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E-Atria HMS Help & Operations Guide

Version 2.0  |  Updated 12 August 2026
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01Recent Updates

These functions were added or strengthened after the previous help guide was published.

Day Care & Emergency (Casualty) Module NEW
Dedicated admission workflows for Day Care (DC prefix) and Emergency/Casualty (ER prefix), ESI Triage Levels 1–5, MLC registry, specialized wards (Day Care Unit & Casualty Ward), clinical Convert to IPD escalation with SBAR handover notes, unified IPD billing merging ER/Day Care charges under distinct group sub-headers, and medical standard Day Care discharge summaries with PADSS criteria (≥9).
OT Management Phase 1 NEW
Surgery requests, OT queue, scheduling, patient call status, pre-operative safety checks, WHO sign-in, operation progress, immutable event history, and signed post-operative assessment are now integrated with IPD Nursing.
Department-specific pre-operative forms
Specialty forms can appear according to the admitted patient's department. Ophthalmology pre-operative examination is available with completed-record edit reasons and audit history.
IPD Nursing and discharge controls
Dedicated nursing access, clinical workspace improvements, configurable discharge content, diagnosis masters, and more reliable HTML/PDF template rendering are available.
Controlled Payment Edit
Authorized finance users can correct payment mode, amount, and recorded user. Zero-value corrections are supported; negative values remain blocked.
Pharmacy credit payout workflow
Pharmacy can review the eligible medical-store credit pool, create payout requests, submit them to Finance, and monitor submitted, approved, partially paid, paid, or rejected status.
Stronger session and permission controls
Single-active-session protection, clearer access-denied pages, streamlined permission management, and dedicated permissions for payment editing, nursing, discharge, and OT actions are active.
Clinical drill-down dashboards
Management dashboards support navigation from summary indicators to underlying operational and clinical records.
Pharmacy usability fixes
Credit payout routes, Medicine Return labels, and the Org. Credit Invoice empty-grid behavior have been corrected.
Deployment note: New database-backed features require their migrations and permissions to be applied by the system administrator.

02Getting Started

1. Sign inUse only your assigned account. Shared accounts weaken clinical and financial audit records.
2. Select a moduleUse the sidebar for Patient, OPD, IPD, Diagnosis, Pharmacy, Finance, Stock, Reports, or Settings.
3. Search firstSearch by patient code, name, mobile, ABHA, invoice, IPD, or case code before creating a duplicate.
4. Verify contextConfirm patient, encounter, department, payer, and date before saving clinical or billing data.
5. Complete the workflowDraft, verify, approve, print, or submit as required. A draft is not always final.
6. Sign outUse the profile menu, especially on shared workstations.

Common screen behavior

  • Most pages open inside the main workspace without a full browser refresh.
  • Filters affect the current list. Clear them before concluding a record is missing.
  • PDF/print buttons may open a new tab; allow pop-ups for the HMS domain.
  • Red actions may cancel, delete, refund, reject, or finalize and require extra care.
Before finalization: Recheck identifiers, dates, amounts, medicine batches, clinical findings, and print template. Final records may require permission and an edit reason to change.

03User Roles & Access

Menus and actions are permission-based. Two users may open the same patient but see different buttons.

Role areaTypical responsibilityRestricted actions
RegistrationPatient search, registration, appointment, token, admission supportClinical verification and financial correction
Doctor / ClinicalConsultation, diagnosis, prescription, orders, dischargeFinance approval and stock administration
Nursing / OTNursing workspace, bedside care, safety checks, OT status, handoverScheduling or signed assessment unless assigned
DiagnosisSample workflow, findings, imaging, verification, report printingVerified-report edits without reason/permission
PharmacyDispensing, returns, inventory, purchasing, supplier and credit workflowsFinance payout approval
Billing / FinanceInvoices, collections, refunds, reconciliation, payoutsPayment edits without finance.payment.edit
AdministratorUsers, permissions, masters, templates, integrations, operationsInfrastructure actions still require confirmation

For Access denied, note the module and action and ask an administrator to review the role. Never use another person's login.

