Initial Interventions in Healthcare Information System to Improve Service Delivery in Civil Hospitals of Gujarat, India

1: INTRODUCTION

1.1 Background

This study project is based on the initial interventions in the healthcare information system to improve service delivery in civil hospitals of Gujarat, India ”. This study is going to discuss the healthcare information system initial intervention that helps to develop service delivery in the Gujarat civil hospital in India. A healthcare information system is the most important role to play in a better healthcare organization such as storing, analyzing, collecting, managing and optimizing the treatment of patients’ histories and different data. A healthcare information system uses all this information to improve patient outcomes, judiciously allocate resources and improve the comprehensive care plans of the organization. The “healthcare information system” can be one of the effective systems within the hospitals which help in designing in managing the data within the healthcare sector. Due to that reason, it is necessary for making some interventions within the HIS (“healthcare information system”) mainly for the improvement of the services, especially the civil hospitals (Pandya et al. 2020). The lack of this aspect is present within the civil hospital in Gujarat, India thus; the study is focused on making a project plan that helps in improving the HIS for improving the service delivery within this area. Many initial interventions designed in the healthcare information system help to improve healthcare and health are under different effective and better ways. Weak and lowest healthcare information systems are significant challenges to achieving the “Millennium Development Goals” related to health because these systems do not adequately monitor and assess data of health information systems are untimely, inaccurate and incomplete.

Including the health information system in the civil hospital in Gujarat in India that helps to improve the quality of care as well as service delivery to the people are important. Practice management software, electronic medical record, clinical decision support, remote patient monitoring, electronic health record, patient portals, and master patient index are included with health information systems in the organization. It helps to develop the quality of care to the patients and also improves service delivery and outcomes. Being mainly one of the most populous countries, India has a large number of private hospitals all over the World. In that case, “out-of-pocket” private payments are making up more than 76% of the overall expenditure within the healthcare sector (Chatterjee et al. 2022). From that, only ⅕ of the healthcare economy has been used for public finance, Due to that reason, a great stark has been found within this country. In the year of 2016, more than 11297 civil hospitals are presented in India. The government of India has taken pre-emptive and proactive steps for responding to the pandemic situation of Covid-19. In the year 2021, more than 3 lakhs hospitals are worth the admission. The Indian government helps in ensuring the facilities within the hospitals and the functioning of their services. 

1.2 Context 

In India, there are different civil hospitals in Gujarat such asGovernment Ayurvedic Hospital and Kapila Dakshi Multispeciality Hospital in Vadodara”. The proper implementation of this project needs a peaceful environment that helps to increase the patient’s care in a better and more effective way without any burden and noise. This civil hospital is well managed and equipped research and teaching hospital with almost 180 capacities indoors. With a children’s procedure room, labor room, modem diagnostics, playhouse related to physiotherapy, eye or ENT OT, modem OT, Trigarbha Kuti, Kriyakalpa, Kshar Sutra, and Panchakarma facilities.

The development of the project plan is mainly based on the evaluation of some of the intervention within the HIS that helps in improving the service quality mainly within the civil hospitals. This kind of project plan has been mainly done within the civil hospitals in Gujarat, India.  

The implementation of the HIS helps in improving technological development. In that case, the Indian government has taken a great evaluation on the development of this project through which the development within the civil hospital can be done. As most of the civil hospitals are presented in Gujarat in India thus the Indian government is mainly focused on this issue (Ramanadhan et al. 2022). In this area, the economical, political, and public policies make a great impact on the determinants of health. Within the country, mainly in this region, the lower income, higher spending of public, democratic regimes and inequalities can make a great impact on this project’s work. In this region, mainly the “political and economy within the health” is highly concerned with the low economic and political domain interaction which helps in shaping the outcomes of the health.  

1.3 Justification

The project plan is highly justified for this process because, through this implementation program, the civil hospitals can develop an estimation of their own based on the importance of the civil hospitals and the improvement of the HIS in the improvement of service delivery. Along with this, through this project plan, the risk analysis cost estimation, and budget planning, the importance of some theory implementation has been done that helps in gathering a lot of pieces of information for making an innovative project. Due to that reason, the project plan is highly justified for the evaluation of the project in the future development of healthcare services.

