From patient information management to medical resource scheduling, from financial management to drug management, and then to medical quality control, this article will interpret the design logic of each module one by one, and discuss how to achieve data sharing and collaboration between multiple terminals through a unified data center, so as to provide hospitals with a full range of digital solutions.
In the wave of digital healthcare, hospital information SaaS platforms are gradually becoming a key tool to improve medical service efficiency, optimize patient experience, and strengthen hospital management. Compared with traditional locally deployed hospital information systems (HIS), the SaaS model is more adaptable to the diverse needs of the medical industry (from tertiary hospitals to community health service centers) with the advantages of multi-tenant sharing, pay-as-you-go, rapid iteration, and low O&M costs. For product managers, an in-depth understanding of the platform’s full-scenario functional module design, multi-terminal collaborative logic, and core features of SaaS architecture is the core of building an information system that is efficient, easy-to-use, and meets the needs of medical business.
1. The design logic of the core module of the HIS system
1. Patient information management
Patient information management is the starting point of medical services, and it needs to take into account the three core goals of data integrity, privacy security, and cross-scenario availability.
1) The electronic medical record module is patient-centered, integrating the patient’s medical information from the initial visit to the follow-up visit, hospitalization, etc., and its design needs to break through the “closed loop in the hospital” and extend to “regional coordination”.
- Data structure: Adopt a combination of structured and unstructured data (structured data such as basic patient information, diagnosis results, etc., unstructured data such as disease course records, consultation opinions, etc.), and add standardized data fields (such as adopting HL7FHIR international standards) to support electronic medical record interoperability with regional medical information platforms, medical insurance systems, and other hospitals. For example, when a patient is referred, the receiving hospital can directly retrieve its historical electronic medical record through a standardized interface without repeated entry.
- Intelligent processing: Natural language processing (NLP) realizes key information extraction and semantic analysis, such as automatically identifying “high fever for 3 days” and associating past medication history, prompting doctors of possible drug allergy risks.
- Data security and privacy protection: Multi-level encryption technology is adopted, combined with “data desensitization + permission granular control” (such as the patient’s ID number is desensitized by default, and only authorized doctors can view the complete information); At the same time, patients are supported to set their own data sharing scope (such as restricting psychological medical records to only open to psychologists).
2) The medical record module records the detailed information of each patient’s visit (registration information, department, diagnosis and treatment process, etc.), which is closely related to the electronic medical record, and it is necessary to build a two-dimensional query system of “timeline + scene label”.
- Real-time synchronization: Deeply linked with inspection departments, pharmacies, and settlement systems, and real-time updates of inspection results, prescription execution status, and payment records. For example, after a patient undergoes CT, the image report generation is automatically associated with the medical record, and a reminder notification is triggered on the doctor’s workstation.
- Patient-side empowerment: In addition to basic queries, add intelligent interpretation functions (interpreting examination indicators in plain language, such as “high white blood cell count, may indicate infection”), and associate health advice, and support patients to view the medical history and understand the details of diagnosis and treatment at any time on the device.
2. Medical resource scheduling
The core of medical resource scheduling is the efficiency of supply and demand matching, which needs to balance “resource utilization” and “service quality” through intelligent algorithms.
1) Outpatient/inpatient scheduling
- Outpatient scheduling: Optimize the scheduling plan through intelligent algorithms based on doctors’ visiting times, professional expertise, and patient appointments (such as predicting patient flow based on historical data and reasonably arranging the number of doctor visits). At the same time, a dynamic adjustment mechanism is introduced, such as when the system finds a surge in pediatric patients on weekends, it automatically pushes the suggestion of “increasing pediatrician weekend visits”, and supports the closed-loop process of “temporary shift change application-approval-automatic system update”.
- Inpatient scheduling: bed allocation combined with patient condition, department needs and flow optimization (such as allocating patients who need frequent postoperative examinations to wards close to the examination department); The “skill matching” algorithm is introduced for nurse scheduling (if nurses with ICU experience are assigned priority to critically ill patients), taking into account qualifications, workload, and continuous working time limits.
2) The equipment reservation module realizes the appointment management of various medical equipment in the hospital, which needs to solve the conflict between “emergency priority” and “regular appointment”, and improve the equipment turnover rate.
- Priority mechanism: Clarify the priority weight of appointments for emergency, general consultation, and VIP patients (such as emergency treatment weight of 10 and general diagnosis of 5), and the system automatically pushes a notification of “estimated delay time” to the delayed patients when jumping the queue.
- Real-time conflict detection: Linked with the workflow of the inspection department, the system automatically retrieves the available time of the device and schedules the examination after the patient issues a doctor’s order, while avoiding equipment conflicts.