04Patient Management

  1. Search first. Use UHID/patient code, name, phone, Aadhaar reference, old UHID, or ABHA.
  2. Review matches. Compare DOB, gender, guardian, address, and contact number.
  3. Create or update. Enter demographics, identity documents, photo, guardian/family data, and attachments.
  4. Open the profile. Use it for OPD, IPD, billing, diagnosis, documents, and health-record history.
  5. Link ABHA. Verify that the ABHA profile belongs to the same patient first.
Duplicate prevention: Try alternate spelling, phone, old code, and family details before creating a new patient.

05OPD Workflow

Appointment and check-in

  1. Select patient, doctor, date/slot, or walk-in.
  2. Confirm department, referral, consultation type, and organization/insurance case.
  3. Generate the visit/token. Scan & Share patients may arrive through the facility QR.
  4. Collect or confirm consultation payment according to policy.

Clinical consultation

  • Record vitals, complaints, history, examination, allergies/ADR, medications, diagnosis, advice, and follow-up.
  • Add medicines with dosage, frequency, route, duration, and instructions.
  • Order pathology or imaging investigations and review previous visits.
  • Generate referral letters, prescription PDFs, and FHIR e-Prescription records when required.
AI assistance: AI can draft complaints, prescriptions, or extract report values where configured. A clinician must review all generated content.

06IPD Admission, Nursing & Discharge

Admission and beds

  1. Create admission with department, doctor, date/time, and reason.
  2. Assign an available Department → Ward → Category → Bed.
  3. Record HPI/admission history and treating doctors.
  4. Use bed transfer instead of overwriting the bed to preserve history.

Nursing

  • Document shift notes and observations against the correct admission.
  • Post bedside consumables, nursing items, and doctor visits promptly.
  • Scan paper forms and use Surgery/OT for operative patients.
  • Check the patient/IPD banner before every entry.

Discharge

  • Complete diagnosis, course, procedures, condition, medication, advice, diet, and follow-up.
  • Select and preview the approved discharge template.
  • Reconcile pending charges, returns, package adjustments, and balance.
  • Verify PDF page breaks, placeholders, dates, letterhead mode, and signatures.
  • Generate/share the ABDM discharge summary when requirements are met.

07Day Care & Emergency (Casualty) Module

Designed in compliance with NABH, HL7 FHIR R4, and ESI (Emergency Severity Index) triage standards. This module supports short-stay observation, planned day care surgical/medical procedures (<24 hours), acute casualty resuscitation, and seamless clinical escalation to Inpatient (IPD) with unified billing and SBAR handover.

Quick Access: Where to Find Admission Links in the HMS

You can register or admit patients for Emergency / Casualty or Day Care (< 24 Hrs) from 4 primary places across the application:

▶ 1. Left Navigation Sidebar:
Under Billing & Accounts in the left sidebar, click directly on:
  • Emergency / Casualty (with red ambulance icon)
  • Day Care Unit (with clock icon)
  • Or under In-Patient & Nursing Care: click Admit Patient Desk
▶ 2. Patient Profile Screen:
Search for any patient and open their profile. Under the action buttons, click:
Casualty Day Care IPD
Instantly pre-selects the admission type and displays triage or procedure fields.
▶ 3. IPD Dashboard & Admissions:
Open IPD Billing from sidebar:
  • Top right buttons: Emergency Admission & Day Care Admission
  • On Current Admissions: click the green + New Admission dropdown
▶ 4. Patient Admission Desk:
Search any patient by Name, UHID, or Phone number. Then click Casualty, Day Care, or IPD.
If patient is brand new, click + New Patient Registration first.

Clinical & Operational Flowchart

The following flowchart illustrates the complete patient lifecycle: acute emergency triage or planned procedure admission, dedicated physical ward allocation, bedside service delivery, discharge disposition, and the audited escalation pathway to full Inpatient (IPD) admission.