2: AIM AND OBJECTIVES

The aim of this project is to analyze the initial interventions in healthcare information systems that help to improve the service delivery system in the Civil Hospitals of Gujarat, India.

SpecificMeasurableAchievableRelevantTime-bound
Improve the quality of careIt can be measured through healthcare information and data, electronic communication and patient support.It can be achieved through different reporting and improving population health.It can help to improve the quality of life and prevent diseases.2 months
Reduce medical error, as well as cost,It can be measured through quantified healthcare processes, patient perceptions and outcomes.It can be achieved through accelerated medical research development efforts to reduce costs and prices.It can be relevant to reducing the different medical errors and also help to improve the safety of patients.3 months
Providing better healthcare services deliveryIt can be measured through an organizational structure that is related to the capability to deliver high-quality healthcare service delivery.It can be achieved through facilitating prevention, early management and detection, and strengthening care coordination.It can be relevant to ensure discharge procedure and continuity of care.2 months

3: LITERATURE REVIEW

3.1 Importance of the healthcare management information systems (HMIS) to improve quality of care and service delivery

Healthcare information systems include decision support, results in management, communication, core health information, reporting and patient support. Healthcare information systems are different phases such as implementation, design, maintenance and analysis. Health care (Ouedraogo et al. 2019). The importance of the healthcare information system in Gujarat is to improve the quality of care and service delivery. The initial intervention of the healthcare information system is to improve the quality of care related to the health of the patients (Kagoya and Kibuule, 2018). The importance of the healthcare information system is its ability to retrieve and store data and improve medication safety by providing legibility that helps to reduce the different risk factors related to medical error. 

As per the opinion of Devendra Patel, “Gandhinagar Civil hospital” is first and foremost to launch the “Health Management Information System (HMIS)”.  Healthcare information technology helps to keep the records of the doctors, patients, nurses, staff and others (Nshimyiryo et al. 2020). Nowadays, patients do not maintain their medical records with bulky files but all records are kept at hospital every time. It helps the doctors to know the history of their patients and their medical records that help to diagnose the patients easily (Lwoga et al. 2021).  Health management information system is trying to build confidence, loyalty and trust for the general and effective hospital in the citizen’s hearts by providing quality and efficient health services by application of IT.

As per the opinion of Usak 2020, the “Department of Health and Family Welfare” conceptualized the streamlined operations that help to develop effective administration, control and patient care (Ismagilova et al. 2022). This helps to ensure the quality of care and health with the use of ICT as an instrument to provide diagnostic tools and standard clinical, integration of information management, and hospital management tools in Gujarat in India (Sligo et al. 2017). The healthcare information system using technological devices during the time of the pandemic, there has been an acute shortage of oxygen for critical condition patients. Smart oxygen helps those in critical situations by supplying them with oxygen as needed and depending upon the SPO2 level the smart IoT-enabled OC automatically switches on and off.

However, healthcare information system management is a tool that can be used to develop satisfaction of the patients  with effective health services by important dimensions of the quality of services (Bombard et al. 2018). The HMIS helped patients as well as the doctor to track every moment of the patients through the different technological support. It helps improve service delivery structural outcomes, the care process of the government and enhanced care processes (Usak et al. 2020). It enhances the engagement with the patients, helps to provide appropriate education and policies, and enhances the service delivery and processes of governance.  Healthcare information system management has developed the engagement process and understanding of the experiences of patients that outcome help to improve the quality of care among the patients.   

3.2 Impact of healthcare information system to improve service delivery in civil hospitals of Gujarat.

As per the opinion of George 2018, Hospital Information Systems are mostly used to easily access information, reduce errors and improvement of documentation. Today has affected the areas of knowledge of humans (Gaur et al. 2020). The treatment and health sector has benefited from the uses of the technology due to the causes of the wide range of produced information and information diversity (Pandya et al. 2020). Hospital Information Systems are developed by the use of technology such as artificial intelligence and IoT that help to improve the quality of care and service delivery and result in outcomes. Over the last two centuries, IoT means the Internet of things in the medical care management system has introduced and increased its development tremendously.

