A hospital EHR is the electronic health record that a whole hospital runs on, from registration and the wards to the operating theatre, the emergency room, the pharmacy and the bill. In India, it is usually called a hospital information system (HIS), or hospital management software. Every team reads and writes the same record: doctors, nurses, the lab, the pharmacy and the billing desk.
A hospital's record is much bigger than a clinic's. A clinic visit leaves one note. A five-day hospital stay leaves hundreds of entries. These include the admission note, doctors' orders several times a day, nursing charts every few hours, lab results, scan reports, every medicine given, and the discharge summary. Each entry is written by someone different. So the record must show each team its own work. A nurse sees which medicines are due on her ward in the next hour, and the billing desk sees every charge.
Imagine a man of 55 admitted with pneumonia, an infection of the lungs, to a 300-bed hospital in Vijayawada. At registration, he shows the QR code of his ABHA number, his national health ID. The registration desk scans it, and his name, age and ABHA number are filled in automatically. The doctor in the emergency room orders a chest X-ray, blood tests and an antibiotic through the HIS. The test orders go to the laboratory information system, and the results come back into his record within hours. The antibiotic order goes to the pharmacy, and the nurse records each dose that she gives. On day 2, he moves to a ward bed, and the ward's nurses see the same record. On day 5, the doctor writes the discharge summary in the HIS. The bill of ₹68,000 is produced from every charge recorded during the stay. He has health insurance, so the hospital sends a cashless claim to his insurer through the National Health Claims Exchange (NHCX).
In intensive care, the record also receives data from machines. ICU device integration software collects each patient's heart rate, blood pressure and oxygen level from the monitors and ventilators. So nobody has to copy the readings by hand.
Indian hospitals also link their records to the Ayushman Bharat Digital Mission (ABDM). With the patient's consent, the hospital can share his discharge summary and lab reports to his ABHA-linked health record. Another hospital can see them there later. Exchanging records between systems in this way is called interoperability. Other software reads the record in a standard format through FHIR APIs.
The same kind of product is also sold to hospitals in the United States, and some of the companies that sell it there build their software in India.