1. EMERGENCY / CASUALTY 2. DAY CARE UNIT (<24H) 3. INPATIENT ADMISSION (IPD) Registration & Triage • Auto Prefix: ER-YYYY-XXXXX • ESI Triage Level 1 to 5 • MLC Case Record & Police details Day Care Registration • Auto Prefix: DC-YYYY-XXXXX • Procedure Name specified • Ward: Day Care Unit (DC-01) Standard IPD Registration • Auto Prefix: A-YYYY-XXXXX • Planned Inpatient Admission • General / Private / ICU Wards Casualty Care & Services • Rapid Resuscitation & Vitals • Stat Diagnostics & Bedside Rx ► Group: EMERGENCY CHARGES Procedure & Recovery • Short-Stay Intervention • Post-Anesthesia Recovery ► Group: DAY CARE CHARGES Inpatient Clinical Care • Bedside Nursing & Doctor Visits • OT Surgery / Daily Ward Rounds ► Multi-Group Unified Billing Stabilized or Needs Admission? Clinical trajectory review PADSS Score Evaluation Score ≥ 9 required to discharge ⚡ CLINICAL ESCALATION: CONVERT TO IPD • SBAR Handover (Situation, Background, Assessment, Recommendation) • Auto Bed Transfer (Free ER/DC bed → Assign Inpatient Bed) → Charges automatically merge into Unified IPD Bill with distinct group headers Direct Discharge PADSS ≥ 9 Emergency Discharge • Stabilized & Sent Home / Transfer • LAMA / DAMA / Referral Out • Casualty Bill Settlement • FHIR Class: EMER Day Care Discharge • Day Care Discharge Summary • PADSS Score recorded (≥9) • Home Meds & Red-Flag Warnings • FHIR Class: SS (Short Stay) Inpatient Final Discharge • Complete Inpatient Discharge • Unified IPD Bill (ER + DC + IPD) • Categorized Subtotal Headers • FHIR Class: IMP (Inpatient)

1. Key Identifiers & Dedicated Physical Wards

To prevent clinical confusion, enhance patient tracking, and ensure strict auditability, distinct admission prefixes and dedicated physical wards are maintained:

Admission Type Registration Prefix Default Physical Ward Billing Item Category HL7 FHIR Encounter
Casualty / Emergency ER-YYYY-XXXXX Casualty & Emergency Ward (ER-01) EMERGENCY / CASUALTY CHARGES EMER (Emergency)
Day Care (<24 hrs) DC-YYYY-XXXXX Day Care Unit (DC-01) DAY CARE CHARGES SS (Short Stay)
Inpatient (IPD) A-YYYY-XXXXX General / Semi-Private / Deluxe / ICU / HDU Multi-Category IPD Billing IMP (Inpatient)

2. Emergency / Casualty Workflow

  1. Rapid Check-in & ESI Triage: Immediate registration at the casualty reception. Clinical staff assign the Emergency Severity Index (ESI) Level based on clinical acuity:
    ESI Level Clinical Triage Category Target Door-to-Doctor Time Clinical Examples
    ESI 1 Resuscitation (Immediate Life-Threat) Immediate (0 min) Cardiac arrest, respiratory failure, severe trauma with shock, anaphylaxis.
    ESI 2 Emergent (High Risk / Severe Pain) ≤ 10 minutes Acute chest pain, severe dyspnea, suspected stroke, acute abdomen, danger vitals.
    ESI 3 Urgent (≥2 Resources Required) ≤ 30–60 minutes Stable vitals requiring IV access, laboratory investigations, and X-ray/USG.
    ESI 4 Less Urgent (1 Resource Required) ≤ 60–120 minutes Simple laceration needing suture, uncomplicated urinary tract infection, sprain.
    ESI 5 Non-Urgent (0 Resources Required) ≤ 120 minutes Medication refill, minor rash, suture removal, chronic mild symptom review.
  2. Medico-Legal Case (MLC) Registry: If the casualty case involves road traffic accidents (RTA), assault, burns, poisoning, industrial trauma, or suspected foul play, toggle "Is Medico-Legal Case (MLC)". Record:
    • MLC Number: Formal hospital police register number.
    • Police Station: Jurisdiction police station notified.
    • Police Constable Details: Name and badge number of intimating/recording officer.
    • Brought By: Ambulance (e.g. 108), Police, Relative, or Good Samaritan with contact number.
  3. Casualty Bed & Orders: Patient is assigned a bed in the Casualty & Emergency Ward. Doctors post emergency orders (stat labs, ECG, imaging, IV fluids, emergency medicines). Consumables and nursing procedures automatically tag under EMERGENCY / CASUALTY CHARGES.
  4. Emergency Disposition:
    • Treated & Discharged: Once stabilized, settle the emergency bill and generate a casualty discharge slip.
    • Escalation / Admission Needed: If the patient requires surgical intervention, specialized ICU/HDU monitoring, or inpatient observation, initiate the Convert to IPD action.