 As per the argument of Lahariya 2020, The healthcare information system helps to provide a mechanism for the different patients to provide better clinical services and share health-related information with their families, parents, friends and others ( Lahariya, 2020). In Gujrat, there are many civil hospitals such as Government Hospital and Government Dispensary that have to improve the better quality of care and services by the use of advanced technology (OSENI, 2022). As an example, the fitness band and the clinical-enabled advanced technology device easily monitor the health of the patients through the web application or the mobile application. After the advanced technology device was introduced to the health management system, health care became smarter.

According to him, there are different impacts of healthcare information systems to improve service delivery in civil hospitals of Gujarat (Hamal et al. 2018). Those impacts are reducing errors or medical errors, developing documentation quality, reducing hospital costs, improving patient quality, and many more. It helps to develop the patient’s health condition for providing better treatment and prevention of the diseases in effective ways (Mishra et al. 2021). This healthcare system helps to improve the hospital management system that has been providing a better quality of services delivered with the use of advanced technology (Patel et al. 2017). It can generate a new system of healthcare in real-time and the feedback of the advanced technology device is positive from the patients, as a result, the quality of the advanced technologically based medical devices is higher and more caring.

However, it is clear that the well-implementation of the healthcare information system is more beneficial for the Gujarat civil hospital in India (Ramanadhan et al. 2022). The purpose of this topic is to use communication instruments and computers to save, gather, extract and process data of patients and help to create a link or relationship between management and caring for information of patients. The design of the healthcare information system is related to the management and maintaining all aspects of services and care including clinical, administrative and financial. The healthcare information system helps to improve service delivery, improve efficiency, reduce errors or medical errors, develop documentation quality, cost-effectiveness, reduce hospital costs, improve patient quality, and many more in civil hospitals of Gujarat. 

3.3 Key challenges of healthcare information systems project implementation in a hospital setting

As per the opinion of Ismagilova 2022, there are different challenges faced by the healthcare information system that is related to the project implementation and evaluation in the hospital setting (Winter et al. 20185). These challenges and barriers are healthcare failure, quality control, vibrant condition and nature of healthcare, lack of saving healthcare, and lack of doctor-patient relationship, patient-centric EHR, physician and many more. Theories and application or their implementations help to cheer the safety and healthier exploits in particular and assist with the enterprising management of a safe and healthy lifestyle. 

According to him, there are different challenges and barriers seen due to the causes of lack of policies and regulations to support a better and more effective health information system, privacy concerns, lack of resources and financial resources and also the nature of the healthcare information  store and system. Lake od program and policies related to the healthcare information system are the major problems that hamper the quality of care of the patients (Kumar et al. 2018). The help of healthcare education programs and camping help to improve the awareness and knowledge related to health, it helps to increase awareness among the people that help to improve the quality of care and services among the people related to health.

As per the opinion of Rendell 2020, the use of technology in different health projects for the leading organizations and working for safe motherhood and updating the quality of healthcare are important. Evidence from different countries shows that patients’ opinions about quality treatment and satisfaction are important for the efficient utilization of health services in Gujarat civil hospital are disuses (Grange et al. 2020). Information technology is important for the healthcare organization and civil hospitals in Gujarat to manage the proper healthcare information systems. The well-implemented healthcare information system has increased the patient’s protection and security, reduced administrative costs and operating costs and also enhanced patient care quality.

During the period of COVID-19, the healthcare information system played an important role in the hospital setting in civil hospitals in Gujarat in India (Wager et al. 2021). The coronavirus stimulated the use of new applications, tools, techniques, and development for the use of technology within the medical sector. Health information technology includes a huge range of technologies such as networking, electronic medical and health records, clinical databases, as well as administrative, financial and biomedical technologies (Dinh-Le et al. 2019). Healthcare information technology helps to modify and change the attitude and behaviour of the people related to health. It helps in diagnosis and sorting to treatment and plays an important role in countering new transmission and use cases in every aspect of the pandemic response.   

3.4 Applying the Technology Acceptance Model to initial interventions in the healthcare information system

The application of the use of Technology Acceptance Models in the field of the healthcare sector in the civil hospital in Gujarat in India is important. Technology Acceptance Models are used to better predict related to the use of the healthcare information system (Bombard et al. 2018). This model helps to improve the quality of care and services in the health sector in civil hospitals in Gujarat.  It helps to identify and separate those patients from the others based on critical conditions or maybe at risk. The physicians, the patients, and the hospitals all are in profit. It helps to modify the behavior of the people with the help of the use of technology that helps to improve positive behavior among the people related to improving the quality of care. The help of artificial intelligence and IoT, help to improve the quality of care in effective ways. 

