timelines and deliverables as mentioned in the
table above.
2. The percentage payment for completion of any milestone will only be released to the IA
if the deliverable has been duly accepted and signed-off by HSHRC. The IA must ensure
that the deliverables mentioned above are completed as per industry defined quality
standards for smooth sign-off process on completion of each milestone.
3. The exit management exercise should be initiated at the beginning of the last year of
Contract expiration and the future option for project continuity should be in place by
the end of last year 0f contract expiration. This will involve the complete Handover and
Takeover activities.

Haryana State Health Resource Centre confidential

87

Implementation of Hospital Information System (HIS)

Request for Proposal - Volume 1

9.2. Institutional Mechanism for Project Review and Monitoring


The project would require a close supervision and appropriate project control for successfully
meeting the objectives and its timely completion. It is proposed that a Project Monitoring Unit
/ Team should be established for the entire duration of the project, from the time of award of
contract to the IA.
The proposed institutional mechanism for the Project Review and Monitoring is shown below
for reference:
High Level Committee / Steering
Committee
Hospitals / CHCs / PHCs

Project Management
Team (HSHRC)

Strategy / Operations
Committee

PMO / MS

Feedback and
Directions

Hospital Project
implementation team

Feedback

Quality/Impact
Assessment

Project Manager

Project status, reports,


tasks, schedules, ATR etc

Components/Delivery
Team

Proposed Roles and Responsibilities


Indicated below are some of the key functions and roles for different components of the
proposed governance structure:
1. High Level Committee / Steering Committee: A high-powered committee
preferably headed by the Secretary (Health Department, GoH) and senior officials of the
Health Department and HSHRC, etc. This would provide a required level of advocacy for
the HIS project and also set directions which are acceptable to all stakeholders. The role
of this steering committee would be to provide strategic direction to the project.
2. Strategy / Oversight for HIS project, Operations Committee: A state level
consultant / group would form this component and would provide feedback and
directions to the Project Management Team, as per strategic directions from the
Haryana State Health Resource Centre confidential

88

Implementation of Hospital Information System (HIS)

Request for Proposal - Volume 1

steering committee, and aid in providing required level of advocacy for the HIS project
and also set directions which are acceptable to all stakeholders. It may include private
and industry participation as well, based on requirement.
3. HSHRC Project Management Team: A group of resources specializing in different
domain like project management, finance, database administration, application design
and development, as well networking and hardware should form a team having the
overall responsibility of HIS project. It would be the nerve centre of the proposed
institutional framework, and will also be responsible for coordinating efforts of various
agencies / organizations, involved in HIS project implementation. This will be PMU;
including representatives from HSHRC and risk management will one of the core
responsibilities of this team.
4. Hospitals / CHCs / PHCs: These will be the actual owner of the processes and
functions covered under HIS system, and will be responsible for constituting the project
teams headed by the PMO or MS. The PMO / MS of the concerned healthcare institution
will be the final deciding authority and own of the processes / functions under the scope
of this project.
Also, there will be Hospital Project Implementation teams which will be the single point
responsibility centre to implement the project in line with the strategic directions and
approvals from Project Management Unit / Team. This will be headed by the team leader
(SPOC) for all conceptualization, design and implementation purposes within their
Hospital premises. This is proposed for all individual Hospitals / Health institutions
during pilot phase as well as during the state wide rollout.
5. Project Manager: They will serve as a single-point contact within the institutional
framework for the purpose of project monitoring / reporting purposes and may be
deployed by the selected IA. They will be responsible for all the activities within the
project and will report to Project Management Unit / Team in coordination with the
team from Health institutions. They will be directly responsible for providing periodic
project statuses, tasks schedule and Action Taken Reports (ATRs).
6. Components / Delivery Team: They will be delivery team from IA / other
components / Agencies which will provide assistance in select areas of the HIS
implementation phase and may also constitute of various other teams within Hospitals
or outside.

It is also proposed that Quality Assessment / Audit will be conducted by any nominated agency
by HSHRC, and will be responsible for providing feedback to the PMU at a predefined
frequency.

Haryana State Health Resource Centre confidential

89

Implementation of Hospital Information System (HIS)

Request for Proposal - Volume 1

9.3. Risk Management


Risk is an important element of any project. It provides an estimate of the magnitude of the
unexpected outcomes (the surprise factor) on the project. A project management methodology is
not complete without a forward looking risk management component. This aspect of Project
Management runs through all the phases of the Project implementation. All processes are
monitored continuously for adherence to quality and any risks or deviations are immediately
attended to and rectified. Some of the main objectives of this aspect of project management in
case of HIS project will be:
1. Identification of high, medium and low risk areas and pain points
2. Identification of Risk Mitigation Methods and implementation plans
3. Tracking, monitoring and reporting risks to previously defined authorities
4. Implementation of alternate strategies at appropriate times
5. Observance of all Quality aspects including documentation, process control and strict
adherence to Service Level Agreements (SLAs).
6. Implementation of alternate strategies at appropriate times

For this project a simple yet very effective risk management approach is being proposed. There
will be a periodic review of the risk management component, which will be evaluated jointly
with HSHRC and Project Management Team, and a recommendation will be presented for the
way forward. The risk management program will require the project management team to report
their top risks looking forward and propose a response to proactively deal with them. This
approach is the simplest way to direct the project delivery team to elevate themselves above the
day -to-day issues and past performance. The following format will be used for this purpose:
S.
No.

Risk
Scenario

Impact
Impact
on
on Cost
Duration

Corrective
Action

Haryana State Health Resource Centre confidential

Responsibility
Center

Completion
Date

Status

90

Implementation of Hospital Information System (HIS)

Request for Proposal - Volume 1

Owing to the nature of the project and the far-reaching consequences that it has in functioning
of District Hospitals, other Health institutions as well as on external interactions, risks
associated with delays and those relating to change management issues are envisaged.
IA shall adopt suitable Risk Management methodology to mitigate all risks envisaged under the
contract. IA shall underwrite all the risk related to its personnel deputed under this contract as
well as equipment and components of the HIS application, equipment, tools and any other
belongings of the IA during the entire period of their engagement in connection with this
contract and take all essential necessary steps to reduce and mitigate the risks.
Following are the key risks envisaged for the pilot HIS implementation:
S. No.

Major Risk Areas

Mitigation Strategy Proposed

Involvement and time of SPOC Project / SPOC must be available on daily/need


identified
by
Hospital basis to discuss various issues and resolution
Administration and District thereof.
Administration.

Transfer of state / district From experience in previous projects it is


officials and / or key decision observed that projects get affected if core
officials / decision makers are transferred
makers involved in the project
midway in the project. A suitable policy,
mechanism to overcome such problems till the
completion of the project would need to be
considered and finalized by HSHRC.

Project schedule over run

Due to administrative, delays in application


development or other reasons project could over
run actual schedule. Regular monitoring and
timely corrective action by project management
team aided by fast decision making by the
steering committee can overcome such issues.

Resistance from Hospital staff


members / actual users of
concerned district hospitals and
other Health institutions

Hospital staff members must be motivated to


understand the value of change and need of
automation through change management
programmes, along with taking up measures to
increase awareness about the new system.

Lack
of
equipment/IT Required IT infrastructure must be in place at
infrastructure in terms of the time of actual implementation of the project.
hardware
and
software

Haryana State Health Resource Centre confidential

91

Implementation of Hospital Information System (HIS)

S. No.

Request for Proposal - Volume 1

Major Risk Areas

Mitigation Strategy Proposed

availability

Application Software requirements to be frozen


jointly by state level committee and pilot
Hospital implementation teams along with IA
technical team and Project Management team.
This would ensure same version of application
software running throughout the state, after
successful pilot.

Actual Users / Hospital staff Actual Users / Hospital staff members must be
members
not
taken
into taken into confidence, as he/she is the actual
confidence
source of information and actual user of the
System.

Haryana State Health Resource Centre confidential

92

Implementation of Hospital Information System (HIS)

Request for Proposal - Volume 1

ANNEXURE:- 1- FUNCTIONAL REQUIREMENT SPECIFICATIONS


*Note:- A = Feature Available (Yes/No)
B = Configurable (Yes/No)
C = Extend of customization [High (H), Medium (M), Low (L), New
Development (ND)]
Annexure - 1 :- Functional Requirement Specifications
A detailed report on Functional Specifications for the key
modules and functionalities is mentioned below.
1

HIS Web Portal

1.2

Static Web Content :- The static information of the web


portal may include the following but not limited to:

1.2.1

1.2.3

Information about the Medical Colleges, District Hospitals,


Sub-District Hospitals, CHCs, PHCs, Doctors / Specialists, their
availability, hospital timings, contacts information, etc.
Information about Services available (OPD / IPD services,
immunization, health Check-ups, government schemes, etc. as
well as applicable fees
Healthcare News and Events

1.2.4

RTI details (based on access rights provided)

1.2.5

Frequently asked Questions

1.2.6

Key initiatives / projects initiated / completed by the Health


department and / Government of Haryana in Health sector

1.2.7

Photo Gallery / Video gallery

1.2.8

From Health Ministers / Health Secretarys Desk, Messages


from the Health department / HSHRC

1.2.9

Tenders and related information

1.2.10

Site Map

1.2.11

Information Desk / Helpdesk and other contact details

1.2.2

Haryana State Health Resource Centre confidential

93

Implementation of Hospital Information System (HIS)

Request for Proposal - Volume 1

1.2.12

Annexure - 1 :- Functional Requirement Specifications


Quick links to external applications / sites, as applicable

Public Reports / Statistics

2.1

There are certain reports / information / statistics which


needs to be regularly published on the Web Portal for general
public viewing and consumption. These reports / information
/ statistics must be automatically updated on the portal as and
when they are approved by the concerned authorized official
through the system. This functionality should be linked to
Content Management module of the HIS core application,
where the authorized user, with adequate rights (granted
through Admin module) may verify the reports / information
/ statistics and submit for publishing. The reports however
must be automatically generated and available for verification
to the concerned authorized official. The selected IA needs to
develop the required functionality in discussion with the
HSHRC
officials.
Note: The web portal features should be enabled in Phase 2, as
per defined implementation plan.
HIS Core Application - Functional Components

3.1

Information Components

3.1.1

System should allow only authorized personnel to manage the


information available through various channels, related to
services, facilities, doctors, specialties, etc. over the web portal
and display units
System should display at least the following, but not limited
to:

3.1.2

a.
Hospital name, type of Health care facility and
location details
b.

Services provided and the timings

c.

Doctors / specialists available and timings

d.

Overall process / visual depiction of key steps

Haryana State Health Resource Centre confidential

94

Implementation of Hospital Information System (HIS)

Request for Proposal - Volume 1

Annexure - 1 :- Functional Requirement Specifications


e.
Applicable fees if any, and exempted categories
f.

Complaints / Grievance redressal

g.

Helpdesk information

3.1.3

System should allow only authorized User to dynamically add,


edit, modify the content and publish them in real time

3.1.4

System should have different presentation layer for each set of


users i.e. Information seekers, updaters, approvers, etc.

3.1.5

System should allow the administrator to either allow or


reject the information update. In case of rejection, the system
should necessarily capture the reason for rejection
System should send intimations to administrators once the
information is uploaded on the Web Portal / Display Units

3.1.6
3.2

Search Component

3.2.1

The system should allow search on Unique ID and / or Bar


code through an attached Bar code scanner as first preference

3.2.2

The system should allow search on basic demographic


information like name, mobile number, fathers name,
address, etc. as second preference
The system should also allow search on IDs issued by
government, like Aadhar number, Voter ID, Ration Card, BPL
number, etc. as third preference
The system should allow for free text search with a
combination of other parameters, like last visit date, couple of
first or last digits from Patients Unique ID, department visited,
etc.
The system should display the names of the registered
patients if any of the above criteria matches. The system
should allow to sort and select the existing record if the
patient is already registered
Payment Component

3.2.3
3.2.4

3.2.5

3.3
3.3.1

The system should allow capture of financial transaction


details

Haryana State Health Resource Centre confidential

95

Implementation of Hospital Information System (HIS)

3.3.2

Request for Proposal - Volume 1

Annexure - 1 :- Functional Requirement Specifications


1. The system should allow payment to be registered on the
service application request against the following:
a.

Payment against the service

b. Payment against the dues / payments as defined under


service charter for the specific service
3.3.3
3.3.4
3.3.5
3.3.6
3.3.7
3.3.8
3.3.9

The system should record and maintain all payment details


against a unique service application number / invoice number
and mapped to Patients Unique ID
The system should be able to maintain all the payment
records in a database and retrieve the same as and when
required
The system should be able to maintain all records of part
payments as well as consolidated payment amounts against a
service request
The system should be able to display and enable recording of
successful payment, at the same time display the failure
message in case of unsuccessful transaction
The system should generate a receipt against the payment and
should allow printing of the payment receipt / invoice
The system should facilitate automatic updation of the
information on the Patients record on successful payments
made
The system should provide all application, data and database
security as prescribed by GoI

3.3.10

The system should follow predefined payment rules and


regulation as defined from time to time in the HIS

3.3.11

The system should be able to SMS and / or emails


confirmation on the registered mobile / email ID with details
of the payments made
The system should be compatible for easy integration either
with standard accounting and financial application, or inbuilt
at a later stage with the HIS interface
Interface Component

3.3.12
3.4
3.4.1

The system should maintain the record for complete data


exchange to and from the HIS

3.4.2

The system should be able to Push or Pull the information


through an API based integration as defined in the RFP

Haryana State Health Resource Centre confidential

96

Implementation of Hospital Information System (HIS)

3.4.3
3.4.4
3.4.5
3.4.6

3.4.7
4
4.1

Request for Proposal - Volume 1

Annexure - 1 :- Functional Requirement Specifications


The system should allow sharing of defined data sets in
electronic format, with any of the existing and future external
systems
The system should display error message in case of
unsuccessful transmission, or confirmation message in case of
successful transmission
The system should enable generation and printing of a
physical record, in a defined format, if external system is not
available i.e. the process has to be carried out manually
The system should allow uploading of scanned documents,
with data entry of basic indexing parameters in case the
interfacing is manual, using Document Management
functionality in the system
The system should allow search / advanced search on the
indexed parameters to view the data / information exchange,
using Document Management functionality in the system
Registration

The system should allow the Registration desk operator to


enter following demographic details of the Patient, but not
limited to:
a. Name
b. Age
c. Sex
d. Address
e. Mobile / contact number
f. ID proof

4.2

The system should generate a Unique Patient ID upon


successful registration, valid for seeking any healthcare
services across any health care institution across state of
Haryana. The proposed sequence should be arrived upon in
consultation with the department . It may be noted it will a
onetime exercise and should be searchable during subsequent
visits of the patient so as to avoid creation of multiple IDs for
the same patient. The system should allow the operator to
search for existing registration record based on search
parameters, as defined in the Search component.