3. Day Care Workflow (<24 Hour Admissions)

Designed for planned surgical, therapeutic, or diagnostic procedures that do not require an overnight bed stay.

  1. Day Care Admission: In Registration, select Day Care. Enter the planned procedure name (e.g. Cataract Extraction with Foldable IOL, Chemotherapy Session, Maintenance Hemodialysis, Upper GI Endoscopy / Colonoscopy, or Tympanoplasty). System generates a DC-YYYY-XXXXX code and allocates a bed in the Day Care Unit (DC-01).
  2. Pre-Procedure & Surgical Care: Pre-op nursing assessment, surgical safety checklist, and procedure delivery. Services, procedure fees, and medications are billed under DAY CARE CHARGES.
  3. Recovery & PADSS Scoring: Before clearing the patient for home discharge, the clinician or recovery nurse evaluates the patient against the Post-Anaesthetic Discharge Scoring System (PADSS):
    PADSS Criteria (2 pts each)Score 2Score 1Score 0
    Vital Signs (BP/Pulse)Within 20% of pre-op baseline20%–40% of baseline>40% of baseline
    Activity & AmbulationSteady gait / no dizzinessRequires assistanceUnable to ambulate / vertigo
    Nausea & VomitingMinimal / none, drinks fluidsModerate, managed with antiemeticSevere / persistent vomiting
    Pain ControlAcceptable / mild, oral analgesicsModerate, requires parenteral medsSevere, unmanaged pain
    Surgical BleedingMinimal / dry dressingModerate, 1–2 dressing changesSevere / active bleeding
    Discharge Threshold: Patient must achieve a total score of ≥ 9 out of 10, be accompanied by a responsible adult, and be oriented to time and place before home discharge.
  4. Day Care Discharge Summary: Select the Day Care Discharge Summary template. It automatically displays:
    • Procedure performed, anesthesia technique, and operating surgeon.
    • Post-operative PADSS discharge score (≥9).
    • Take-home medications with clear dosage, frequency, and duration.
    • Dietary, wound dressing, and activity instructions.
    • Red-Flag Emergency Warnings: Explicit warnings regarding severe bleeding, sudden fever >101°F, persistent vomiting, wound discharge, or chest pain, with direct 24/7 hospital emergency telephone numbers.

4. Clinical Escalation: Convert to IPD Workflow

When an Emergency or Day Care patient deteriorates, suffers surgical complications, requires prolonged observation (>24 hours), or must be shifted to an intensive care unit (ICU/HDU), the system provides an audited, one-click Convert to IPD escalation workflow.

1. Trigger ActionOpen patient panel (billing/ipd/panel/{id}) and click "Convert to IPD" in the top header.
2. Bed & Doctor TransferSelect the target Inpatient Ward (General, Private, ICU) and confirming doctor. Previous ER/DC bed is released immediately.
3. SBAR HandoverDocument Situation, Background, Assessment, and Recommendation for safe nursing & doctor handover.

The SBAR Clinical Handover Framework

NABH standards require structured clinical communication during patient transfers across care settings. The conversion modal enforces the SBAR format:

SSituation: Reason for conversion (e.g. "Post-operative bleeding following day-care laparoscopic hernia repair requiring exploratory laparotomy and overnight monitoring").
BBackground: Baseline clinical history, co-morbidities (e.g. hypertension, diabetes), and initial reason for presenting to ER or Day Care.
AAssessment: Current vital signs, Glasgow Coma Scale (GCS), stat lab results, imaging impressions, and interventions administered in Casualty or Day Care Unit.
RRecommendation: Inpatient monitoring orders, ICU/ward instructions, pending laboratory results, scheduled specialist consultations, and emergency escalation criteria.
Preservation of Clinical History: The patient's record is updated with converted_from_type and converted_from_code. A permanent badge (e.g. Converted from ER (ER-2026-00012)) is rendered across all clinical and billing screens for complete audit transparency.