Applying and using the technology acceptance model helps the physician, doctors and patients are getting more profit. The patients are more comfortable with the uses of the technological devices and it helps to provide better information related to the patients (Mishra et al. 2021). Also, doctors can easily get the medical history of the patients. Patients are more comfortable with technology devices; they can easily monitor their health with the help of IoT-enabled medical devices. The patients as well as the patient’s guardians can easily monitor their health issues; they no need to go to a doctor. This is the contribution of Artificial Intelligence to the medical and health industry. This also helps to improve their health in the effective costs spend.

These technological devices help to help to improve service delivery, improve efficiency, reduce errors  or medical errors, develop documentation quality, are cost-effective, reduce hospital costs, improve patient quality, and many more in civil hospitals of Gujarat (Rendell et al. 2020). This help to provide the documentation information related to the health of the patients that help to improve the quality of care and services. Artificial intelligence and IoT are also beneficial for the healthcare professional that help to provide better information related to the health of the patients and their medical history. It helps to improve the knowledge, skills and care of practice and behavior among the people that help to improve the better quality of services and care. 

3.5 Literature Gap

Through the help of the entire study find out a few literature gaps that have been related to the improvement of the health care system in the Civil Hospital in Gujarat In India. Due to lack of resources and time management, there are many gaps seen such as the collection of data, analyzing and determining the proper tools and instruments of the healthcare information system in the healthcare organisation (Mishra et al. 2021). Another gap in the literature review is the lack of budget, it hampers the collecting the proper quality of the information related to the study. In this study is not mention the important information related to the healthcare information management system related to specific diseases in Gujara and also does not mention the problems and challenges that are faced due to the causes of COVID-19.  

3.6 Summary

In this entire study of the literature review, helps to understand the initial interventions in the healthcare information system to improve service delivery in civil hospitals of Gujarat in India. This study helps to understand and identify the importance of the healthcare management information systems (HMIS) to improve the quality of care and service delivery (Pandya et al. 2020).  The importance of the healthcare information system is its ability to retrieve and store data and improve medication safety by providing legibility that helps to reduce the different risk factors related to medical error in the civil hospital in Gujarat. This study explores the challenges and barriers that are healthcare failure, quality control, vibrant condition and nature of healthcare, lack of saving healthcare, lack of doctor-patient relationship, patient-centric EHR, and physician. The technological devices help to improve service delivery, improve efficiency, reduce errors or medical errors, develop documentation quality, are cost-effective, reduce hospital costs, and improve patient quality.  

4: THEORETICAL FRAMEWORKS FOR CHANGE: MANAGING CHANGE &/OR LEADERSHIP THEORY

4.1 Leadership theory

In Transformational Theory, the leaders are passionate, full of energy, and drive. This type of leadership is used in civil hospitals, board rooms, the entertainment industry, and schools or colleges (Simplypsychology.org, 2020). This leadership needs to understand fully and apply this style to maintain powerful leadership. To raise the self-confidence of the team members as well as the morale of the team the implementation of leadership is highly necessary (Sy et al. 2018). Transformational leaders help the followers of civil hospitals to grow and evolve into leaders by responding to personal followers’ requirements by assigning them and by aligning the purposes as well as goals of the respective followers, the group, the leader, and the huge organization. Due to that reason, this project plan needs to be focused their all concerns in the implementation of the “transformational leadership theory” helps to meet all of the project goals. Along with this, through this implementation, the work process can be improved easily which helps in maintaining the overall progress by giving motivation and essential pieces of information about the important aspects.

