1. Birlamedisoft Pvt. Ltd.
XENON/Quanta HIMS
(Hospital Information Management Software)
Brief Information Gathering Form
Sr. Particular
No. Details
1 Name, Address, Tel no, details of Hospital
2 Number of beds in the Hospital
3 Provide the approximate number of users who will be using
the application
4 Provide the total number of computer Nodes where the
application needs to be installed?
5 Average number of laboratory and Radiological tests done
per day
6 Number of Doctors working in the hospital
7 Number of OPD consulting clinics associated with the
hospital. Please list the OPD specialties
8 Average number of Registrations done per day (both OP
and IP)- OP registrations, IP registrations and approximate
(average) Emergency admissions
9 What are the total number of employees in the hospital?
10 Indicate and details of the individuals in charge of
administration and decision making at the hospital
11 Who is the deciding Authority for HMS/HIS purchase in the
hospital
12 Any indicative time frame for the decisions to be taken on
purchase of software
13 Does your hospital have an IT Dept? How many people are
working in this department
14 Is your Organization using any software currently? If so
which and since how long they are using the software?
15 Will there be any data migration involved?
16 How many days training required on the software. (Specify
No of days)
17 Does the hospital work with TPA’s, Sponsor companies,
Corporate, Insurance
Companies, Referral Third party clinics and medical
centers? Please specify.
18 Do you have good internet connection available (Preferably
1- 2 MBPS) broadband connection?
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2. Birlamedisoft Pvt. Ltd.
XENON/Quanta HIMS
(Hospital Information Management Software)
Brief Information Gathering Form
19 Do you want HIS in any particular language? Ex.
French, Arabic, Spanish, Hindi, Marathi, in your local
language, kindly specify your language.
20 Select the functional Modules required at your
hospital:
1. Patient Registration
2. Appointment Scheduling
3. Admission Discharge Transfer (ADT)
4. IPD Clinical
5. Wards & Bed Management Module
6. Patient Relations (Complains and feedback module)
7. Doctors Workbench
8. Nursing Workbench
9. Operation Theater Management Module
10. Electronic Medical Record & Clinic Specialties
11. Laboratory Information System (LIS)
12. Radiology Information System (RIS)
13. Microbiology Dept
14. Histopathology & Cytology Dept
15. Pharmacy Management
16. Inventory & fixed asset Management
17. Procurement DEPT
18. Central Sterilized Supply Department (CSSD)
19. Blood Bank Management
20. Dietary (F&B)
21. Housekeeping/Laundry
22. Equipment Maintenance System (EMS)
23. Healthcare Packages
24. Patient Billing
25. Insurance and Contracts Management
26. Management Information System (MIS)
27. Hospital Administration (Master Setup and
Maintenance)
28. Roster Management (Duty Rosters)
29. HRMS (Human Resource)
30. Payroll
31. Financial Accounting (A/C Receivable and Payable,
Budget, Cost centre )
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3. Birlamedisoft Pvt. Ltd.
XENON/Quanta HIMS
(Hospital Information Management Software)
Brief Information Gathering Form
32. Help Desk
33. Patient Module
34. Facility Management
35. Waste management
36. Energy Audit
37. Communication module
38. PACS & Tele Radiology
39. User management & Authority System
40. Emergency/ Casualty
41. Ambulatory Services
42. Library management
43. Medical College Management
21 Are you looking for Online/Web based HIS software or
Desktop based Client Server (Offline) HIS software
22 Do you have multiple branches of the hospital, If yes, How
many
23 Are you looking for main hospital computerization or do you
want to computerize all branches
24 Any Budget you have decided for computerization
25 Any other information you want to share with us.
26 Any other modules required. If so list them below
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