5. Unified IPD Billing with Distinct Group Headers

A core financial requirement of hospital operations is that when a patient converts from Day Care or Casualty to full IPD, no billing charges are lost or split into fragmented invoices. The entire financial account is unified under the Inpatient admission.

  • All prior medications, dressings, doctor consultations, lab tests, and procedures delivered in the Emergency room remain intact under EMERGENCY / CASUALTY CHARGES.
  • All surgical consumables, daycare room charges, and anesthesia charges delivered in the Day Care unit remain intact under DAY CARE CHARGES.
  • Subsequent inpatient charges (Room Bed charges, ICU monitoring, Nursing care, Inpatient pharmacy) accumulate under standard IPD item types.
  • Final IPD Bill Print: The final discharge invoice organizes and prints these charges under clearly demarcated sub-headings with line-item rates, quantities, taxes, and category subtotals:
    Printed Section HeaderContent & ScopeTypical Line Items
    EMERGENCY / CASUALTY CHARGESServices rendered during casualty stayCasualty consultation, stat ECG, IV cannulation, oxygen, emergency trauma tray
    DAY CARE CHARGESInterventions during daycare stayDaycare bed rent, endoscopy tray, daycare nursing observation, dialyzer pack
    ROOM / BED CHARGESInpatient ward/ICU charges post-conversionGeneral Ward Bed / Deluxe Room / ICU monitoring charges per diem
    INVESTIGATIONS & LABPathology & imaging investigationsCBC, Serum Creatinine, Chest X-Ray, CT Scan, Ultrasound
    SURGERY & PROCEDURESInpatient operative interventionsMajor surgery charges, surgeon fees, OT anesthesia, recovery charges
  • TPA & Mediclaim Compliance: Insurance third-party administrators (TPAs), Ayushman Bharat (PM-JAY), and corporate panels require clear demarcation of pre-admission casualty/daycare expenses from inpatient ward expenses. The unified bill provides 100% itemized transparency.

6. Bed Management & Live Tracking

  • Dedicated Casualty & Day Care Wards: Configured in Settings → Bed Master. Default wards Casualty & Emergency Ward (ER-01) and Day Care Unit (DC-01) are active. Additional day care wards (e.g. Dialysis Unit, Chemo Daycare) can be defined with ward type Day Care.
  • Current Admissions Filtering: In Billing → IPD Admissions, users can switch views using live pill buttons:
    • All — Combined hospital bed census.
    • Inpatient IPD — Standard admitted inpatients.
    • Day Care — Patients occupying Day Care short-stay beds.
    • Emergency — Patients actively under Casualty / Triage observation.
  • Automatic Bed Release: When Convert to IPD is executed, the patient's Casualty or Day Care bed is automatically flagged available (VACANT) for new arrivals, eliminating ghost bed blocks.
Clinical Safety Rule: Never overwrite a patient's admission code manually in the database. Always use the Convert to IPD modal so that SBAR handover notes, bed occupancy transfers, and HL7 FHIR encounter progressions are recorded in the audit trail.

08OT Management

Available from IPD Nursing and OT Surgery Queue. Request, scheduling, examination, status, and post-operative actions have separate permissions.

  1. Create request. Enter procedure, surgeon, priority, indication, and requested schedule.
  2. Complete pre-op examination. Use the department-specific form; revisions to completed forms require a reason.
  3. Schedule. Authorized OT staff assign date/time and coordination details.
  4. Call patient. Update the case when preparation begins.
  5. Complete safety gates. Confirm pre-op checks and WHO sign-in before starting.
  6. Record progress. Move through requested, scheduled, called, in progress, and completed; give reasons for cancellation or major changes.
  7. Sign post-op assessment. Record observations, outcome, instructions, and handover.
Clinical integrity: OT actions create event history and use version checks. Refresh if another user changed the case.