With the transactional style of leadership, the leader encourages people to work harder by proposing rewards for their good work as well as behavior such as paid vacation, promotions, bonuses, and many more (Langston.edu, 2022). On the other hand, these types of leaders give punishments for poor work and behavior such as demotions, and improvement programs. In the transformational style of leadership, employees are intrinsically motivated to follow the example of the leader as they have respect for their leaders in civil hospitals (Moura et al. 2019). This leadership style helps to set a consistent and clear goal for the future and also helps others by encouraging them. The leaders lead through influence the other team members to face the challenges effectively. As per this evaluation, it can be stated that the implementation of this kind of leadership approach helps to motivate the team members for hard working on this project. However, this kind of approach also helps in motivating the employee for following the improvement programs. The project is mainly based on the healthcare development project thus the implementation of this kind of leadership approach helps in influencing the team members for achieving success within the work. For that reason, the implementation of this leadership theory helps in accomplishing this project significantly.

Transformational leaders believe their supporters as equivalents, each with his own skills and knowledge, and desire to obtain the most useful in them via coaching and encouragement instead of barking orders (Parry et al. 2019). Employees feel supported and get the energy to work again. The leaders of the transformational style stand out in their ability to explore the status of the company and make a moral concept for its growth and progress. By using this style of leadership, employees get extremely motivated to do the work that is perceived as an enjoyable and purposeful adventure (Gardner et al. 2021). It becomes easier to optimize the performance of every employee.

After that in the transactional theory of leadership, the employees depend on rewards and punishments to reach the optimal job performance of their subordinates (Online.stu.edu, 2018). In this style, transactional leaders reward the team members to the exact levels as well as punish the team members for not performing well. In this leadership style, the relationship between team members and leadership is established on this theory that believes individuals are not self-motivated in their work and require instruction, structure, and supervision to perform their tasks (Heyler and Martin, 2018). This theory postulates that if the leader wants to change the task then the workers will perform that change job.

As per the transactional leadership theory, leaders of this leadership style operate within an institution’s existing system (Ma and Jiang, 2018). The leader aims to have associates provide detailed effects that are well-spoken and measurable. A leader of transactional style with a civil hospital considers the team members on whether or not they satisfy specific needs and desired results. Thus, transactional leaders demand the self-interest of their team members in order to keep them on track. Advantages of this type of leadership style include the achievement of short-term goals. This can perform to maintain procedure establishment and deliver consistent outcomes (Cho et al. 2018). This leadership style can help to establish criticism within the hospital that focuses on maintaining the procedure establishment.

In the Charismatic leadership Theory, the leader uses effective communication skills, charm, and cogency with the other team members (Ernst et al. 2021). The leaders provide the ability to connect with each other on a deep level. The characteristics of a charismatic leader look different from those of other leaders. A charismatic leader in the hospital can share strong and effective communication with the other team members. The leaders are more empathetic and can relate to the situation. This leader has more other characteristics including confidence, charm, motivation, optimism, and engagement. There are some advantages to this leadership style that the leaders use (Novitasari et al. 2021). This style is highly motivated as well as inspirational.

4.2 Change management theory

In terms of the transformation of management and leadership theory, the “Lewin Change Model” has an impactful influence on the transformation process. Through the implementation of this “Lewin Change Model”, this project plan can influence all of their transformational processes. Effective implementation of a concerned model in a civil hospital can bring an effective outcome in a concerned organization. According to the model, it can be observed that there are three different stages of transformation. As the project is based on the improvement of the HIS within the healthcare sector in Gujarat thus the implementation of this theory is highly justified for this project evaluation because it helps in monitoring and evaluating the overall transformation in different kinds of stages. That includes unfreezing, transitioning and freezing again and those steps will help to develop an impactful transformation (Shamir and Howell, 2018). The beginning of the implementation process will start with the engagement of the unfreezing process. In this stage, the ongoing approach needs to be altered from its real-time state. During the implementation of this process, a few things need to be under observation such as inertia and dismantling of existing points of view in terms of leadership. Along with that, it is crucial to bypass the mechanism of operational approaches. The second stage of the transformation process includes a review of alterations that already happen in the hospital during the initial stage (Northouse, 2021). During this stage, a critical view of the loops and uncertainties has to be maintained and revised planning is required to resolve those issues. In the end, the final stage is the freezing process that involves the identification of old theories, approaches and styles and the replacement of those factors with new factors. Hence, it can be stated that this model has a high-value impact in the field of management and leadership transformation. That brings an effective outcome in a concerned organization and “Organizational Performance” increases.  The overall operations within this project are very important things that help in improving the project development and achieving different kinds of effective outcomes. Thus the concern towards the implementation of this change management is highly necessary for the improvement of the organizational process. According to research, it has been observed that concerned theory has leveraged the approaches of transformation through a simple process.   This leadership style makes the subordinate feel heard and understood. This style also develops movement toward better results and encourages others to collaborate with each other.  Due to that reason, the implementation of this change management model is highly justified for this project planning.  