Haryana State Health Resource Centre confidential

97

Implementation of Hospital Information System (HIS)

4.3

4.4

4.5

4.6

4.7

4.8

Request for Proposal - Volume 1

Annexure - 1 :- Functional Requirement Specifications


The system should allow for pre-registration online (HIS Web
Portal). It is proposed the pre-registration screen would be
made available on Web, and upon filling of required
demographic details by the Patient / Relative, a unique
temporary pre-registration number should be assigned. The
form should be automatically forwarded to the Registration
desk operator, and the system should allow search of the
registration record using unique pre-registration number.
Once registration is complete at the Registration desk, and
generation of Unique ID for the Patient, the temporary preregistration number should be invalid.
The system should indicate if the Patient is liable to pay any
fees for availing any healthcare services, based on defined
criteria for exemption. The exemptions should be a
parameterized and integrated harmoniously in the system. In
case, deletion of exemption/ updating is required, system
should have provision for updating.
The system should display the available registration details /
Patient registration information already existing in the
database when any of the above parameters matches, during
the registration of the Patients.
The system should also allow the Registration desk operator
to select the relevant OPD doctor and specialty as per the
defined roster available for the day. The system should assist
the operator in suggesting an equal distribution of the Patient
queue for all doctors in the same OPD. The system should
have the feature of auto-scheduling and over-ride
The system should automatically generate the Token number
specific to the concerned OPD. This token number should be
tracked throughout different departments / sections of the
Hospital for the visit. This display systems installed within the
Hospital premises should display the Token number and the
sequence for all Patients to see where such facility is available.
The system should be able to print the registration receipt on
a sticker which can be attached to the pre-printed OPD card.
The registration receipt is proposed to have the following
information, but not limited to:
a. Bar Code (generated as per Unique ID)

b. Unique ID (having State, District, Year, and random unique


system generated number)
c. Payment Information {in case of exempted patients, the
payment mentioned will be Zero (0)}

Haryana State Health Resource Centre confidential

98

Implementation of Hospital Information System (HIS)

Request for Proposal - Volume 1

Annexure - 1 :- Functional Requirement Specifications


d. Date and Time Stamp

e. Token Number
f. Any other relevant information, as applicable
4.9
4.9

In case of Emergency Registration the system should


generate bar-coded wrist tags with unique ID, which can be
attached to the Patient, based on defined categories.
The system should have features to scan the barcode and link
the demographic as well as preliminary treatment details to
the Patient ID. Rest of the search and registration features
should remain as described above.
Help Desk

5.1

The system should display the tariff of all investigation and


procedures available in the hospital

5.2

The system should have the provision to add/update any


feedback/grievance reported by patient/relative

5.3

OPD Doctor schedule view

5.4

Categorization of patients as per doctors availability to reduce


queuing and waiting time
Faster Search facility for registered patients

5.5
6
6.1
6.2
7
7.1
7.2

Billing
Consolidated billing for all the outpatient services. The system
should allow the operator to collect applicable fee, as defined
in the Payment component
Automatic receipt generation
OPD
The system should allow configuration of maximum number
of patients to be assigned to a particular OPD doctor in a
particular shift.
The system should allow patient registration record to be
automatically forwarded to the dashboard of the concerned
OPD doctor. The Patients should be queued in chronological
sequence with facility to override as per token for exception
cases.
Haryana State Health Resource Centre confidential

99

Implementation of Hospital Information System (HIS)

7.3
7.4

7.5

7.6
7.7

7.8
7.9

7.10

Request for Proposal - Volume 1

Annexure - 1 :- Functional Requirement Specifications


On selections of the Patient registration record, the system
should display his / her token number on the display unit, and
at least next 2 in sequence.
The system should allow the OPD doctor to select the relevant
section on the screen for entering diagnosis, treatment,
investigation, minor procedures, drugs, referrals, etc.
whichever applicable.
The system should provide options to the OPD doctors
dashboard, like viewing past treatment details, investigation
results, any allergies / health conditions, etc. if the doctor
requires. The doctor should be able to view the required
information with single click
It is proposed that the system should have interfacing /
integration capability for the use of Digital Pen / Digital Pads
by the OPD doctors at a future date.
In case of Radiology investigations, the system should display
the available slots for getting the required test done. The
concerned doctor / operator should be able to select the
available slot and provide the sequence at the radiology
department
The system should automatically forward the relevant
sections of the above form, to concerned departments, for
further action on the Patients case.
The system should provide the pre-defined list of
investigation, minor procedures, drugs, etc. with easy select
options at the billing counter dashboard. The details once
entered by the operator, the details should be automatically
forwarded and queued to the respective departments
dashboard. The respective operator at the concerned
departments can search the Patients record by either scanning
the barcode or through unique ID, and then proceed with
required process.
Health records of the patients should be captured and collated
through various touch points in the hospital electronically,
after patient visits the OPD. These records may be pharmacy
store for dispensing medicines, labs for investigations,
radiology for X-ray/ ultrasound etc., injection room for
administering an injection and/ or any minor OT procedure.
System should allow entry of treatment details by the data
entry operators present at the respective functional units, as
per the advice mentioned in the OPD card.

Haryana State Health Resource Centre confidential

100

Implementation of Hospital Information System (HIS)

7.11

7.12

7.13

7.14
7.15
7.16
8
8.1

Request for Proposal - Volume 1

Annexure - 1 :- Functional Requirement Specifications


The system should allow concerned doctors to mark the
investigations, procedures, drugs, injections, etc. as
Emergency, so that these Patients will be sequenced on
priority at respective department.
The system should allow for requesting ambulance services
for referral cases, through user friendly select options. The
system should automatically forward these requests to the
Ambulance services operator dashboard for further action.
In case of admissions, the system should automatically
forward the request to Admission counter dashboard, with the
registration details, and any other relevant information
captured in the system.
In case of surgery, the Patient details should be forwarded to
OT scheduler screen. The system should allow the respective
operator to allocate a slot for surgery.
In Emergency cases, the system should automatically forward
the intimation to Emergency department, with required
Patient details, as captured in the system.
In the third phase Computerized doctor orders (Laboratory
and Radiology)

8.2
8.3

Inventory Management of life saving drugs

8.4

Categorization of Patients as per type of emergency / Disaster


case
Faster capture and retrieval of triage / treatment details

8.6
8.7

Emergency
The system should allow patient categorization and
registration through the use of bar coded wrist tags. The
system should have the facility to later fill up the demographic
as well as emergency Triage assessments
Post treatment standardized registration process

8.5

Seamless and automatic flow of Patient clinical details to


various dept.
The system should allow the operator to enter the preliminary
treatment details given by the Emergency doctors, through
user-friendly select options as far as possible.

Haryana State Health Resource Centre confidential

101

Implementation of Hospital Information System (HIS)

8.8

8.9

8.10

8.11
8.12

8.13

8.14

Request for Proposal - Volume 1

Annexure - 1 :- Functional Requirement Specifications


In case of Medico-Legal case, the system should display a predefined checklist for the operator to complete the MLC
formalities. The system should allow the operator to capture
the status of the MLC formalities. The system should
automatically generate the Medico-Legal report in a predefined format, with the information captured in the system.
Tracking and tagging brought dead/ MLC and referral cases
The system should allow for requesting ambulance services
for referral cases, through user friendly select options. The
system should automatically forward these requests to the
Ambulance services operator dashboard for further action.
In case of admissions, the system should automatically
forward the request to Admission counter dashboard, with the
registration details, and any other relevant information
captured in the system.
In case of surgery, the Patient details should be forwarded to
OT scheduler screen. The system should allow the respective
operator to allocate a slot for surgery.
In case of death of the Patient, the intimation should be
forwarded to the concerned operator assigned for generating
and providing Death certificates. The system should
automatically generate the Death Certificate using the data
entered in the system, in a pre-defined format and forward it
for approval to concerned doctors. Once approved, system
should allow for printing and issuing, and capture the status of
the same. There is already a system implemented for
generating the Death Certificate. It is proposed that the HIS
system may forward the information / data related to death of
a Patient, to the existing system using the Interface
Component, if integration of HIS with the existing system is
possible. The existing system may continue to generate the
Death Certificate as per current process.
In case the Patient is referred from IPD or Labor room, the
system should automatically forward the Patient record in
Emergency department / EMO dashboard. In case of OPD
Patients, the system should allow unique ID search, as
described in the Search component
In case specialist consultation is required; the system should
allow selection of concerned specialist, and send the
intimation to his / her dashboard as well as through SMS.
System should have provision of Cross-consultation

Haryana State Health Resource Centre confidential

102

Implementation of Hospital Information System (HIS)

8.15

8.16

8.17
8.18

8.19

8.20

8.21

Request for Proposal - Volume 1

Annexure - 1 :- Functional Requirement Specifications


The system should provide other options to the EMOs
dashboard, like viewing past treatment details, investigation
results, any allergies / health conditions, etc. if the doctor
requires. The doctor should be able to view the required
information with single click
The system should allow the EMO / Operator to select the
relevant section on the screen for entering diagnosis,
treatment, investigation, minor procedures, drugs, Blood,
referrals, etc.
The system should automatically forward the relevant
sections of the above form, to concerned departments, for
further action on the Patients case.
Health records of the patients should be captured and collated
through various touch points in the hospital electronically,
after patient visits the Emergency. These records may be
pharmacy store for dispensing medicines, labs for
investigations, radiology for X-ray/ ultrasound etc., injection
room for administering an injection and/ or any minor OT
procedure. System should allow entry of treatment details by
the operators present at the respective functional units, as per
the advice of EMO, if that is the procedure adopted by Hospital
administrators.
The system should allow concerned doctor to mark the
investigations, procedures, drugs, injections, etc. as
Emergency, so that these Patients will be sequenced on
priority at respective department.
In cases of Discharge on Request (DOR)/ Left Against Medical
Advice (LAMA) the system should allow status to be captured
in the system. The system should generate the reports,
including Discharge Summary in a printable pre-defined
format.i.e. there should be Standardization in generating
discharge summary and follow-up instructions / discharge on
Request / Left against Medical Advice
If a Patient visits Emergency, after normal OPD hours, the OPD
procedure will follow, as stated above. However the
registration and the billing will happen at the Emergency
section only. The system should allow for registration, billing
and tracking of such Patients, after normal OPD hrs.
IPD (Admission, Discharge and transfer)

Haryana State Health Resource Centre confidential

103

Implementation of Hospital Information System (HIS)

Request for Proposal - Volume 1

Annexure - 1 :- Functional Requirement Specifications


The ADT module should ensure that process of admission,
transfer and discharge of patients takes place. It also ensures
that there is proper tracking of patient status, ward
management and bed management. The system should also
have the provision to mark the patient as vulnerable.
The process of admission should ensure verification of
registration, patients consent for admission, capture
admission details, view availability of wards, beds and rooms,
provision to assign beds and print admission and occupancy
report.
The system should display the packages under which Patient
needs to be admitted. The details of the package and
corresponding requirements should automatically be
displayed by the system to the operator / nurse.

9.1

9.2

9.3

9.4

The system should allow mapping of patients to IPD doctors /


specialist in a particular ward.
The system should generate inpatient/ admission ID upon
successful admission of patient in the system. The system
should be able to generate the bar-coded wrist tag, PrePrinted Wrist Tag once the Patient is admitted. The system
should be able to retrieve the Patient record once the barcoded wrist tag is scanned.
Bed Allocation: The system should allow the Nurse at the
nursing station to allocate bed in the concerned ward to the
admitted patients. The system should display the status of the
beds in all the wards in real time.