09Diagnosis, Laboratory & Imaging

Supported workflows include Pathology, Biopsy, X-Ray, Ultrasound, MRI, CT, and Echo.

Laboratory

  1. Receive the OPD, IPD, or walk-in request and confirm patient/tests.
  2. Record sample collection and lab number.
  3. Enter values; review units, reference ranges, flags, and comments.
  4. Save draft, then verify/sign according to policy.
  5. Print individual or compiled reports using the correct template.

Imaging

  • Upload images, scans, or DICOM studies against the report.
  • Use the viewer/gallery and draft findings/impression.
  • Complete doctor verification; AI suggestions require radiologist review.
Verified reports: Authorized edits require a meaningful reason retained in the audit trail.

10Pharmacy / Medical Store

Dispensing

  • Create counter, OPD, IPD, or organization-linked invoices in the correct context.
  • Confirm medicine, batch, expiry, stock, rate, tax, discount, and quantity.
  • Use Medicine Return or Medicine Return 2 for the applicable return flow.
  • Use Org. Credit Invoice for corporate/insurance-linked medicine billing.
  • Finalize an IPD medicine account only after invoices, returns, discounts, and payments reconcile.

Inventory and purchase

  • Maintain drug, generic, formulation, category, company, supplier, batch, tax, and rate masters.
  • Create purchase orders, receive invoices/batches, and process purchase returns.
  • Monitor expiry, low stock, movement, and supplier ledger reports.

Credit payout request

  1. Open Pharmacy → Credit Payout Request.
  2. Review/filter the eligible pool.
  3. Select valid lines, confirm amounts, add remarks, and submit.
  4. Monitor status while Finance handles approval and payment.

11Billing, Invoices & Payments

  • Bill OPD consultation, procedures, diagnostics, IPD charges, packages, and pharmacy links.
  • Apply discounts only with authority and supporting remarks.
  • Use payment/refund request workflows instead of informal adjustments.
  • Confirm organization/insurance case before posting payer charges.
  • Print/export daily collection and balance reports for reconciliation.

Payment Edit

Authorized users can correct payment mode, amount, or recorded user. Amount may be 0.00 for a valid correction but cannot be negative.

Do not use Payment Edit to hide a refund or cancellation. Use the approved reversal workflow and retain the reason.

12Finance & Accounting

Cash BookDaily department collections and opening/closing position.
Bank DepositsDeposit references, dates, amounts, and status.
ReconciliationMatch statements to system transactions.
POS SettlementTrack terminal settlements, charges, and differences.
Doctor PayoutsAgreements, commission, approval, and disbursement.
Vendor ControlPO, receipt, invoice, payment, and balance.

Review pharmacy payout line evidence, approve/reject according to policy, record payments, and retain remarks for each status change.

13Insurance & Organization Cases

  1. Create/select the case and verify patient, payer, policy, approval, and validity.
  2. Link OPD, IPD, diagnosis, procedures, and pharmacy invoices.
  3. Apply approved rates/packages, including Ayushman mappings.
  4. Use contingent billing when liability depends on case outcome.
  5. Prepare claim sheets and supporting documents.
  6. Track submission, query, approval, deduction, payment, and balance.
Case selection: Select a valid system case. Empty or placeholder identifiers are not payer cases.

14ABDM, ABHA & Health Records

ABHA identity

  • Create ABHA through supported Aadhaar/mobile OTP flows.
  • Verify/fetch profile before linking to the HMS patient.
  • Display/download ABHA card and use facility QR for Scan & Share.

Care context and sharing

  1. Confirm verified ABHA and correct visit/admission.
  2. Discover/link the care context.
  3. Select e-Prescription, Discharge Summary, Diagnostic Report, Immunization, Wellness, Health Document, or supported invoice.
  4. Preview FHIR R4 data: identity, dates, practitioner, coding, and attachments.
  5. Share and monitor gateway/bridge status.