5: PROJECT PLAN

5.1 Scope and planning

As the civil hospitals in Gujarat have to improve their service delivery by considering the communication planning and risk assessment table. Operating the overall healthcare information system brings major development in modern technology to upgrade the AI technologies and enable the healthcare providers to use telemedicine facilities that bringing major development and change in modern healthcare science (Khider and Hamza, 2022). To ease the different health care approaches for the use of technology faster the operation of healthcare services and enables the healthcare system for better delivery and quality care facilities. The timeline for determining the scope of the project enables construction for analyzing the limit and creating a budget plan for evaluation of the quality (Rendell et al. 2020). The collection of different resources helps to identify the communication plan and creates the risk management approach for monitoring and evaluating the project. Due to that reason, the use of this planning and scope evaluation of the project of the implementation of the interventions within the civil hospitals can make some the proper development in their overall progress. Through all of those planning, the overall risk management, and budget planning can be done. Thus the planning and scope of this project are highly justified for this project planning.

5.2 Time

A total time plan has been created considering all the steps initiating from constructing the scopes to creating risks and collecting resources needs more than 30 days. The patient care and clinical services depend on the hospital admin and its ancillary services as modern technologies change the services to deliver hospital management and information systems (Prabhu et al. 2020). To improve the delivery services in civil hospitals the major objective is to focus on streamlining operations to improve the efficiency in government healthcare sectors. As stated by Sakinala, (2018) better patient care helps for effective administration and control to monitor the quality of healthcare services.  As this is one of the effective projects and needs to be implemented soon for the development of the civil hospitals in Gujarat, India. The overall planning and scope evaluation can be properly estimated in this estimating time. Thus the time plan is highly justified for this project evaluation. During the estimation of the time, the project can achieve its success rate and can make a great innovation which helps in improving their service delivery. 

5.3 Cost

“BUDGET PLAN” “As of 1st-30th April 2022”
“Income”   
 “Equivalent (₹)”“Sold”“Income (₹)”
“Cafeteria Meals”6.022250001327500
“Patient Family Member’s Meals”3.62200000710000
 Total4250002037500
“Expense”   
“Operating Expenses”   
“Employee Cost”360880  
“Incentives”8000  
“Time-Off Payment”77053.60  
“Health care insurance”99000  
“Retirement benefits”27066  
“FICA”54132  
“Total Employee Cost”626131.60  
“Other Expenses”   
“Food Expenses”1289401  
“Supplies”16911.96  
“Equipment”12822.90  
“Training”700.03  
“Capital Expenses”5200  
“Total Other Expenses”1325035.89  
“Total Expenses”1951167.49  
“Final Budget”86332.51  

Table 1: Budget Plan

(Source: Self-developed)

In the given Budget Plan it can be effectively determined that the healthcare organization has to make effective expenses in its regular operation. This plan is conducted to provide a conceptual and cohesive understanding of the civil hospital’s expenses and incomes through its free services. The only source of earning revenue directly is by selling means to the patient’s family members, and this is one of the best sources of income for the hospital. This budget provides clarity to the selling of a total of 425000 units of meals, including cafeteria and patient’s family member’s meals. These meals were sold at a relatively cheaper price due to being a public hospital facility.

With respect to the expenses part, it is divided into two important aspects as operating and other expenses. Operating expenses are the ones that are direct expenses to the hospital and have to incur on a monthly basis without any deviation or delays. On the other hand, the other expenses comprise the cost that the civil hospital incurs with respect to needs within the facility. Operating expenses comprise employee costs, time-off payments, incentives, FICA, health care insurance, and retirement benefits. The other expenses undertake food expenses for the patient, supplies, training costs, equipment, and capital expenses. Due to that reason, the use of this budget plan is highly justified for this project planning through which they can successfully accomplish this project that helps in improving the service quality within this HIS development.