9.5

9.6

9.7

Transfer can be between beds in same ward or between


wards or between departments or between departments but
on the same bed.
The system will allow the reception clerk to look up the list of
available beds and transfer the patient to a suitable bed

9.8
9.9

The system should keep record of the temporary transfer of


patient to various departments like OT, radiology, etc

10

IPD (Wards Management)

10.1

The system should allow the IPD doctor / Nurse to select the
relevant section on the screen for entering diagnosis,
treatment, investigation, minor procedures, diet, drugs,
referrals, blood requisition, etc. at the Nursing station. The
system should have interfacing / integration capability for the
use of handheld devices by the IPD doctors.

Haryana State Health Resource Centre confidential

104

Implementation of Hospital Information System (HIS)

10.2
10.3
10.4

10.5
10.6

Request for Proposal - Volume 1

Annexure - 1 :- Functional Requirement Specifications


The templates / formats for generating doctor and Nursing
orders should be available in the system for easy selection and
usage by the concerned user.
The system should automatically forward the relevant
sections of the above form, to concerned departments, for
further action on the Patients case.
The system should intimate all the concerned departments /
users in case doctor decides to discharge the Patient. The
intimations should also display the pending tasks for
clearance to all concerned.
Also the doctors will have the facility to define the Emergency
requests, which will be given priority in sequence.

10.7

Upon receiving clearance from all concerned, the system


should allow the Nurse / operator to generate the Discharge
summary in a pre-defined format. The information in the
Discharge summary should be pulled in from the Patient
digital record.
Tracking of Transfers and Referrals

10.8

Diagnostic results and alerts for Critical Values.

10.9

Billing: Record of transaction according to type of billing and


patient category from various service areas. The system
should be able to compile all the payments from the Patient /
Relative for the availed / required services, and also compute
the balance payment.
Maternity Ward and Labor Room

11
11.1

Maternity module will have all the features of the ward/ IPD
management module

11.2

The system should have personalized dashboard for Labor


room.

11.3

Registration and tagging of new born with unique ID bar


coded wrist tags immediately after delivery, for easy
identification. The system should link the two IDs for easy
identification and representation of family tree with health
parameters.
The system should track all the patient details under separate
ID for the Labor Room related processes.

11.4

Haryana State Health Resource Centre confidential

105

Implementation of Hospital Information System (HIS)

11.5

11.6

Request for Proposal - Volume 1

Annexure - 1 :- Functional Requirement Specifications


The system should allow the IPD doctor / Nurse to select the
relevant section on the screen for entering details of delivery
i.e. type of delivery, diagnosis, treatment, investigation, minor
procedures, diet, drugs, referrals, blood requisition, etc. at the
Nursing station. The system should have interfacing /
integration capability for the use of handheld devices by the
IPD doctors.
The system should automatically forward the relevant
sections of the above templates / formats, to concerned
departments, for further action on the Patients case, especially
Ultra sound investigation requests.

11.7

The required forms should be filled after delivery and the


system should allow uploading of the scanned copy of the
signed form by the Parents. The system should retrieve the
record when the Parents apply for Birth registration.

11.8

The system should be able to record basic assessment done by


Pediatrician/nurse post child birth.

11.9

The system should be able to record information and track the


new born if the new born is shifted to Post Natal Ward/
NICU/SNCU and kept under treatment/observation.
Operation Theatre

12
12.1

12.2
12.3
12.4

12.5

The system should allow for OT scheduling on daily basis. The


system should allow patient registration record to be
automatically forwarded to the dashboard of the OT counter
operator. Also the system should allow mapping of patients to
concerned surgeon / doctors / specialist/anesthetist and
schedule the surgery..
The system should allow both Emergency and Elective
surgeries scheduling as advised by the doctor / surgeon
The system should allow the operator to select the vacant slot
for the prescribed surgery from the calendar / schedule of the
concerned Surgeon.
The system should allow for scheduling, prioritizations and
intimations. The system should allow the re-scheduling of the
prescribed surgery, after recording the reasons for rescheduling.
The system should display the packages under which Patient
needs to be admitted and operated. The details of the package
and corresponding requirements should automatically be
displayed by the system to the operator / nurse.

Haryana State Health Resource Centre confidential

106

Implementation of Hospital Information System (HIS)

12.6
12.7
12.8
12.9

Annexure - 1 :- Functional Requirement Specifications


The system should send Information / alert to Patient,
Anesthetist and Surgeon through the system, and SMS if
required, about the surgeries scheduled.
The system should generate a Surgical Package Program(SPP)
token number once the payment is made and surgery is
scheduled / confirmed.
The system should allow for time scheduling one day before
the actual date of surgery, as per available slots for the next
day.
The surgery Parameters are proposed to be captured in the
system through single click options in the system. At least the
following 2 parameters should be captured:
a.
Surgery start time
b.

12.10
12.11
12.12

12.13

12.14
12.15
12.16

Request for Proposal - Volume 1

Surgery end time

The system should allow capturing of surgeons name,


anesthetists name, procedure/surgery performed and type of
Anesthesia.
Also the doctors will have the facility to define the Emergency
requests, which will be given priority in sequence.
After every surgery is scheduled, the system should provision
for the specific set of articles, equipments, items, drugs, tools
etc. as per predefined logic. The intimations for making
available all the concerned articles, equipments, items, drugs,
tools etc. to specific departments should be automatically sent
by the system for necessary action.
It should have the facility of entering tracking of samples. The
system should generate Barcode which can be attached to
sample containers. The system should allow Lab to upload the
test details in the system after performing required tests. The
system should ensure that the Information is available to the
concerned Surgeon / doctor/ anesthetists through the system
for reference.
The system should track the movement of Patient (internal
transfers) to the concerned ward, and forward the details
automatically to the departments / ward dashboard.
The system should have pre-defined checklist for the
scheduled surgeries, in order to keep a check on the
preparatory work done before the actual OT process begins.
For Surgeons and Anesthetists, the system should have the
option for using handheld devices / Digital Pen or Digital Pad,
at the later stages of the project implementation.

Haryana State Health Resource Centre confidential

107

Implementation of Hospital Information System (HIS)

Request for Proposal - Volume 1

Annexure - 1 :- Functional Requirement Specifications


Medico-Legal Case / Report (MLC / MLR)

13
13.1

13.2

13.3

The system should have provision to mark/ flag the MedicoLegal cases. These cases should be tracked. All the
assessments done by the concerned doctor in case of
Emergency should be tracked and recorded through Unique
patient ID.
The system should have a predefined checklist to validate the
legal requirements and status for the doctor / presiding
Nurse. The system should generate auto alerts / intimations
reminding the concerned doctor / Nurse of necessary action
to complete the legal requirements and update the status in
the system.
The system should be able to capture patient treatment
details.

13.4

The system should have a Standardized/ pre-defined format


for generating the MLR, and should populate data from the
assessment / treatment, as required into the MLR as far as
possible.

13.5

The system should have a pre-defined checklist of jurisdiction


of concerned Hospital and Police stations, which will be
informed and coordinated with, in MLCs.

13.6

The system should be able to capture the details of the


Postmortem conducted, in case the same is conducted after
Patients death / brought dead cases. Post Mortem Report,
samples (if any, taken during Post Mortem) and body handed
over to the Police should be recorded in the system.

13.7

The system should have provision of either integrating with


the Police systems, or uploading scanned copies of the Police
papers.

13.8

The system should be able to track the Age verifications


requests, court orders etc. in this case the approval /
instructions from the Civil Surgeon to the PMO should be
recorded in the system.
Note: This functionality should be integrated with existing
system deployed for MLC in various Hospitals. Only steps 1
and 2 should be implemented in HIS as part of the project
scope.

Haryana State Health Resource Centre confidential

108

Implementation of Hospital Information System (HIS)

Request for Proposal - Volume 1

Annexure - 1 :- Functional Requirement Specifications


Laboratory

14
14.1

14.2
14.3
14.4

The system should have provision to track requests from


various departments like OPD, IPD, Emergency, Labor room,
OT, etc. The system should also have provision to track
samples from outside Hospital as well, sent for testing. The
system should track all internal and external test requests
through a separate unique test ID.
The system should have defined list of Lab tests under various
categories, available for selections by the concerned operator
/ Nurse / doctor, through user friendly select options.
The system should have a facility to setup/ configure all
possible type of tests by a designated lab within a hospital.
The system should generate the invoice automatically after
selection of the required tests prescribed for a Patient. The
invoice / receipt should contain the following information, but
not limited to:
Bar Code (generated as per Unique Patient ID)
Test ID
Payment Information {in case of exempted patients, the
payment value will be null
Date and Time Stamp
Token Number
Any other relevant information, as applicable

14.5
14.6

14.7

The system should have personalized dashboard with queue


management of all the requests made through the system,
including provision to define priority.
The system generated Token Number will be provided to the
Patient for providing the samples at Phlebotomy counter, after
required payment is done. Also the doctors will have the
facility to define the Emergency requests, which will be given
priority in sequence.
The display systems installed within the Hospital premises
should display the Token number and the sequence for all
Patients to see. On selections of the Patient record / Lab
request by the Lab in-charge / technician, the system should
display his / her token number on the display unit, and at
least next 2 in sequence.

Haryana State Health Resource Centre confidential

109

Implementation of Hospital Information System (HIS)

14.8

14.9
14.10
14.11

14.12
14.13

14.14
14.15

14.16
14.17

Request for Proposal - Volume 1

Annexure - 1 :- Functional Requirement Specifications


The system should have separate processes / workflow
defined for Phlebotomy counter as well as test labs. The
system should generate unique sample IDs, which can be
attached to the sample containers / tubes.
The system should have the provision to scan the Patient
unique ID bar code and the Sample ID bar codes, and link it
with the Test ID generated for the Patient.
The system should track the status of the samples sent to Lab
from Phlebotomy counter.

The system should match the number of sample IDs generated


and numbers of samples collected, and send intimations
accordingly to the Phlebotomy counter operator and Lab incharge.
The system should allow Lab technician to accept the samples
sent for testing. The system should have provision to highlight
the discrepancy if any.
The system should capture the test results directly from the
testing equipments, if the facility is available, or provide an
option for the Lab technician to enter the test results in a predefined format, with user friendly select features to the extent
possible.
The system should have the feature of reports authentication
by the concerned pathologist/microbiologist and the reports
can be published only after authentication.
In case of OPD Patients, the system should generate an SMS
alerts to Patients mobile number as soon the Lab test reports
are submitted and ready for printing. In case of IPD, Labour
Room, Emergency, OT, etc. the system should have provision
to display the test results on the respective dashboards of the
doctors / specialists, and send required intimations to the
concerned staff.
The system should track the dispatch status of Lab test
reports from the Report Dispatch Counter, when the Patient
/ relative collect the required reports.
The system should have provision to track the Panic values.
As soon as the test results are entered / captured in the
system, the system should automatically determine if the test
results are within a specified pre-defined range. The system
should send alerts to the concerned Hospital staff / Nurse /
Doctor, and display the test results on their respective
dashboards in all such cases. This provision should be
available for all in-patient cases.

Haryana State Health Resource Centre confidential

110

Implementation of Hospital Information System (HIS)

14.18

14.19

14.20
14.21
14.22
14.23
14.24
15

Request for Proposal - Volume 1

Annexure - 1 :- Functional Requirement Specifications


In out-patient cases, it is proposed that the follow-up calls
from the Help desk may request the Patients to visit the OPD,
if the test results depict Panic values. This feature may be
implemented at later phases of the project implementation.
The system should have laboratory inter linkages with store
for inventory and stock management of the reagents used for
various tests and should have provision for auto indenting, if
the supplies go below a specified level.
There should be provision for raising e-indent for bulk
requirements of reagents and other items, articles and
equipments by the concerned Lab technician.
Seamless and automatic flow of patient information and lab
investigation results to various departments including
patients, relatives.
Details of reagent/other items consumed with the tests/
linkage of supplies with test should be there.