- Equipment efficiency analysis: Record equipment usage time, idle time, failure rate and other data, generate utilization rate reports, and provide a basis for purchasing or eliminating equipment (for example, if the utilization rate of an MRI machine is less than 60% for a long time, it prompts to adjust the schedule or charging standard).
3. Financial management
Financial management needs to take into account process compliance and payment convenience, especially in the context of frequent adjustments to medical insurance policies, and need to have flexible adaptability.
1) Fee settlement
- Multi-scenario linkage: Linked with outpatient doctor workstations, pharmacies and other modules to automatically generate expense lists; Support outpatient charges (window or online payment, such as APP, WeChat mini program) and hospitalization fees (deposit payment, expense accounting, discharge settlement, etc.).
- Multiple payment methods: covering WeChat, Alipay, bank cards, etc., and adding bedside settlement (nurse handheld terminal assistance) and credit payment (docking with the medical insurance credit system, eligible patients can be diagnosed and treated first and then paid).
- Cost transparency: Show patients the “cost details + medical insurance classification” (such as a certain examination item marked with “80% medical insurance reimbursement (out-of-pocket 20 yuan)”), and support viewing the cost basis (such as the price department pricing document).
2) Medical insurance docking
- Real-time interaction: Interact with local medical insurance systems in real time, automatically identify the patient’s medical insurance type, and calculate real-time reimbursement according to the policy (such as automatically judging the reimbursement ratio and calculating the deductible amount when outpatient charges).
- Special Situation Handling: Support the process and data interface of scenarios such as remote medical treatment and critical illness medical insurance to ensure smooth reimbursement.
- Dynamic policy adaptation and abnormal warning: Built-in medical insurance policy rule engine, administrators can update rules (such as adding new medical insurance drugs) through the visual interface; real-time early warning of abnormal data (such as the amount of medical insurance prescription issued by a doctor far exceeding the average of the department) to reduce audit risks; Regularly reconcile with the medical insurance department to ensure accurate data.
4. Drug management
The core of drug management is the traceability of the whole chain, from procurement to patient medication, to achieve “source can be traced and destination can be traced”.
1) Inventory
- Refined management: covering warehousing (docking with the supplier system, recording drug batches, expiration dates, etc.), warehousing (issuing according to the principle of first-in, first-out), inventory and other links.
- Intelligent procurement and early warning: Automatically generate procurement suggestions based on historical drug data, seasonal disease trends (such as increasing antiviral drug inventory during the winter flu season), and supplier delivery cycles. Set the inventory warning value and remind the replenishment when it is below the threshold (for example, when there are only 10 boxes left in a drug inventory and 20 boxes of safety stock, an early warning will be automatically sent to the purchasing personnel).
- Expiration date management: Adopt “batch + expiration date two-dimensional early warning”, mark drugs expiring in the past 3 months as “priority use”, prohibit drugs expiring in the past 1 month from leaving the warehouse, and automatically contact suppliers to return and exchange goods.
2) Prescription circulation
- In-hospital circulation: After the doctor issues an electronic prescription, the information is automatically transmitted to the pharmacy, and the pharmacist dispenses the drug after approval, and the patient can check the circulation status on the terminal.
- Collaboration inside and outside the hospital: Support the circulation of the department to designated pharmacies (in line with the “prescription outflow” policy), after the patient selects “out-of-hospital drug pickup” on the APP, the prescription information is encrypted and transmitted to the cooperative pharmacy, and the pharmacy notifies the patient to pick up the medicine or deliver it to the door after dispensing.
- Intelligent Audit: AI assistance is introduced in the pharmacist review process to automatically identify problems such as “contraindicated compatibility” (such as repeated use of amoxicillin and potassium clavulanate) and “excessive dosage” to improve efficiency.
5. Medical quality control
In order to strengthen hospital management, improve service standardization through data monitoring:
- Real-time monitoring of key indicators: such as “medical record writing completeness rate”, “prescription pass rate”, “incidence of hospital infection”, etc., when the indicators are below the threshold, early warning is pushed to the department director.
- Adverse event reporting: Support medical staff to quickly report medical errors, patient complaints and other events through mobile terminals, and the system will automatically grade (general/serious) and transfer them to the corresponding departments for processing, forming a closed loop of “reporting-processing-review”.
2. Multi-terminal scenario adaptation and collaborative logic
The core of multi-terminal collaboration is to provide the right functions in the right scenarios, realize data interoperability through a unified data center, and avoid information silos.
1. APP
Patient side: focus on simplifying the whole process of medical treatment
- Basic functions: online appointment registration (filtering number sources by department, doctor, time), payment (support multiple payment channels), query medical records and inspection reports (no need to wait for paper reports).