5.4 Quality

The initial intervention in the healthcare information system to improve the service delivery process of Gujarat, India has developed by considering the approach of traditional methods. The critical method is dealing with the “Gujarat Hospital Management Information System (GHMIS)” under the department of health and family welfare (Gil.gujarat.gov.in, 2022). The civil hospital condition in Gujarat has to provide efficient and quality healthcare facilities. Thus, the vision is to provide better healthcare to the citizens and improve the services of poor state peoples. The project plan focuses on analyzing the approximate time and cost required for the development of the project and delivering the project methodology phase.  However, quality assurance is highly necessary mainly for the evaluation of this project development through which the service quality can be improved. As the project is based on the implementation of the intervention in the HIS which is digital technology thus the quality assurance is highly necessary for this project’s success.

5.5 Resources

For quality assurance, resource collection is the next step through which the project evaluation can be done properly. These expenses together form the total expenses for the hospital and provide a comprehensive understanding of the overall cost that is to pay to run the hospital. The difference between total income and total expenses is a positive sum that represents that this hospital can still take more tolls on expenses and provides better support to the hospital’s operations. Using this budget plan, it is accurate to say that the hospital is running successfully and constant support from the government and funding organizations can be seen in the near future. With respect to the hospital’s overall expansion and treating the surplus amount can be catered to in a more organized manner. As the holistic view of resource utilization brings the stakeholders better analysis of the administrative staff and doctors also, the total solution is provided by the “Tata Consultancy Services Ltd.”(Arora and Dhole, 2019). As the project is based on the development of health and family welfare, it provides quality services for improving patient care services and better analysis of IT applications in clinical and diagnosis activities. GHMIS administers or controls different hospitals across the state that supports the medical staff and considers the treatment cycle based on the predefined healthcare indicators (Tiwari and Gor, 2018). The healthcare solutions address the major functions that prioritize the requirement of administration in policy development. The control mechanism delivers efficient functioning and hospital-permitted records and reports. For quality assurance, resource collection is the next step through which the project evaluation can be done properly. As this is one of the important projects which is based on the development of the information system within the healthcare sectors through the implementation of different kinds of technologies. Thus this kind of resource collection is highly justified for the4 project evaluation.

5.6 Communication

GoalsToolsTimetableTarget audience
Promoting programs to build effective interventions in the healthcare information system.Success stories365 daysStakeholders
Improve and enhance the funding for the development continuously (Mwinnyaa et al. 2021).Targeted programs provide brief summary90 daysFund providers
Enhance the funds generated and better utilizationEvaluation report180 daysAgency leads
Working well for implementing the project management approach for improving the service deliveryBriefing the documents in board meetings on a monthly basis.30 daysProgram implementation team

 Table 1: Communication planning table

(Source: Self-developed)

The communication planning involves better analysis of the project management approach and delivers better guidance to analyze the tools used for better communication with the stakeholders, agency leads, and fund providers, and program implementation team (Ramanadhan et al. 2022). The timetable helps to evaluate the effectiveness of interventions in the healthcare information system for improving the service delivery in civil hospitals (Kumar et al. 2022). The tools used for communication planning analyze the goals of the target audience for bringing change and development in the healthcare sector. In Gujarat, the healthcare information system analyzes the activity based on the administration and controlling process of healthcare providers (Faujdar et al. 2019). In this project planning process, this kind of communication planning is highly significant for the development of the project process. Through this kind of project planning, the engagement of the stakeholders can be done properly. Due to that reason, the use of this kind of communication method is highly justified for this project evaluation.

5.7 Risk management

Type of risk Major challengesRisk evaluationControlling processSeverity
Strategic riskFaced issues due to rising medical cost and adoption of virtual care (Weststrate, et al. 2019).Through identifying the project management approach whether  it provides benefits or creates challenges (Baby et al. 2018)Prepare effective marketing approach and maintain quality in healthcare servicesModerate
Business riskViolent incidents in hospitals and telemedicine impact (Hamal et al. 2018)Conducting internal research for seeking feedback of the patient’s (Getele et al. 2019)Hire the efficient and experts as a healthcare staff (Rahemi, 2019).Moderate
Investment issuesFinancial issues to deal with the requirement of capitalThrough considering the behavior and investment measures of stakeholders (Sindhwani et al. 2019).Maintain better relation with stakeholders and use efficiently the funds in healthcare managementMajor
Economic conditionDemand and supply affected Different typesHigh mortality rates, the value of delivering healthcareProviding better healthcare services in low cost and quality care of the patient’s Sakinala, S., 2018Major
Technological issuesSecurity violence and cyber crimesErrors in system functioning or difficulty to navigate it.Update technology with maintaining pepper securitySevere