The system should have the capability and provision for


unidirectional and bi-directional interface with lab
equipments.
In the second phase the laboratory reports should be available
on the web with proper authorization and user authentication
Radiology

15.1

15.2

15.3

The system should have provision to track requests from


various departments like OPD, IPD, Emergency, Labor room,
OT, etc. The system should also have provision to track
investigation requests from outside Hospital as well. The
system should track all internal and external test requests
through a separate unique Radiology ID. The system should
have co-ordination between departments for scheduling of
patients. It should have a seamless and automatic flow of
patient information, radiology investigation requests.
The system should have defined list of Radiology tests under
various categories, available for selections by the concerned
operator / Nurse / doctor, through user friendly select
options.
The system should generate the invoice automatically after
selection of the required tests prescribed for a Patient. The
invoice / receipt should contain the following information, but
not limited to:
a. Bar Code (generated as per Unique Patient ID)

Haryana State Health Resource Centre confidential

111

Implementation of Hospital Information System (HIS)

Request for Proposal - Volume 1

Annexure - 1 :- Functional Requirement Specifications


b. Test ID

c. Payment Information {in case of exempted patients, the


payment value will be null
d. Date and Time Stamp
e. Token Number
f. Any other relevant information, as applicable
15.4

15.5

15.6

15.7

15.8
15.9

15.10
15.11

The system should have personalized dashboard with queue


management of all the requests made through the system,
including provision to define priority. The system should
categorize and prioritize patients to reduce queuing and
waiting time.
The system should allow respective Doctors advising
Radiology investigations / Nurse / operator, to see the
vacancy / sequence at Radiology Department and opt for a
specific schedule, as required.
The system generated Token Number will be provided to the
Patient undergoing Radiology tests, after required payment is
done. Also the doctors will have the facility to define the
Emergency requests, which will be given priority in sequence.
The display systems installed within the Hospital premises
should display the Token number and the sequence for all
Patients to see. On selections of the Patient record / Radiology
request by the Radiology technician, the system should
display his / her token number on the display unit, and at
least next 2 in sequence.
The system should have the provision to scan the Patient
unique ID bar code and the Test IDs bar codes, and link them
with the Patient digital record.
The system should track the status of the Radiology tests
requested, match the number of Radiology tests requested
and number of Radiology tests conducted, and send
intimations accordingly to the concerned administrators and
Radiology in-charge / technician.
The system should allow Radiology technician to accept the
Patient sent for Radiology testing. The system should have
provision to highlight the discrepancy if any.
The system should allow the Radiologist to enter the test
results in a pre-defined format, with user friendly select
features to the extent possible.

Haryana State Health Resource Centre confidential

112

Implementation of Hospital Information System (HIS)

15.12

Request for Proposal - Volume 1

Annexure - 1 :- Functional Requirement Specifications


The system should have the capability to interface with PACS
and it should be DICOM compliant.

15.13

In case of OPD Patients, the system should generate an SMS


alerts to Patients mobile number as soon the Radiology test
reports are submitted and ready for dispatch. In case of IPD,
Labor room, Emergency, OT, etc. the system should have
provision to display the test results and images on the
respective dashboards of the doctors / specialists, and send
required intimations to the concerned staff.

15.14

If an antenatal case is prescribed for ultrasound then a digital


requisition slip should be filled along with Form F (in digital
format available in the system) with restricted access and
should be attached to test digital file automatically. In case of
MLC, the details of the tests should be attached to the Patients
digital file.
The system should track the dispatch status of Radiology test
reports from the Report Dispatch Counter, when the Patient
/ relative collect the required reports / films.

15.15

15.16

15.17

The system should have provision to track the Panic values.


As soon as the test results are entered / captured in the
system, the system should automatically determine if the test
results are showing some abnormal parameters. The system
should send alerts to the concerned Hospital staff / Nurse /
Doctor, and display the test results on their respective
dashboards in such cases. This provision should be available
for all in-patient cases.
In out-patient cases, it is proposed that the follow-up calls
from the Help desk may request the Patients to visit the OPD,
if the test results depict Panic values. This feature may be
implemented at later phases of the project implementation.

15.18

The system should have Radiology inter linkages with store


for inventory and stock management used for various tests
and should have provision for auto indenting, if the supplied
goes below a specified level. There should be provision for
raising e-indent for bulk requirements of films / articles by
the concerned Radiology technician.

15.19

In the second phase the radiology reports should be available


on the web with proper authorization and user authentication

Haryana State Health Resource Centre confidential

113

Implementation of Hospital Information System (HIS)

Request for Proposal - Volume 1

Annexure - 1 :- Functional Requirement Specifications


Blood Bank

16
16.1

The system should allow the Registration desk operator to


register the donor with the demographic details and have a
provision to link it with the unique patient ID for the donor
and generate Donor card. The registration receipt / donor
card should contain the following information, but not limited
to:
a.
Bar Code (generated as per Unique ID)
b.
Unique ID (having State, District, Year, and random
unique system generated number)
c.
Date and Time Stamp
Any other relevant information, as applicable

16.2

16.3

16.4
16.5

16.6

The system should allow for online pre-registration of blood


donors (HIS Web Portal). It is proposed the pre-registration
screen would be made available on Web, and upon filling of
required demographic details by the Donor, a unique
temporary pre-registration number should be assigned. The
form should be automatically forwarded to the Blood Bank
Registration desk operator, and the system should allow
search of the registration record using unique pre-registration
number. Once donor physically arrives at the registration
desk, registration is complete at the Registration desk, and
after generation of Unique ID for the Donor, the temporary
pre-registration number should be invalid.
The system should display the available registration details /
Donor registration information already existing in the
database when any of the parameters matches, during the
registration of the Donor. In order to avoid re-registration or
else select the reason for not selecting any displayed record
and going ahead with the new registration.
The system should display all the relevant information related
to blood donation as well as requisitions / availability through
various channels like Web Portal, Help Desk, Display units etc.
Donors should be able to search details of blood donation
camps, etc. [Patients should be able to check blood availability
online. A state level global data bank for blood availability and
provisioning involving alerts for non availability of blood.]
The system should give the last bleeding date with an alert or
minimum mandatory bleeding duration.

Haryana State Health Resource Centre confidential

114

Implementation of Hospital Information System (HIS)

16.7
16.8

16.9
16.10
16.11

16.12

16.13

16.14
16.15

Request for Proposal - Volume 1

Annexure - 1 :- Functional Requirement Specifications


The system should capture the number of units donated by
the donor.

The system should have personalized dashboard for Blood


Bank having all information about donors, blood units
available in different categories and requisitions from various
departments.
System should have the provision to enter Lab test results
manually/automatic interface with blood bank equipments.
System should have provision of flagging and blacklisting the
reactive donor if there is a disease including interfacing with
external database for fetching relevant information.
The system should also have provision to capture the blood
units collected through donation camps / replacement units,
along with all other related information about the camp or
replacement units. The digital stock information should be
automatically updated by the system after the details are
entered by the concerned User. The system should be able to
capture data regarding the voluntary blood donors and
regular donors in the camps.
The system should have pre-defined list of cell and serum
grouping, sample blood tests, which should be selected by the
concerned operator / Blood Bank in-charge through user
friendly select options.
The system should generate the bar-coded stickers to be
attached to the Blood bags, having following details, but not
limited to:
a.
Blood unit ID
b.

Blood related details like group etc.

c.

Type (Blood, Platelets, and Serum etc.)

d.

Barcode for easy identification.

e.

Expiry date

f.

Blood Collection Date

System should have provision of storage of blood and blood


components as separate unit and sub unit with storage rack
iron matching.
The system should record the details of all discarded blood
units. In case the blood is discarded after conducting the tests
on the blood collected; the system should send an intimation /
SMS to the registered donor about the same.

Haryana State Health Resource Centre confidential

115

Implementation of Hospital Information System (HIS)

16.16

16.17
16.18
16.19

16.2

16.21

16.22

16.23

16.24

16.25

Request for Proposal - Volume 1

Annexure - 1 :- Functional Requirement Specifications


The system should have provision to suggest the near expiry
blood / components to be issued incase requisitions for the
same are received through the system. It should have a system
of complete tracking of blood tests, groups, expiry details.
The system should have a seamless and automatic flow of
blood requisitions from various departments including alerts
and intimations.
The system should have option of provisioning the blood units
in case of surgeries, or mark the requisitions as Emergency, if
they are required urgently.
A bar-coded tag should be attached to the blood sample
container sent for cross matching for easy tracking and the
system should capture the blood sample details from the
Patient for whom the requisition is made.
Incase matching blood is found, the system should display the
units available. The system should allow the Blood Bank
technician to update the status of the requisition and issue
required units of blood.
Blood Banks should be able to enter the cross match details of
the unit before issuing. In fact computerized cross match
report with the issued units will help in dealing with any post
transfusion reaction easily.
In case of any reactions / adverse effects on the Patients
health, after giving blood, the same should be returned to
Blood Bank and the system should capture the details and
mark it for further analysis.
In case the matching unit is not found, the requisition should
be denied and the alert should be sent to relative / patient /
department. The concerned doctor should get the alert about
the unavailability of the required blood unit. If the digital
database is integrated, other options are suggested by the
system based on the information available. If there is no
digital database, the information is provided by searching
manual records, if any and status updated in the system. The
Fees collected from the Patient / relative is returned in this
case and status should be updated in the system.
The system should have the capability to integrate with blood
banks of public and private hospitals for availability check, in
case of emergency and disease outbreak and also planning
purposes.
Audit-trail of the blood unit (Blood Unit Tracking Report)

Haryana State Health Resource Centre confidential

116

Implementation of Hospital Information System (HIS)

16.26

Request for Proposal - Volume 1

Annexure - 1 :- Functional Requirement Specifications


The system should have provision for integration with the
existing blood bank software running in the state.

17

Birth Registration

17.1

17.2

After birth of a baby, birth details should be entered in the


system by concerned operator / Nurse in a predefined format
/ digital format of the birth form. Print out of the form should
be given to parents and signature obtained on the form.
The print out should have the following information but not
limited to:
a.
Bar Code (generated for easy identification)
b.
Unique ID (having State, District, Year, and random
unique system generated number) linked to mother ID
c.
Date and Time Stamp
d.

Any other relevant information as required

17.3

Duplicate copy of the birth form signed by the parent(s)


should be scanned and uploaded in the system for reference.

17.4

17.7

On receiving the request for Birth registration, and payment of


the required fees, the system should be able to retrieve the
signed form, and allow operator to enter the details for
generating birth certificate.
The system should forward the digital certificate to
authorized signatory / approving authority for authentication
and approval. The approving authority should be able to
verify the Digital Birth Certificate using Digital Signature or
any other authentication device.
The system should generate an alert for the operator to print
and issue to the verified Digital Certificate to the Parents and
update the status in system.
A state level global databank should be available for Births

18

Note: This functionality should be integrated with existing


system deployed for Birth and Death Registration in various
Hospitals. Only steps 1, 2 and 3 should be implemented in HIS as
part of the project scope
Death Registration

17.5

17.6

Haryana State Health Resource Centre confidential

117

Implementation of Hospital Information System (HIS)

18.1
18.2

18.3

18.4

Request for Proposal - Volume 1

Annexure - 1 :- Functional Requirement Specifications


The system should also allow the doctor / nurse to designate
if the death is due to unnatural causes.

If the death is unnatural, the system should send intimation to


the Police. In case the process is to be followed manually, the
system generates and intimation in a pre-defined format, to be
printed and sent as hard copy. The system should create a
new task in the MLC dashboard for further action.
In case of natural death, the death details should be entered in
the system by concerned operator / Nurse in a predefined
format / digital format of the Death form. Print out of the form
should be given to relative and signature obtained on the
form.
The print out should have the following information but not
limited to these details:
a.

Bar Code (generated for easy identification)

b.
Unique ID (having State, District, Year, and random
unique system generated number)
c.
Date and Time Stamp
d.

Any other relevant information as required

18.5

Duplicate copy of the Death form signed by the relative should


be scanned and uploaded in the system for reference.

18.6

On receiving the request for Death registration, payment of


the required fees, the system should be able to retrieve the
signed form, and allow operator to enter the details for
generating Death certificate.
The system should forward the digital certificate to
authorized signatory / approving authority for authentication
and approval. The approving authority should be able to
verify the Digital Death Certificate using Digital Signature or
any other authentication device.
The system should generate an alert for the operator to print
and issue to the verified Digital Certificate to the relative and
update the status in system.
A state level global data bank for death registration should be
available.

18.7

18.8
18.9

Note: This functionality should be integrated with existing


system deployed for Birth and Death Registration in various
Hospitals. Only steps 1, 2, 3 4 and 5 should be implemented in
HIS as part of the project scope.
Haryana State Health Resource Centre confidential

118

Implementation of Hospital Information System (HIS)

Request for Proposal - Volume 1

Annexure - 1 :- Functional Requirement Specifications


Software Integration

19
19.1
19.2

Integration of the
applications like:
Birth & Death

19.3

MLC

19.4

Post Mortem

19.5

MCTC

19.6

HIMS

19.7

Referral Transport

19.8

SNCU

19.9

Reconciliation of Accounts

19.10

HR (Training)

19.11

NIC Supply Chain/ Drugs

19.12

National Programs and Schemes

20

proposed

software

with

available

Pharmacy Management

20.1
20.2
20.3
20.4

Pharmacy Management services take care of all system critical


information that ensures that all medication required for
properly treating a patient are adequately stocked and
maintained. It is important that all drugs, items and articles
are constantly at the disposal of the care providers. All
pharmacy stores and sub stores shall be part of this module.
There should be a concept of creation of main stores and sub
stores in each facility with integration of all the stores.
Following are the designated sub-stores, but not limited to
OPD Pharmacy, Emergency Department , Injection and
Immunization Room ,OT, Labor Room, Wards
A list of suppliers with unit cost of each item will be
maintained.
System to facilitate creation of standard and unique codes for
department and locations

Haryana State Health Resource Centre confidential

119

Implementation of Hospital Information System (HIS)

20.5
20.6
20.7
20.8
20.9
20.10
20.11

Request for Proposal - Volume 1

Annexure - 1 :- Functional Requirement Specifications


The system should allow the Store In-Charge to upload the
scanned copies of required document like bills, invoices, etc.
and fills other details in the system.