- Extended functions: intelligent guidance (enter symptoms such as “cough, fever”, recommend departments and estimate the duration of the visit); Health record integration (related to physical examination institutions and community hospital data to form a panoramic view of personal health, such as “blood pressure records in community hospitals 3 months ago”).
Doctors: Strengthen the efficiency of mobile diagnosis and treatment
- Mobile ward rounds: View patient medical records, vital signs, and test results through the APP in the ward, issue medical orders (such as adjusting medication), and synchronize the information to the nurse’s workstation in real time.
- Extended function: offline mode (view medical records offline when the signal is weak, and automatically synchronize after network recovery); Multitasking (simultaneously handling “viewing patient A’s report”, “responding to patient B’s consultation”, and “issuing patient C’s discharge order”, avoiding conflicts through task prioritization).
2. PC
As the core operation interface of medical staff, it strengthens the depth of professional functions:
- Doctor Workstation: Provide functions such as detailed medical record writing, prescription issuance, and examination application; Built-in “template library + custom template” (such as cardiologists can save “acute myocardial infarction diagnosis and treatment templates”, and call and modify details with one click when receiving a consultation) to shorten the operation time.
- Nurse workstation: responsible for nursing management (execution of doctor’s orders, writing nursing records, bed management, etc.); Added “Nursing Reminder” function (automatic pop-up window reminds you to change fluids when the patient’s infusion is about to end).
3. WEB
For hospital managers, strengthen data analysis and decision support:
- Administrative office: personnel management (employee information, attendance, performance appraisal), financial management (financial statement viewing, budget formulation), material management (procurement and use statistics of drugs and consumables).
- Decision support: The operation dashboard displays indicators such as “outpatient volume/hospitalization volume trend”, “average hospitalization day of each department”, and “proportion of medical insurance reimbursement” in real time, and supports drilling down to view details (such as “hospitalization decline” can be drilled down to “internal medicine decrease by 5%”); Process optimization tools (simulate the impact of different scheduling schemes and equipment procurement plans on operational metrics, e.g., “adding 2 surgeons” can reduce surgery waiting time by 30%).
4. WeChat Mini Program
As a lightweight service entrance, focus on “high-frequency and low-complexity operations”:
- Basic functions: registration, payment, query reports, etc., no need to download the APP, lowering the threshold for use.
- Extended functions: family authorization (the patient authorizes family members to check records and pay on behalf of the elderly, which is convenient for elderly or child patients); Hospital service navigation (integrated hospital map, enter destinations such as “pediatric outpatient clinic 3rd floor”, generate walking routes, and indicate the number of waiting lists); Associated with the hospital’s official account, push information and health science popularization.
5. Visualize the large screen
Provide decision-making support to management, balancing daily operations and emergency command:
- Daily operation: Real-time display of key indicators such as outpatient volume, number of hospitalizations, bed utilization rate, medical income, etc., and intuitively present the operation status of the hospital (such as when the outpatient volume of a department continues to grow and doctors are tight, the schedule can be adjusted or the number of personnel can be increased in time).
- Emergency command: In the event of a public health emergency (such as an epidemic), real-time display of data such as “number of fever outpatient visits”, “occupancy rate of isolation wards”, and “inventory of protective materials” to support remote scheduling of resources.
3. SaaS architecture design and core features in the implementation of medical scenarios
The core of the SaaS model is to serve multiple tenants with a single system to meet individual needs, and its architecture needs to be designed to take into account standardization and flexibility, security and availability.
1. Multitenant architecture: balancing the balance between sharing and isolation
Multiple hospitals (tenants) share a set of system infrastructure, but data and configuration are isolated from each other, using a hybrid isolation + tenant configuration center strategy.
- Hybrid isolation policy: ordinary data (such as basic hospital information, department settings) is distinguished in the database table by tenant ID (logical isolation); Sensitive data (e.g., electronic medical records, prescription records) are stored in independent databases (physically isolated). For example, tertiary hospital A shares an application server with community hospital B, but A’s patient data is stored in database A and B is stored in database B, ensuring that the data cannot be accessed beyond the boundary through permission control.
- Tenant Configuration Center: Each hospital can customize business processes, forms, and permissions – for example, a hospital requires the signature of the department director for discharge settlement, and administrators can add process nodes. Traditional Chinese medicine hospitals can add tongue coating description, pulse and other fields to the outpatient medical record; One hospital has a head nurse who can view the cost details of patients in the department, while another hospital only allows the head nurse to check the bed usage.
2. On-demand services and flexible scaling: Precise allocation of resources
Through modular subscriptions and elastic scaling, pay-as-you-go is achieved and resource waste is avoided.