 Table 2: Risk management table

(Source: Self-developed)

As stated by Pandya (2020) risk management table analyzes the effective measures helpful for different risks faced in healthcare as the development of healthcare systems and services. The different risks such as technological risks, strategic risks, business risks, economic conditions, and investment issues create a major impact (Prabhu et al. 2020). The understanding of the severity of risks is important to deliver with the risk evaluation process, through understanding the major challenges and developing the controlling process. The risk matrix allows every aspect analysis that impacts the healthcare information system and its severity that affects the operation of healthcare delivery (Ramanadhan et al. 2022). By meeting the criteria of communication the entire project development enables to bring improvement in healthcare service. The risk assessment is highly necessary for the evaluation of this project. As this project is based on the improvement of the HIS process within the healthcare sector thus the risk assessments can help in making the project easier which helps in progressing the monitoring process.

5.8 Monitoring and evaluation

To acquire the financial, technical, and human resources in order to build the communication plan table to analyze whether the team members and stakeholders involved in the project. The communication methods help in detail analysis and also analyze the risk management approach for effectively identifying the monitoring and evaluation procedures (Wrike.com, 2022). The project management approach used in this is “Agile project management” to analyze the methodology and build a better adaptive framework for the healthcare information system of Gujarat (Mostafa et al. 2020). The analysis of the healthcare system in Gujarat has evaluated the major aspects of the Gujarat healthcare information system. As efficient healthcare services bring online availability of doctors and evaluate the easy access to medical reports.

Figure 1: Time plan

(Source: Self-developed)

6: CONCLUSION  

It can be concluded that the initial interventions are of much importance in order to increase the quality of service in Gujarat’s Civil Hospitals. There are different hospitals in Gujarat that have initiated different initial interventions such as Kapila Dakshi Multispeciality Hospital in Vadodara,  and Government Ayurvedic Hospital. Other than that the Health Management Information System (HMIS) that happens to play a significant role in the health  care system was first launched by Gandhinagar Civil Hospital. Effective patient care, control and administration can be executed through streamlined hospitals along with that the use of ICT is another important aspect. The usage of smart oxygen can be counted as another intervention helpful in those hospitals as they are automated to get switched on and off.

However, it has been observed throughout the study that there are many Government Dispensaries and Hospitals that are unable to give different initial interventions that are required for emergency patients.  IoT-enabled medical devices are not fully enabled in hospitals of Gujarat can be considered a major drawback to initialize different health interventions. The usage of AI in government hospitals can be helpful for psychotherapy and different other interventions. The different challenges are to be achieved through the “Millennium Development Goals”. However, monitoring of proper data sets and their accessibility has not been performed properly through these goal settings.

A budget for the project plan has been contemplated that reflects different aspects of revenue flow. In terms of income, it has been observed that a total amount of 2037500 rupees have been gained. Along with that, they have different expenses also that reflect a total amount of 1951167.49 rupees. The only source of earning revenue directly is by selling means to the patient’s family members, and this is one of the best sources of income for the hospital. The difference between the net income and expense is a positive sum and it reflects that concerned hospitals can run more toll expenses. That can help in strengthening the overall structure of the hospital in terms of efficiency.

There are different theories that have been incorporated or can be included in the healthcare providing services of the hospitals in Gujarat. Through the application of these theories, better management in administrative and patient control levels can be regulated thus the inclusion of different interventions can  be provided.  The transactional theory and transformational theory, these theories include encouraging the staff in participating in hospital facilities properly.

Different types of risks are also included in risk assessment tables including risks related to contamination along with any surgical risks that can be counted as major and severe risks in hospitals. However, different health interventions conclude different types of risks. Technological risks are also included in different health interventions such as cybercrime, technological malfunction and many others.

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