The system should have the ability to maintain Location


master data
Standard list of the drugs and medical supplies used in the
store should be maintained
Capturing unique Item Description and code in the Inventory
Master File
Capturing associated Unit of Measurement in the Inventory
Master File
Capturing Lead Times in the Inventory Master File
Facility to define Item Codes under an item group
Facility to generate Store ledger with the following details for
each item:
- opening balance (Quantity and value)
- receipts and issues

20.12

- closing balance (Quantity and value)


Should be able to enter supplies needed patient -wise by
entering/ selecting:
Name of item

20.13
20.14

20.15
20.16

20.17

Quantity
The system should be able check the availability and quantity
of items / drugs / articles / tools etc. at all sub-stores and
main store.
Stock would be classified and maintained on any and all of the
following categories like sub store wise, VED , ABC, Expiry
date of medicine, disease wise, FSN and high risk medication,
High Cost
The system will facilitate retrieving details of available drugs
(batch number, expiry date, location) in the pharmacy / drug
store & reserve drugs for the indent based on the item code
and quantity mentioned in the approved indent
A list of available and authorized medications with their
source (warehouse or local purchase) will be maintained and
auto updated from existing software.
Monitoring and Tracking of Supplies to Hospital units,
Management
of
materials,
Management
of
suppliers/drugs/items/equipments

Haryana State Health Resource Centre confidential

120

Implementation of Hospital Information System (HIS)

20.18

20.19
20.20

20.21
20.22
20.23

20.24
20.25
20.26
20.27

20.28
20.29

Request for Proposal - Volume 1

Annexure - 1 :- Functional Requirement Specifications


To provide alerts to the officials concerned for tracking their
use in order to enable effective monitoring and avoid any
pilferages.
The system will have the ability to support planning
methodologies; re-order point, safety point, lot sizing, lead
times, min/max levels etc

Facility to transfer and record material from one location


store to another
Medicines/articles
that
are
consumed
as
per
prescription/generated
and
daily
expense
register
(prescription wise consumption) should be generated by the
system as per information entered by respective Users.
The items which are damaged should also be entered into the
system to adjust the stock of that only after proper approvals
on the system by the authorized person.
The system should provide facility so that outgoing medicines
and prescriptions will be automatically deducted from its
stock list
The system should provide facility so that ; For each
item-store combination, the minimum, maximum and reorder quantities will be maintained depending on the policies
and procedures adopted for replenishment of stock at the
sub-stores
To provide alerts to the officials concerned for tracking their
use in order to enable effective monitoring and avoid any
pilferages.
The system should maintain data for any Recall of Drug due to
any reaction reported, and track the entire batch of medicines
The system will generate a list of near-expiry items that are
due to expire 30 days or as defined from the date and display
as an alert to the user
The system should keep an account of all the drugs which are
near expiry or have expired so that period they may be
returned back to the Central Drug Store to be returned back to
the vendor.
DEMAND, INDENTING, RECIEPT OF STORES
Each of the stores should have the capacity of raising an
indent based on demand forecast/previous consumption at
fixed time interval through the store module as well as auto
indent based on minimum reorder levels and availability in
main store.

Haryana State Health Resource Centre confidential

121

Implementation of Hospital Information System (HIS)

20.30

20.31
20.32
20.33
20.34
20.35
20.36
20.37
20.38
20.39

20.40

20.41

Request for Proposal - Volume 1

Annexure - 1 :- Functional Requirement Specifications


The system should have provision to track auto indents as
well as online requests from various departments like OPD,
IPD, Emergency, Labor room, OT, Pharmacy, etc. The system
should track all requests through a separate unique store ID.
The demand generated should be automatically consolidated
by the system for the Store In-charge.

The system should be able to shortlist the items to be


purchased at hospital level and items to be indented from
warehouse.
Should be able to print the indent sheets according to
prescribed format
The system should provide facility so that ; allowing tracking
of the indent throughout the creation and approval cycle using
the unique indent number
The system will have the ability to display the alert for the
indent approving authority on receipt of indent approval
requests in the system.
The system will have the ability to capture the approval of
the Indents & transmit the approved indent details to the
stores.
If the medicine is not available with the approving authority
the system would generate Non Availability Certificate
automatically to initiate local purchase.
According to approved indent a dispatch note will be
generated in a prescribed format and will be sent by the
system to indenting authority.
Once the supplies are received, digital stock register is
updated automatically. The system should maintain a redefined checklist for the inspection of stock and capture the
status of the inspection for each aspect / items.
A barcode should be generated through the system and
attached to the stock for further identification and tracking
within the hospital stores. In case the bar code is already there
the system should have the provision to read the bar code.
The system will have the ability to record the details of drugs
received against the approved indent including the following:
Date of Receipt
Drug Name
Drug Quantities
Batch Number

Haryana State Health Resource Centre confidential

122

Implementation of Hospital Information System (HIS)

Request for Proposal - Volume 1

Annexure - 1 :- Functional Requirement Specifications

20.42
20.43

20.44

Expiry date
The system will have the ability to validate the receipt against
the Indent & Dispatch note
The system will have the ability to generate Receipt Report
in which item details like quantity demanded , Expiry date,
Batch number, quantity received, quantity accepted,
quantity rejected etc are included
The system should allow entry of drugs procured locally and
maintain complete inventory of list of items/articles.
REPORTS AND ANALYSIS

20.45
20.46
20.47
20.48
20.49
20.5
20.51
20.52
20.53

20.54
21
21.1
21.2
21.3
21.4

Generate inventory reports as per requirement of user


Store wise periodic analysis and demand projection
Inquiry & Reporting for Inventory Status (by item-code, type,
etc.)
List of Indent with status
List of materials vendor-wise
List of vendors with unit cost of item
Location-wise, specialty-wise, disease-wise and month-wise
consumption reporting.
Comparative analysis of location-wise inventory
The system will have the ability to maintain detailed audit
trails for the transactions carried out in the system for issuing
the drugs including date & time and details of user conducting
the transaction in the system
Inquiry & Reporting for Slow Moving and Obsolete Inventory
Equipment Management
There should be an Machinery and Equipment Store and sub
store in each facility.
The system will have the ability to maintain separate
Machinery Equipment (M&E) Asset registers locally at each
healthcare facility and department location.
Centralized definition of Machinery Equipment categories,
description across asset classes etc.
The system will have the ability to generate unique Machinery
& Equipment number asset number at the time of asset entry
in the system.

Haryana State Health Resource Centre confidential

123

Implementation of Hospital Information System (HIS)

Request for Proposal - Volume 1

Annexure - 1 :- Functional Requirement Specifications


21.5
21.6

The system will have the ability to link unique Machinery &
Equipment number with the Supply Order
The system will have the ability to maintain all relevant
information about the M&E including: Location
M&E description/specification
Supplier ID
Date since in operation/Installation
Life of the asset
Order No.

21.7
21.8
21.9
21.10
21.11
21.12
21.13
21.14
21.15
21.16

Maintenance schedule of Asset


The system will have the ability to retrieve details of all M&E
for any location in the structure.
The system will have the ability to consolidate M&E
Registers at all healthcare facilities/department locations
into M&E Register for the department.
No restriction on the number of M&E held.
There should be provision to record initial cost, description
and book value of the asset.
There should be provision to condemn equipments along with
reasons and mode of condemnation and update the asset
register.
The system will have the ability to capture the current
working condition of the equipment.
The system
will have the
ability to plan, schedule,
monitor/track and record maintenance activities.
Ensure that asset inventory get automatically updated when
the asset is installed at a location or transferred to the other
location.
The system should facilitate generation of maintenance
schedules for preventive maintenance.
The system will have the ability to generate maintenance and
performance reports i.e. log books, defect lists, asset history,
asset list w. r. t location wise, inspection check list/ schedule,
delay & down time, uptime analysis, asset wise consumables
and other user defined reports .

Haryana State Health Resource Centre confidential

124

Implementation of Hospital Information System (HIS)

Request for Proposal - Volume 1

Annexure - 1 :- Functional Requirement Specifications


21.17

The system will have the ability to generate and schedule


emergency maintenance work order.

21.18
The system will help in costing of the maintenance activity.
21.19
21.20
21.21
21.22
21.23

Track actual resources (tools, manpower, consumables,


spares) utilization against planned / standards.
Details on allocation of assets/ equipments, Real-time
availability and utilization of equipments
The system should allow the authorized hospital staff to raise
a complaint / request through the system in case of any
maintenance issues.
The system should send an alert to Maintenance cell In-charge
who should then investigate the nature of the complaint and
should be able update the complaint status in the system.
The system should be able to project the status if the
compliant / request is not resolved as per defined timelines /
SLAs and send alerts / intimation to the concerned hospital
staff about the resolution of the compliant.

21.24
21.25
21.26
21.27
21.28
21.29
21.30

Tracking the history sheet of equipments


Tracking of complaints / requests from various departments
and status
Categorization of complaints/ requests according to AMC /
CMC / Warranty etc.
Seamless coordination with AMC / CMC agency and /or other
technicians
Standardized requests for raising and consolidating demand
for new Machinery and Equipments.
Life of equipment should be entered with alerts for
condemnation.
The system should have a provision to condemnation the
equipment. This should be linked with utilization.

22
22.1

22.2

Human Resource Management


An integrated HIS application with basic Human Resource
Management System is proposed, which shall maintain and
manage staff information across various departments within a
hospital.
The proposed system should cover only the following aspects
of HR function within the domain of Hospital administration:

Haryana State Health Resource Centre confidential

125

Implementation of Hospital Information System (HIS)

Request for Proposal - Volume 1

Annexure - 1 :- Functional Requirement Specifications


i.
ii.
22.3

Postings and Transfers


Roster Management

iii.
Trainings
It is proposed that the HIS should maintain the Employee
master, Hospital master and Sanctioned Posts within the
system, so that the above 3 can be easily managed. The HIS
may integrate with the existing HR system to achieve the
functionality requirement.

23
23.1

24
24.1
24.2
24.3

Finance and Accounts


An integrated HIS application with basic Finance and Accounts
Management System is proposed, which shall manage the
billing and consolidation of finances across various
departments within a hospital. The proposed system should
cover only the basic book keeping and may integrate with the
existing accounting packages to achieve the functionality
requirement.
Medical Record Department (MRD)
Every medical record should have a unique identifier linked
with pt unique ID.
There should be ICD-10 based coding of diseases.

24.6

Access restriction to authorized persons to make entries in


medical record system.
The record should provide an up-to-date and chronological
account of patient care.
Provision for maintaining confidentiality, security and
integrity of information.
Should have feature for patient file tracking (hard copy).

24.7

Provision for alerts in case of missing data.

24.4
24.5

25

Ambulance Services (including Referral Transport)

25.1
25.2

The system should have provision to raise and track requests


from various departments like OPD, IPD, Emergency, Labour
room, OT based on unique patient (pt) ID.
The system should integrate with the Referral Transport
system (RTS).

Haryana State Health Resource Centre confidential

126

Implementation of Hospital Information System (HIS)

25.3
26

Request for Proposal - Volume 1

Annexure - 1 :- Functional Requirement Specifications


The HIS system should have the capability to forward the
information to the RTS and only maintain the status in the
system.
General Store Management

26.1

General Store services take care of all system critical


information that ensures that all general store items required
are adequately stocked and maintained. All general stores and
sub stores shall be part of this module.

26.2

There should be a concept of creation of Central Stores and


sub stores in each facility.

26.3

The system should be able check the availability of store items


etc. at all sub-stores and main store. Following are the
designated sub-stores, but not limited to:
a.
OPD Pharmacy
b.

Emergency Department

c.

Injection and Immunization Room

d.

OT

e.

Labor Room

f.

Wards

26.4

Creation of item groups, item code, handling different units of


measurement.

26.5

Each of the central stores and sub stores should have the
capacity of raising an indent through the store module as well
as auto indent based on minimum reorder levels.
Illustrative list of items can be General Store items,
instruments, linen etc.

26.6
26.7

26.8
26.9

The system should have provision to track indents as well as


online requests from various departments like OPD, IPD,
Emergency, Labor room, OT, Pharmacy, etc. The system
should track all requests through a separate unique store ID.
The demand generated should be automatically consolidated
by the system for the Store In-charge.
After receiving the supplies, the system should update the
digital stock register. If the items have not been received in
store, the Central Store receives a not available alert
automatically through the system.

Haryana State Health Resource Centre confidential

127

Implementation of Hospital Information System (HIS)

26.10

26.11
26.12
26.13

Request for Proposal - Volume 1

Annexure - 1 :- Functional Requirement Specifications


Once the supplies are received, inspection is done for quantity
as well as quality. The system should maintain a re-defined
checklist for the same and capture the status of the inspection
for each aspect / items. Also barcode should be generated
through the system and attached to the stock for further
identification and tracking within the hospital stores.
Monitoring management and Tracking of materials and store
Supplies to Hospital units, Management of materials.