Consent and HIU

  • Request consent only for a legitimate purpose and date range.
  • Track requested, granted, denied, expired, and revoked status.
  • Fetch health information only after grant; data may contain FHIR documents and attachments.
Privacy: ABDM access is purpose-limited and consent-driven. Use data only for authorized care.

15Hospital Stock

  1. Configure category, item, units, conversion, location, min/reorder, and expiry control.
  2. Departments raise indents with quantity and purpose.
  3. Authorized users approve, reject, or revise.
  4. Storekeepers issue approved quantities and batches.
  5. Create purchase orders and goods receipts.
  6. Review consumption, issues, expiry, low-stock, reorder, and daily-use reports.
Purchase and issue units may differ. Wrong conversion causes incorrect stock and reorder quantities.

16Reports & Dashboards

AreaExamplesReview focus
ClinicalOPD, diagnosis workload/TAT, discharge, OT queueCompleteness and delays
BillingCollections, balances, refunds, credit invoicesMode/user totals and exceptions
FinanceCash book, bank audit, POS, doctor payoutUnmatched/unapproved items
PharmacyStock, expiry, movement, sales, returns, supplier ledgerNegative stock and expiry risk
InsuranceOrganization dues, claims, deductionsAging and documents
AuditNABH edits, billing logs, user actionsWho changed what, when, and why

Use drill-down links from totals to source records. Retain the same dates and filters while reconciling.

17Administration & System Operations

Application administration

  • Manage users, groups, permissions, passwords, and active access.
  • Maintain doctor, referral, insurance, bank/payment, charge, diagnosis, medicine, and stock masters.
  • Configure OPD, diagnosis, and discharge print templates.
  • Configure AI, HealthPlix, ABDM HFR/gateway/bridge, and report-doctor mappings.

System Operations

  • Review OS/uptime, CPU, memory, disk, RAID, database, web, PHP-FPM, and SSH health.
  • Use Update HMS only during an approved window and review its log.
  • Restart services only when needed. Reboot/shutdown require confirmation and coordination.
Production safety: Confirm backup and rollback readiness before migrations, updates, restarts, or environment changes.

18Security, Audit & Compliance

  • Never disclose passwords, OTPs, API keys, or tokens.
  • Single-active-session protection may end an older login.
  • Grant the least permission required and review access after role changes.
  • Clinical verification, payment edits, refunds, cancellations, OT changes, and completed-form revisions require audit evidence.
  • Verify SNOMED CT/ICD-10 codes against documented clinical meaning.
  • Follow NABH, ABDM/FHIR, NHCX, privacy, retention, and hospital policies.

19Backup & Maintenance

  • Schedule database and uploaded-document backups and test restoration.
  • Retain an off-server/off-site copy according to policy.
  • Apply code updates and migrations in a controlled sequence.
  • After deployment test login, dashboard, patient search, billing, PDF, uploads, jobs, and integrations.
  • Monitor storage, database growth, logs, failed queues, ABDM tasks, and large attachments.
  • Keep production error display disabled; use protected logs.

20Troubleshooting

ProblemCheckAction
Access deniedRole, permission, moduleAsk Admin; do not borrow credentials.
Page/form does not loadSession, network, URL/status, consoleRefresh dashboard, reopen, report exact URL/status.
Save does nothingRequired/invalid number or date fieldsCorrect highlighted fields; report console/network details.
DataTables warningEmpty table, screen URL, table IDReport URL and table ID.
Unexpected token <HTML server error returned instead of JSONCapture endpoint/status; Admin checks logs.
PDF mismatchTemplate, paper mode, placeholders, pasted HTMLPreview intended template and report record/template.
Wrong stockBatch, conversion, return, issue, receipt, transferReconcile ledger before adjustment.
Payment mismatchInvoice, mode, user, amount, refund/voidUse approved correction and document reason.
ABDM pending/failedABHA, consent, HFR/token, bridge/task logIdentify failure; preserve request ID.
OT changed elsewhereStale version warningRefresh, review history, re-enter update.

Include in a support request

  • Exact URL and module
  • Date/time and user role, never password
  • Patient/IPD/invoice/case code through approved channels
  • Steps, expected result, and actual result
  • Screenshot and console/network status