- Modular subscription system: split the system functions into basic package + value-added package – basic package (required) includes core functions such as electronic medical records, registration fees, and drug inventory (suitable for community hospitals, annual fee of 50,000 yuan); The value-added package (optional) includes AI-assisted diagnosis (+30,000 yuan/year), remote consultation (+20,000 yuan/year), etc. (tertiary hospitals can subscribe to the full module + customized development, with an annual fee of 500,000 yuan).
- Dynamic resource scheduling: Based on the elastic scaling capabilities of cloud servers, it copes with traffic fluctuations – automatically increases server computing power during peak physical examination periods (March to April) to avoid APP lag. Release resources and reduce costs during the trough period. According to data from a platform, elastic scaling can reduce resource costs by 30%.
3. Continuous Iteration and Version Management: The ability of the system to evolve
Release and version compatibility through grayscale release to ensure continuous system optimization without affecting normal hospital operations.
- Grayscale release: The new feature is first launched in a pilot tenant (such as a department of a hospital), and the feedback is collected and fully pushed. For example, after the update of the medical insurance reimbursement rules, it will be piloted in three hospitals and opened to all tenants after confirming that there are no problems.
- Version compatibility: support tenants to choose automatic update (small hospitals can choose automatic update at 2 a.m.) or manual update (large hospitals can choose to manually trigger on weekends); Older versions of the feature are retained for at least 6 months, ensuring that the hospital has enough time to complete staff training.
4. Security and compliance system: a protective net for medical data
Ensure data security and business continuity through technology+process to meet stringent compliance requirements (such as HIPAA, domestic personal information protection laws).
- Full-link encryption: Transmission encryption (SSL/TLS1.3), storage encryption (AES-256 algorithm), and keys are managed by the hospital autonomously (mandatory rotation every 90 days). For example, the patient’s ID number is stored as: f2z, decrypt only by entering the correct key.
- Refined access control: 3D permission model based on role-data-operation – role dimension (interns can only view medical records, attending physicians can view + modify); data dimensions (pediatricians only have access to pediatric patient data); Operational dimension (pharmacists can review prescriptions, but cannot prescribe them).
- Disaster recovery and emergency response: Implement a two-location three-center backup strategy (local computer room + off-site disaster recovery center + cloud backup), and provide daily incremental data backup and weekly full backup. In the event of a computer room failure, the system switches to the Disaster Recovery Center within 30 minutes to ensure that the service interruption time ≤ 30 minutes (RTO≤30 minutes) and the data loss ≤ 24 hours (RPO≤ 24 hours).
5. Ecological integration: a collaborative network of medical services
As the hub of the medical ecosystem, the SaaS platform opens up the connection with external systems through open API and ecological co-construction.
- Open API system: Provide standardized interfaces (RESTfulAPI, HL7FHIR), dock with telemedicine platforms (write remote consultation data into electronic medical records), medical device manufacturers (such as ECG monitor data is automatically synchronized to patient records), health management APP (patient exercise data is associated with chronic disease management), medical insurance bureau system (upload settlement data in real time), etc.
- Partner ecosystem: Build an ecosystem with AI medical companies, drug suppliers, etc., and provide one-stop services. For example, the platform has a built-in lung nodule image-assisted diagnosis tool of an AI company, which can be directly called by the hospital after subscription, without the need for separate deployment.
4. Unified data center: the nerve center of functional synergy
Data sharing and collaboration between various functional modules and multiple terminals through a unified data center is the core support for the efficient operation of the SaaS platform system.
- Data standardization engine: Cleaning and standardizing heterogeneous data from APP, PC, and medical insurance systems – unified format (such as 11-digit mobile phone number of patients), unified terminology (such as “myocardial infarction” acute myocardial infarction uniformly mapped to ICD-10 encoding 9), and deduplication processing (identifying duplicate registration records and retaining the latest information) to ensure data consistency and accuracy.
- Tenant data isolation and aggregation: Ensure that the data of hospital A will not be accessed by hospital B through tenant filters. Support cross-tenant data aggregation of group hospitals (for example, a medical group views the overall operation data of its five hospitals, and the data is desensitized to remove private information such as patient names and ID numbers).
- Real-time synchronization engine: real-time data flow based on Kafka message queue – after the patient registers in the mini program, it is synchronized to the waiting list of the doctor’s workstation, the pending settlement list of the charging system, and the waiting information on the outpatient screen within 1 second; After the doctor issues the doctor’s order, it is immediately synchronized to the task to be performed at the nurse workstation and the list of drugs to be dispensed in the pharmacy system.
Each terminal realizes complementary functions with the support of the data center: the patient-side APP focuses on convenient services, the PC-side medical workstation focuses on in-depth business processing, the WEB side focuses on management and operation, and the WeChat mini program provides a lightweight entrance and visualizes the large screen to support decision-making. Through the data center, the data of each terminal is interrelated and works collaboratively, improving the overall operational efficiency and service quality of the hospital.