Store wise periodic analysis and demand projection


Generate inventory reports as per requirement of user

27
27.1

27.2

27.3

27.4

Document Management
The proposed solution should support storing of various
documents / reports in any type of electronic format including
word processing, spreadsheet, image, etc. A Document
management system should provide storage, versioning,
metadata, security, archival as well as indexing and retrieval
capabilities.
The proposed solution should support archival of digital
documents in any format (like PDF, PDFA, Word, Excel, Image,
etc.), support roles and rights based security where there can
be multiple levels of access right to the content like read,
create, modify, delete, etc. The proposed solution should
support inbuilt Document Image Viewer for displaying
image document without native viewer.
The proposed solution should support the search functionality
within the content. It should support search criteria like
search by metadata fields, content objects, documents, pages,
etc. It should support Full Text Search on image and electronic
documents.
It should support extensive Audit-trails and support logging of
all the actions done by individual users. The proposed solution
should support Image Assisted Indexing of Scanned
Documents and support direct upload of Scanned Document
to DMS. Apart from this, DMS should have option to link to
scanned old physical files repository. The proposed DMS will
have search facility having different search criterias.

28
Content Management
28.1

A Content Management System (CMS) within the HIS core


application is envisaged, allowing Hospital administrators to

Haryana State Health Resource Centre confidential

128

Implementation of Hospital Information System (HIS)

28.2

28.3

Request for Proposal - Volume 1

Annexure - 1 :- Functional Requirement Specifications


dynamically update elements / sections / contents / forms /
formats / notices etc. that change regularly, without the
constant need of a web developer.
The CMS should offer easy administration of the overall HIS
Application, simply requiring nominated and authorized staff
members to log-on to a secure area of this Application and
complete simple web forms and upload to the centrally
controlled database, so that the changes are reflected
throughout the Application pages / sections, as applicable.
The formats for various reports / notices and other
communications like promotional messages can also be
designed through this module and uploaded on to the HIS
application.

29
HIS Core Application Admin, Reporting and Audit Trail
29.1
29.1.1

29.1.2

29.1.3
29.1.4

Application Admin
It is envisaged that there would be a User Interface provided
for the Admin module, for User Management, Rights
Management, and Masters Management etc. The UI for Admin
need to be configured as per the ACCESS CONTROL policy
drafted by the Haryana State Authorities / HSHRC and agreed
upon by other stakeholders.
This should be the heart of the HIS application software. And
for every change carried out as during the Change
management, the impact analysis with reference to the Admin
controls must be analyzed, discussed, approved by Haryana
State Authorities / HSHRC and then implemented.
Maximum and/or nearly all the variables must be dynamically
controlled through masters from Admin instead of being hard
coded.
Admin USER will be strictly a single USER login for the HIS
application software and the ACCESS policy shall be integrated
and collaborative for the HIS users.

29.2
Authentication

Haryana State Health Resource Centre confidential

129

Implementation of Hospital Information System (HIS)

29.2.1

29.2.2

Request for Proposal - Volume 1

Annexure - 1 :- Functional Requirement Specifications


Authentication is the process of identifying an individual,
usually based on a username and password, as a valid
application User. Authentication will be done for valid Active
Directory Users. A valid User for this application is one who
has been set-up in this application such that he/she can access
the application. Active Directory Users will have to access the
login screen for authentication.

When the Application is installed, it should have the


configured Active Directory.

29.3
29.3.1

29.3.2

29.3.3

Privilege Administration
Privilege Administration is the process of assigning privileges
to individual Users or User Groups. The privileges specify the
level of authority assigned to User or User Group i.e. whether
it is for a tab, a screen or a field.
If a User Group has certain privileges, and a User gets assigned
to that User Group, then automatically the User inherits those
privileges. The application allows selective revoking or regranting of privileges e.g. if a User has acquired certain
privileges on account of being assigned to certain User Group,
then for that User, the application should allow revoking of
the inherited privileges at individual User level, as required.
There should be a UI available for adding new privileges also,
with due approval and verification process inbuilt in the
system. This will allow the Administrators to configure new
privileges and will apply to all Users once configured and
committed in the systems.

29.4
29.4.1

29.4.2

User and Group Management


User Management will be a management and authentication
feature within the application that will provide administrators
with the ability to identify and control the state of users that
will have right to log into the HIS application and use it.
The module will help create different types of new Users,
Manage
their
designations,
locations,
Roles
and
Responsibilities, as well as their rights within the entire
system. This will also provide the feature of activating or
deactivating any users, including other User management
features, but is not limited to, the ability to query and filter
users that are currently logged into the network, and control
user login counts and login times.

Haryana State Health Resource Centre confidential

130

Implementation of Hospital Information System (HIS)

29.4.3

Request for Proposal - Volume 1

Annexure - 1 :- Functional Requirement Specifications


There should be facility to form Groups and the Users can be
assigned to desired Groups. These groups can be formed
based on roles, responsibilities, type of work, etc. The
properties of these groups can be assigned for better
manageability of each User within the Group.

29.5
29.5.1

29.5.2

29.5.3

29.5.4

Rights / Privilege Management


Through the User authentication server Rights Management
Services (RMS), there will be a form of User authentication
functionality that will allow various users to access the HIS
system and work as per their defined Roles and
Responsibilities.
Rights Management Services will be used for restricting access
to rights-protected content / sections / modules / screens /
Fields, etc. to authorized users only. Rights to all active users
will be granted based on their hierarchy and level in the
organization, designation, assigned roles and responsibilities,
location etc. among other parameters.
It is also proposed that the new rights can be created through
the Rights Management UI interface as well as existing rights
be managed through the same. The access to this section of
the application will be strictly based on Role Based Access
Control (RBAC) for the Administrator(s) only as defined in
the ACCESS Policy
The details of any change in this module will be captured in
the Audit Trail of the application. Also there should be facility
to assign/modify/delete rights globally for the desired Groups
within the system.

29.6
29.6.1

Masters (Lists and Values) Management


The system should have the facility to display the Masters list
for selection. The system should display the data in rows,
spread across following columns:
a.

29.6.2

Masters list Name

b.
Option to Exclude or Include for selection.
c.
Option for add / edit / delete records in a particular
Master list
The system should have facility to display number of records
per page i.e. Display <X> Records per page option. It should
have pagination facility, to display the number of records in
more than one page. Also the system should allow sorting of
records on the Masters list Name.

Haryana State Health Resource Centre confidential

131

Implementation of Hospital Information System (HIS)

Request for Proposal - Volume 1

Annexure - 1 :- Functional Requirement Specifications

29.7
29.7.1

29.7.2
29.7.3
29.7.4
29.7.5

29.7.6

Masters List Table


The data in this table grid should be displayed based on the
User selection of the Masters list option. The data displayed in
the grid should be the list of the entire Look up / List Values
already stored in the database for the selected Master list
field. The User can then modify an existing Look up / List
Values value or add a new one.
Master list column The system should dynamically display
the name of the Master Field which has been selected by the
User for editing.
Exclude / Include Column The system should have the
provision to include or exclude any specific value to be
available for selection in the application.
Edit / delete records options Column This should provide
option for editing / deleting an existing value / record.
The system should have provision to add a New Record Row
in the table. The system should also have a provision to check
for any duplicates while modifying an existing value or
entering a new value for any Master List.
The system should have provision to export the list values of
the Masters list in any other MS office application (like Word,
Excel, PDF, etc.)

30
30.1

30.2

30.3

MIS Reporting
This module will give HIS Administrators and other Users the
ability to have a customized view of the entire list of reports
they use or wish to use. Required security will be applied to
this module providing a restricted access as per different
category of Users within HIS.
This module may be further linked to the Personalized
Dashboard where the same links to these reports can be
displayed in small port lets, so that any User may not always
search for their frequently used reports from the Reports
module, and they can add it to their own dashboard for ease of
use. All the reports made available need to be controlled
through Admin module for variable access depending upon
the nature and status of the User,
The access control list of the reporting servers needs to be
mapped and configured with the admin access control
policies.

Haryana State Health Resource Centre confidential

132

Implementation of Hospital Information System (HIS)

30.1

Request for Proposal - Volume 1

Annexure - 1 :- Functional Requirement Specifications


Following are the 3 kinds of reports proposed in the HIS
application:
All / Fixed Reports This subsection within the Reports
module will have a list of all fixed reports as a hyperlink,
which will display the reports as per pre-defined logic / query
on the screen, with the option of exporting the report to
different formats (PDF, HTML, Word, Excel or Comma
Separated Values, etc.), Print and Save the report. All these
may be one click fixed reports or with some dynamic feature
to allow changes to only certain parameters (like date or
period range though dropdown fields) in the pre-defined
query and then execute the command to prepare the report.

30.2
30.2.1

30.2.2

B.

(iii)

Custom Reports / Adhoc Reports


1. An UI interface will be provided to specific users that will
give them view of HIS database providing the ability to
generate custom reports as and when required by selecting
any particular field, table or column (as per Database design)
through drag and drop / select feature.
2. The UI will help form simple queries and execute them by
providing the user with ability to select fields / tables from the
display and enter certain parameters. The filter criteria and
other user friendly features will also be provided for ease of
use. The screen view of the report will be displayed and then
the user will have option of exporting it to different formats as
mentioned above.
The key features of this functionality will be as follows:
This functionality will be permission restricted. Based on the
type of rights / permissions granted to any user, they will
have ability to view the tables of HIS database through the
User interface.
Report Builder tool may be used to implement this
functionality so that Users can easily create and execute
queries by only entering the basic parameters. However the
decision of Haryana State Authorities / HSHRC will be final
and binding on all parties concerned.
My Reports This subsection will have a list of reports as a
hyperlink that is frequently used by the users, as a kind of
personalized section displaying only the preferred reports for
any User. These frequently used reports will be a subset of the
All / Fixed reports and would be bookmarked to appear on his
/ her personalized dashboard also, as customized by the
individual Users.

Haryana State Health Resource Centre confidential

133

Implementation of Hospital Information System (HIS)

Request for Proposal - Volume 1

Annexure - 1 :- Functional Requirement Specifications


Advance Analytics/ Business Intelligence: The Reports
generated by Advance Analytics / BI system shall be made
accessible through an interface to be viewed by the designated
users. The advance analytics/ BI reports for reference are
mentioned below:
Statistical Analysis: The system should generate reports
comprising of complex statistical dynamics and multiple
parameters to be generated from historic data. These reports
may be generated through the UI provided within the
application to authorized users
Trending Analysis: The system should have the capability of
providing the various trends in the form of graphs and charts ,
based on certain parameters and historical data. These may
used by the Authorized Users to analyze trends at certain
location / period and take appropriate decisions.
Forecasting reports: The system should have the capability
to predict the future trends based on the historic data analysis
and past records, considering the governing parameters to be
the same. These may used by the Authorized Users to analyze
the basic trends at certain location / period and take
appropriate decisions.
Anomaly Detection: The system should display alerts /
information, based on certain pre-defined criteria, if there is
any deviation from the standard trend / output. Access to such
information / reports should be restricted to certain
authorized Users / decision makers only. These may be used
by users for decision making purposes or further
investigations as required.
Disease Surveillance: These are proposed to be automatic
indicators regarding various diseases, based on diagnosis and
lab results, across various spectrum of state population who
are availing health services through different Hospitals. The
system should provide the facility to keep a track on the
deviation on patterns of diseases across the state, based on
available data.

(iv)

31
31.1

Audit Trail
Audit trail will be a detailed record showing who has accessed
the system/application and what transactions / operations
have been performed by the concerned user during a given
period of time. Audit trail must display the following details,
but not limited to, with filter / sorting criteria options:
a. Timestamp

Haryana State Health Resource Centre confidential

134

Implementation of Hospital Information System (HIS)

Request for Proposal - Volume 1

Annexure - 1 :- Functional Requirement Specifications


b. User Name
c.
Module Sub Module Screen Section Field Name
d. Previous Value
e. Current Value

31.2

f.
Remarks (if any)
It is must that the Audit Trail module does not have a Delete
or Edit right granted to any user irrespective of any type or
hierarchy as created in the system. The view rights should
also be controlled through RBAC in Admin Module.

32
32.1

User Log-in / Authentication Services


There should be a provision of logging into the system
through Internet as well as Intranet. Once the users enter
their login credentials, the user credentials from the user
authentication server / Patient database must be verified and
then only the access should be granted inside the application
modules.

32.2

32.3

The personal Dashboard facility should be available for all


the users after successful login as a first interface within the
application. The type of information and content, to be
displayed on the personal Dashboard of Users should be
dynamically controlled through the Access control module /
Admin Module. However, it should be noted that for each user
there should be only one session at a time should be
maintained i.e. when one User logs-in to the application using
his / her own credentials, then the same credentials must not
be allowed to be used for logging into the application through
same or different computer.
The logged in users with the adequate privileges, as granted
through the Admin module, should be able to access the
modules in the application. The external Users (if granted
access through well defined registration process) should be
able to access their personalized dashboard showing their
details and entire medical history, diagnosis and treatment
details. They would also be able to register their grievances,
track the status and resolution, as well as provide feedback /
suggestions on services, facilities, etc.

Haryana State Health Resource Centre confidential

135

Implementation of Hospital Information System (HIS)

Request for Proposal - Volume 1

Annexure - 1 :- Functional Requirement Specifications

33
33.1

33.2

33.3

Registration, Password Retrieval / Reset


This functionality on the HIS should allow Users (Patients /
Citizen) to register themselves and avail services. Once the
User fills in all their details, the proper authentication and
verification process should follow, where the concerned
Hospital / Department official(s) will verify the details and
approve registration.
Once registration is approved, the users can log into the HIS
system and access information and services for which rights
are provided to them. These functionalities will be available
on their personal Dashboard after successful login.
Additionally, it is also proposed that the HIS will also have
standard password retrieval / reset functionality to ensure
that Users do not face any issues while logging into the system
and availing online information and services, as applicable

34
34.1

Search / Advanced Search


It is proposed that the system should provide the users with
Search / Advance Search features to get necessary
information, based on the certain parameters or criterias predefined in the system. The results should be displayed to the
Users in a User friendly manner with features like pagination,
sorting, drill down etc. The IA is expected to develop the
entire search functionality within the application in discussion
with the HSHRC officials / module leaders.

35
35.1
35.2

Grievance Redressal / Feedback / Suggestions


The system should capture the details of the grievance
reported by the patient in availing hospital services and its
tracking
It is envisaged that the Users might face certain issues and
challenges during their normal online / offline interactions
with the various hospitals. Some of them may also like to
provide constructive feedback and suggestion with regard to
improvement areas in Hospitals overall functioning. These
issues, suggestions and feedbacks may be of different nature
and categories, but any User should be able to reach out to the
concerned official, especially with their grievances, if any.

Haryana State Health Resource Centre confidential

136

Implementation of Hospital Information System (HIS)

35.3

Request for Proposal - Volume 1

Annexure - 1 :- Functional Requirement Specifications


It is therefore required that even if any User is not registered
in the system, they should be able to log their Grievances for
taking necessary corrective actions through HIS. The HIS
should also allow unregistered Users to send written requests
(grievances / feedback / suggestions) etc. to a common inbox
which may be suitably addressed and provide required details
/ information to the User on the contact details provided by
him / her.

36
36.1

36.2

(A)
(B)

Personalized Dashboard
The dashboard functionality should enable each of the key
Hospital staff (Doctors, Anesthetists, Surgeons, CMO, etc.) to
view their virtual personal space and manage their tasks,
organize their work etc. based on their roles and
responsibilities in the Hospital functions and assigned
privileges.
This should be strictly privilege restricted section based on
Role Based Access Control (RBAC) mechanism defined
through the Admin module. The following features are
proposed for the personal Dashboard facility controlled
through the Admin module for all the internal users:
Quick Links Links within the application as well as external
links to access any application module or website other than
HIS)
Pending Activities/Tasks A list of tasks assigned / to be
performed by the concerned User, arranged sequentially,
along with number and type of tasks. The standard sequence
of completing the tasks for all users should be First in First out
(FIFO) sequence. To override the standard sequence, the
concerned user will need to specify the reason and enter the
details in the system. Audit trail would capture any such
change in the system. An additional facility to view other
Users tasks, if sufficient rights are provided (especially to
senior hospital officials) should also be provided, but strictly
controlled through Admin module of the application. Senior
Hospital officials in some cases might want to view the work
load and performance efficiency of any junior staff in handling
particular set of tasks. They may also want to reassign a
certain task to themselves or to other staff members, due to
any administrative reason, and get the task completed. All
such functionalities and features must be developed by the IA,
while designing the automated processes within the HIS
application.

Haryana State Health Resource Centre confidential

137

Implementation of Hospital Information System (HIS)

Request for Proposal - Volume 1

Annexure - 1 :- Functional Requirement Specifications


History of Completed Activities / Tasks All the completed
activities should be displayed to the concerned User, in case
they want to refer it in future. User friendly features like
pagination or drill down to see further details of the
completed tasks may be provided, as required.
MIS reports (Fixed and Adhoc / Customized reports) which
may be bookmarked from the Reporting module of the
system; and
Red Flags notifications, alerts etc. as per pre-defined logic or
escalation matrix

(C)

(D)
(E)

37
INTEGRATION SERVICES
37.1

37.2

37.3

Integration with SMS Gateway :


The SMS Gateway Service will act as a common service,
integrated with the core HIS application, and will be used to
deliver SMS based services to all citizens / Patients and in
some cases doctors and other Hospital staff. SMS Gateway will
support both Push and Pull services wherein a common
information service can be pushed to a group of people based
on different criteria. A citizen / patient can also request for
specific information at the individual level through Pull based
SMS service by sending a specific keyword to the HIS portal /
application.
Integration with Mobile/Handheld Devices:
It is proposed that the HIS application may be integrated with
Mobile / Handheld Devices to make the system widely
reachable and accessible, especially within the hospital
premises where the PC penetration would be limited
impacting the application accessibility. Therefore, a lighter
version of the HIS application may be developed to support
browsing of the application through these devices.
Integration with SSDG, State Portal, NSDG, National Portal
and MSDG
It is envisaged that in the future HIS application will need to
integrate with SSDG, State Portal, NSDG, National Portal and
MSDG respectively, as per NeGP guidelines and DEITY, Govt of
India vision for all government applications. It is mandatory
that the requirements of Integration and Scalability must be
taken into account while developing / customizing the
application so that any change is easily addressed as and
when these systems are implemented at the state and national

Haryana State Health Resource Centre confidential

138

Implementation of Hospital Information System (HIS)

Request for Proposal - Volume 1

Annexure - 1 :- Functional Requirement Specifications


level. The bidder is expected to provide quotation / costs for
any such integration as optional, separately in their financial
proposal.

Note: The IA is required to make adequate provisions in the


software application for integration with Mobile / Handheld
devices. These devices may be integrated with the application in
future, as per requirement from the individual Users.
38
38.1

38.2

38.3

HIS Lite / Offline Application


To support the functioning of the HIS application, when there
is limited or no connectivity option, an Offline Client
Application or HIS Lite should be developed. A part of the
core system functionality will be provided as desktop based
offline client application, hosted at the local server within each
Hospital premises. The application will have its own local
database to store the transactional data and masters required
for the local application. This application will be built in a
manner to support synchronization with central database to
avoid any duplicate data entry requirements and provide
consistent information.
HIS Lite is intended to be a desktop based offline client
application which can process multiple functionalities and
records. It will have the feature of getting synchronized with
HIS core application on demand or on triggered event to
synchronize data with HIS application, when connected to the
HIS network.
In order to avoid the delay in switch over between the
centralized core application and HIS Lite, in the event of
connectivity breakdown, it is required that the HIS Lite is
deployed in-line with the centralized core application

Haryana State Health Resource Centre confidential

139

Implementation of Hospital Information System (HIS)

38.4

Request for Proposal - Volume 1

Annexure - 1 :- Functional Requirement Specifications


In other words, the transactions within the Hospitals should
flow through the HIS Lite first and then to the centralized Core
Application. However, in the event of normal connectivity, the
System should automatically bypass HIS Lite and directly
access the central core application. Whereas in case of
connectivity breakdown, the System should automatically
switch onto the HIS Lite and keep processing the transactions,
without causing any delay at the front end. As and when the
connectivity is restored, the system should automatically
switch back to the central core application and bypass the HIS
Lite. The data from HIS Lite should sync with the central core
application as soon connectivity is restored.

39
Local HIS Lite Application dependencies:
Local application shall have the following features to operate
independently without any dependence on the network
connectivity:
a.
Master data management with persistent queue
mechanism for local and central data synchronization. Master
data management shall maintain HIS core application and
support services records which will eliminate the data
inconsistency , data duplicity and facilities in identification
and merging of records
b. All hospitals shall have the same version of localized and
centralized application. Any version upgrades shall be
uniformly deployed to all hospitals and the central application
c.

Local application shall have:


i.

Master index

ii.

Terminologies

iii.
User access control and
authentication details of that particular hospital/ facility
iv.
Master data of users
The above mentioned dependencies are indicative only.
Implementation agency shall identify and implement all the
local dependencies during the implementation stage.
40
Online Help/Reference with Search Option

Haryana State Health Resource Centre confidential

140

Implementation of Hospital Information System (HIS)

Request for Proposal - Volume 1

Annexure - 1 :- Functional Requirement Specifications


Powerfull and intutive feature should be an integral part of
software and help content should have proper indexing and
internal references, mapped with key words, in order to allow
any User to search and reach the desired content with the help
of those key words.

Haryana State Health Resource Centre confidential

141

Implementation of Hospital Information System (HIS)

Request for Proposal - Volume 1

10.2 Escalation Matrix:


A suitable escalation matrix should also be incorporated based on the SLAs defined
for each individual task within the entire process, according to the following
parameters:
a. Importance/Urgency of the process defined
b. Time frame defined at the stage of the process
c. Level of escalation
It is envisaged that while designing the new automated processes as described above,
the responsibility centers (for internal employees based on designation and roles /
responsibilities assigned) as well as approximate time duration to carry out the tasks,
and eventually to complete the entire process, will be clearly defined in the system.
These will be used as inputs to display required information to the personal
Dashboards of individual Users, and also used for auto escalations to seniors in case
of inactivity by any staff without valid reason.
Following diagram represents a hypothetical automated flow with User interaction in
the HIS system to explain the logic:

Step 1: Process Initiation


Responsibility Center: User 1 (Time 1
day)

Senior User (Escalation 2nd Day)

Step 2: Intermediate Step


Responsibility Center: User 2 (Time 2
days)

Senior User (Escalation 3rd Day)

Step 3: Process Completion


Responsibility Center: User 3 (Time 1
day)

Senior User (Escalation 2nd Day)

As shown in the above diagram, a fully automated HIS process requires 3 steps from
start to finish, with responsibility centre as 3 different Users namely User1, User 2
Haryana State Health Resource Centre confidential

142

Implementation of Hospital Information System (HIS)

Request for Proposal - Volume 1

and User 3 respectively. In this case, if the User 1 logs into the system, he will see one
task pending on his personal Dashboard, which he can click to see other details of the
task. If however, at the first step the User 1 who is the responsibility centre to
complete that step, and if he doesnt perform this task in stipulated 1 day, it will be
automatically escalated to Senior User, who can then take necessary remedial action.
Similarly, it will be for other 2 steps also. The Senior User may be same for all steps
or different, as the case maybe.
Each automated process in the HIS system is envisaged to have this feature, so that
the Dashboard feeds for individual internal users can be derived by the system and
displayed accordingly. Similarly all the Red Flags or Escalations can also be
displayed.

Note: The IA is required to analyze the re-engineering components in order to adequately


build this functionality in all the processes of HIS. It is also a mandatory requirement that
all the processes should be interlinked to share data / information, and also to Admin
module so that access rights and content can be dynamically controlled as and when
required by HSHRC officials themselves.

10.3 HIS Core Application


Requirements

General

Functionality

1. The system should allow Citizens to search for relevant information on


hospital/department and services provided by the particular hospital, online and
through display units installed at hospital premises, as defined in the Information
component. (e.g. information on Registration, OPD, Blood Bank, Ambulance services
etc.).
2. The system should provide hospital locator functionality (General Hospitals/CHC/PHC)
that Citizens can use to locate the nearest public health center.
3. Relevant information on hospital and the services provided should be displayed on
display units at hospital premises. It is proposed that the content displayed on the
display units will be managed through the system itself, through a separate content
management module.
4. Patients may send SMS to a pre specified number in a pre specified format. On receipt on
the SMS, the system should send a SMS as response containing required information, to
patient/citizen mobile.
5. The system should have personalized dashboard functionality for each user /
department, with defined functions based on Role Based Access Control (RBAC).
6. A comprehensive search and advanced search component should be built in the system.
The search component should be available across various modules and sub modules of

Haryana State Health Resource Centre confidential

143

Implementation of Hospital Information System (HIS)

Request for Proposal - Volume 1

the system. The online help pages should have search functionality so that user can
search using the relevant keywords
7. The system should have a proper authorization and authentication mechanism.
8. If a user is inactive for a specified period of time, the user session should expire.
9. The system should allow for scheduling and Roster management for all Doctors, Nurses,
Paramedics and other hospital staff as required on the daily basis. This should be
controlled through Application Admin in the system.
10. The system should allow patient registration record to be automatically forwarded to the
dashboard of the concerned doctor / department.
11. Users should be able to access audio visual training content in addition to plain text
search as part of the online help functionality. Audio Visual clips should have the
functionality to start, stop, pause, back and forward options, so that the user can play the
training content as per his/her own free will and requirement
12. All the specific module / sub-module / section wise audio-visual help content should be
integrated to form a complete training of the HIS application and processes, and
uploaded on the HIS system for free access, download and ready reference
13. Users should be able to download the user manuals in PDF format.
14. The system should have a counter at the bottom of the Web Portal Home page to record
the number of people hitting the website / web page over Internet; this would help
analyze the usefulness of information presented through Web Portal.
15. The system should support multi-lingual interface (minimum Hindi and English) as per
localization and language technology standards for National e-Governance plan defined
on the e-Gov standards and guidelines published by Government of India.
16. The system should have roster management, schedule management, and resource
management kind of functionalities / features.
17. The system should have maximum select options, and very minimal free text option for
entering information / data.
18. The system have Intelligent suggestion feature based on pre-defined rules / logic /
parameters.
19. The system should automatically project, if the Patient is an exempted for paying fees /
bills.
20. The system should display the admission fees based on the category of patient i.e. free
delivery in case of Obstetrics, below poverty line (BPL), indoor package program (IPP),
surgical package program (SPP), etc.

Haryana State Health Resource Centre confidential

144

Implementation of Hospital Information System (HIS)

Request for Proposal - Volume 1

21. The system should have the facility to forward requisition / orders from various
departments online.
22. The system should be able to maintain real time inventory at the store and sub-store
level.
23. The system should be able to generate auto e-indenting and indentify the re-order level
at each store and sub-store.
24. The system should be able to generate auto procurement notice based on defined criteria
/ parameters.
25. The system should allow seamless flow of information / data throughout the modules
and sub-modules.
26. The system should assist in making auto maintenance calls / alerts, scheduled
maintenance and AMC / CMC, etc.
27. The system should have Pre defined forms with section marker, to allow auto population
of data in reports. Template based forms / sections / screens are proposed for easy
administration and usage.
28. The system should allow publishing of various reports on Web, after due authorization of
the concerned authority, for public consumption, along with key statistics.
29. The system should not allow selection of particular tests in case of breakdown of
equipments or non availability of tests. The system should track such incidents and make
it available on through the MIS and DSS for authorities to take corrective actions.
30. The services should be made available through Web Portal as well, after due registration
and authentication of the Internet Users. The final decision on the type of services to be
made available through Internet will be defined by HSHRC and the IA is expected to
implement the same accordingly.
31. The system should track and maintain the stock mentioned in Essential Drugs List,
especially at Pharmacy level.
32. The system should have configurable Store and Sub-Stores, with personalized dashboard
at each store level.
33. The system should have configurable MIS and DSS functionality at State, District as well
as Hospital Level, for administrators.
34. The system may also integrate with comprehensive BI tools for generating advanced
analytics / business intelligence reports and assist administrators in faster decision
making.

Haryana State Health Resource Centre confidential

145

Implementation of Hospital Information System (HIS)

Request for Proposal - Volume 1

10.4 Helpdesk Support / Incident Management Services


The help desk service will serve as a single point of contact for all ICT related incidents,
information and service requests as well as grievance redressal. The service will provide a Single
Point of Contact (SPOC) and also resolution and tracking status of incidents.
The scope of work will include:
1. Facility for providing any kind of assistance to all internal as well as external Users
regarding general information related to healthcare services, facilities, timings, fees, etc,
along with information related to automated modules / workflow in the application,
interpretation of any errors, functionalities and usage, etc.
2. Facility for reporting issues / problems with the IT infrastructure.
3. Should operate from 8AM to 8PM on every business day i.e. 6 days a week; if necessary it
should be also available on Holidays as per prior information and demand. The term
Holiday would include all public / government holidays as well as weekends.
4. Should also operate during late hours on demand; if necessary. The term late hours
would mean time period of 8PM of current day to 8AM of the next day, on all working
days and Sundays.
5. To provide a service desk facility and to set up all necessary channels for reporting issues
to help desk. The incident reporting channels will be the following:
a. Specific E-Mail account
b. Toll Free Phone Numbers
c. HIS Web Portal / HIS Application
d. SMS (expandable feature)
6. To implement a call logging system in line with the severity levels as mentioned in the
SLA.

The indicative call process is described below:

Haryana State Health Resource Centre confidential

146

Implementation of Hospital Information System (HIS)

Request for Proposal - Volume 1

Supervisor

Helpdesk Executives

Toll free number, Web Portal,


Application,
e-Mail, SMS
Helpdesk Server

Hospital User

Patient

The Helpdesk is envisaged to undertake the following activities:


1. Log issues / complaints / Grievances related to Application, IT infrastructure, BioMedical Infrastructure, Data Centre, IT systems at client locations, grievances related to
services availability and quality etc., as under different categories and issue an ID
number against the issue / complaint / Grievance
2. Assign severity level to each issue / complaint / Grievance
3. Track each issue / complaint / Grievance to resolution
4. Escalate the issues / complaints / Grievances, to State Authorities if necessary as per the
escalation matrix defined in discussion with HSHRC.
5. Provide feedback and resolution to the callers.
6. Follow up on the collection of reports, revisit and recording general feedback /
complaints on the services provided in the hospital facility.

The services must be available in atleast two languages, viz. Hindi and English. A call at the
helpdesk will be defined as successful registration of the call and a complaint ticket is generated
in the system, or successful dissemination of information sought by a User. All calls will be
monitored as per the call logs generated from the system. It is also proposed that the issue /
complaint / Grievance statistics should be analyzed and also a knowledge base, based on
frequently asked questions to aid the users, should be created in the long run.

Haryana State Health Resource Centre confidential

147

Implementation of Hospital Information System (HIS)

Request for Proposal - Volume 1

Note:
1. It is proposed that initially there will only be a Helpdesk counter at individual
Hospitals, with couple of parallel lines of Toll free number and an Operator. The
operator will be responsible for handling the calls, assisting the Patients who visit the
operator in person, providing general information on facilities, services, procedures,
timings etc., and recording the incidents / complaints / grievances in the system. Later
on, the entire system will matured to a centralized Helpdesk / Incident Management
centre.
2. The resources for IT support and the Helpdesk / Incident Management services may be
responsible for both and Facility Management as well, to optimize the deployed
manpower. However the IA need to ascertain the exact requirement and model of
operations for providing adequate support services for these two categories.

10.5 Annexure 2_ Present IT Infrastructure


For the purpose of this project it may be assumed that no significant IT infrastructure is
available at the present moment however any available equipment can be factored in reuse,
where feasible at the time of finalization of the Bill Of Material.

10.6 Annexure 3_ Indicative Bill of Material


The BOM provided below is indicative. The bidder should provide the complete BOM in his
technical proposal (without price). The same BOM with prices shall be provided in his
commercial proposal. The BOM in the technical bid should match the BOM in the commercial
bid.

REQUIREMENT OF COMPUTER NODES


SN
O

AREA

DH

Registration

2
3
4

Billing
Pharmacy
Laboratory

2
5
5

Breakup of DH

4 Main
Registration
1 Emergency
Registration
3- Laboratory
2- Phlebotomy

Printer
at DH

SDH

Printer
at SDH

CHC

Printer
at CHC

PHC

Printer
at PHC

2
3
2

1
3
2

Haryana State Health Resource Centre confidential

1
1

148

Implementation of Hospital Information System (HIS)

OPD

23

6
7
8
9

Ward
OT
HR
Labour
Room
DMS/ Admin
Equip Store
Blood Bank
Admission
Counter

10
3
1
2

10
11
12
13

2- Medicine
2- Surgery
3- OBG
2- Paediatrics
1- Psychiatry
2- Emergency
2- Eye
2- ENT
2- Ortho
2- Skin
2- Dental
1- AYUSH
1
1

3
1
2
2

64

Request for Proposal - Volume 1

4
2
1
1

2
1
1
1

1
1

2
1
1
1

15

30

1
1

2
1
1

21

Medical College (Other than Rohtak)/ District Hospital Bill of Material


Item Description

Quantity

Compliance (Y/N)

Remarks

Server(s)
Desktops

64

Multifunction Laser
Printers

15

Online UPS
Antivirus Clients for Client
desktop

Haryana State Health Resource Centre confidential

149

Implementation of Hospital Information System (HIS)

Item Description

Quantity

LCD for EQMS including


software

Request for Proposal - Volume 1

Compliance (Y/N)

Remarks

Compliance (Y/N)

Remarks

LAN Setup
Site preparation with
passive and electrical
cabling, earthing, server
rack, AC 1.5 TN, Fire
extinguisher etc.
Redundant Broadband
connectivity

Sub-District Hospital Bill of Material


Item Description

Quantity

Server(s)
Desktops
Multifunction Laser
Printers

30
7

Online UPS
Antivirus Clients for Client
desktop
LAN Setup
Site preparation with
passive and electrical
cabling, earthing

Redundant Broadband
connectivity
Haryana State Health Resource Centre confidential

150

Implementation of Hospital Information System (HIS)

Request for Proposal - Volume 1

Community Health Center (CHC) Bill of Material


Item Description
Desktops

Quantity

Compliance (Y/N)

Remarks

Compliance (Y/N)

Remarks

21

Multifunction Laser Printers

Online UPS
Antivirus Clients for Client
desktop
LAN Setup
Redundant Broadband
Connectivity

Primary Health Center (PHC) Bill of Material


Item Description

Quantity

Desktops

Multifunction Laser Printers

Online UPS
Antivirus Clients for Client
desktop
LAN Setup
Redundant Broadband
Connectivity

Haryana State Health Resource Centre confidential

151

Implementation of Hospital Information System (HIS)

Request for Proposal - Volume 1

10.7 Annexure 4_ List of Deployment Locations (FRUs)


The deployment locations for the purpose of HIS Solution implementation are mentioned
hereunder. These locations have been referred to as First Referral Units (FRUs). FRUs are
generally the facilities, wherein the healthcare providers shall refer to in case the patient needs
specialist treatment and/or medical intervention that is not available at the source facility. In
addition to the FRUs, the deployment locations shall include 4 Medical Colleges (MC), 20
District Hospitals (DH), 10 Sub-District Hospitals (SDH), 7 Community Health Centers (CHC),
2 Urban FRUs and 10 Primary Health Centers (PHCs) of Panchkula District, 2 CHCs of
Panchkula District

Annexure

List of FRUs
Sl.No.

District

Name of FRUs

Status
District Hospital
District Hospital
District Hospital
District Hospital
District Hospital
District Hospital
District Hospital
District Hospital
District Hospital
District Hospital
District Hospital

District Hospital
District Hospital
District Hospital
District Hospital
District Hospital
SDH
SDH
SDH

1
2
3
4
5
6
7
8
9
10
11

AMBALA
BHIWANI
FARIDABAD
FATEHABAD
GURGAON
HISAR
JHAJJAR
JIND
KAITHAL
KARNAL
KURUKSHETRA

12

MEWAT

13
14
15
16

MOHINDERGARH NNL
PALWAL
PANCHKULA
PANIPAT

GH Ambala City(DH)
GH Bhiwani DH
BK Hospital Faridabad(DH)
GH Fatehabad(DH)
GH Gurgaon DH
GH Hisar(DH)
GH Jhajjar DH
GH Jind(DH)
GH Kaithal
GH Karnal(DH)
GH Kurukshetra
AL Afia hospital Mandi
(DH)
GH narnaul DH
GH Palwal
GH Panchkula(DH)
GH Panipat(DH)

17
18
19
20
21
22
23
24

REWARI
ROHTAK
SIRSA
SONIPAT
YAMUNANAGAR
AMBALA
AMBALA
BHIWANI

GH Rewari(DH)
GH Rohtak (DH)
GH Sirsa
GH Sonipat (DH)
MLGH (DH)
SDH Ambala Cant
SDH Naraingarh
SDH Charkhi Dadri

Haryana State Health Resource Centre confidential

District Hospital
District Hospital
District Hospital
District Hospital
District Hospital

152

Implementation of Hospital Information System (HIS)

25
26
27
28
29
30
31
32
33
34
35

FARIDABAD
FATEHABAD
HISAR
JHAJJAR
JIND
KARNAL
YAMUNANAGAR
JIND
KURUKSHETRA
PANCHKULA
PANIPAT

GH Ballabgarh SDH
SDH Tohana

36
37
38

ROHTAK
SIRSA
MOHINDERGARH NNL

CHC Meham
CHC Dabwali
SDH Mahendragarh

39

FARIDABAD

FRU I

FARIDABAD

FRU II

40
41-44
44-53
54
55

4 MEDICAL COLLEGE
PANCHKULA
PANCHKULA
GURGAON

GH Hansi(SDH)
GH Bahadurgarh SDH
SDH Narwana
Nilokheri CHC-Cum SDH
SDH Jagadhri
CHC Safidon
CHC Shahbad
CHC Kalka
CHC Samalkha

10 PHC
CHC Raipur Rani
Sector 10 Hospital

Request for Proposal - Volume 1

SDH
SDH
SDH
SDH
SDH
SDH
SDH
CHC
CHC
CHC
CHC
CHC
CHC
CHC
Urban FRUs at
Faridabad
Urban FRUs at
Faridabad
4 Medical Colleges
10 PHC
CHC Raipur Rani

10.8 Annexure 5_ Indicative average number of Scans per Hospital per


day
Medical College Rohtak
1. X-Rays: 1000
2. CT Scan: 200
3. MRI: 60
4. Ultra Sound: 500

Rest of the Medical colleges and District Hospitals


1. X-Rays: 170
Haryana State Health Resource Centre confidential

153

Implementation of Hospital Information System (HIS)

Request for Proposal - Volume 1

2. CT Scan: 10
3. MRI: 30
4. Ultra Sound: 70

Haryana State Health Resource Centre confidential

154

Implementation of Hospital Information System (HIS)

Haryana State Health Resource Centre confidential

Request for Proposal - Volume 1

155

Вам также может понравиться