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<title>E-Atria HMIS &mdash; Operations &amp; Module User Guide</title>
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<body id="top">
<header class="guide-header py-4">
<div class="page-shell px-3 px-lg-4">
<div class="d-flex flex-wrap align-items-center justify-content-between gap-3 mb-3">
<div class="d-flex align-items-center gap-3">
<img class="brand-mark" src="assets/img/logo.png" alt="E-Atria HMIS logo">
<div>
<h1 class="guide-title">E-Atria HMIS Module User &amp; Operations Guide</h1>
<div class="version-label">Official HMIS Manual &nbsp;|&nbsp; Revised for ABDM M1/M2/M3, Clinical Masters &amp; Template Design</div>
</div>
</div>
<div class="no-print d-flex gap-2">
<button type="button" class="btn btn-outline-light btn-sm fw-semibold" onclick="window.print()">
<i class="bi bi-printer me-1"></i>Print Manual
</button>
<a href="/dashboard" class="btn btn-light btn-sm fw-bold text-navy">
<i class="bi bi-arrow-left me-1"></i>Back to HMIS
</a>
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<label class="visually-hidden" for="guide-search">Search guide content</label>
<input id="guide-search" class="form-control" type="search" placeholder="Search forms, modules, reports, templates, ABDM workflows...">
</div>
</div>
</header>
<main class="page-shell px-3 px-lg-4 py-4">
<div id="no-results" class="no-results mb-3" role="status">
<i class="bi bi-exclamation-circle me-2"></i>No guide section matches your search keyword. Please try another term.
</div>
<div class="layout">
<!-- Sticky Table of Contents -->
<aside class="toc-panel no-print" aria-label="HMIS Guide Contents">
<div class="p-3 border-bottom d-flex justify-content-between align-items-center">
<h2 class="mb-0 fs-6 fw-bold"><i class="bi bi-list-nested me-2 text-primary"></i>HMIS Modules</h2>
<span class="badge bg-primary-subtle text-primary">v2.5</span>
</div>
<nav class="toc-links py-2">
<div class="toc-group-title">Overview &amp; Setup</div>
<a href="#recent-updates"><i class="bi bi-stars"></i>Recent Updates</a>
<a href="#roles-access"><i class="bi bi-person-badge"></i>Roles &amp; Permissions</a>
<div class="toc-group-title">Patient &amp; Front Desk</div>
<a href="#patient-management"><i class="bi bi-person-lines-fill"></i>Patient Registration</a>
<a href="#opd-workflow"><i class="bi bi-calendar2-check"></i>OPD &amp; Consultations</a>
<a href="#ipd-nursing"><i class="bi bi-hospital"></i>IPD, Day Care &amp; ER</a>
<a href="#ot-management"><i class="bi bi-calendar2-week"></i>Operation Theatre (OT)</a>
<div class="toc-group-title">Clinical &amp; Diagnostic</div>
<a href="#doctor-work"><i class="bi bi-heart-pulse"></i>Doctor's Work &amp; Rx</a>
<a href="#diagnosis"><i class="bi bi-activity"></i>Pathology &amp; Radiology</a>
<a href="#template-design"><i class="bi bi-palette"></i>Template Design Guide</a>
<div class="toc-group-title">Pharmacy &amp; Inventory</div>
<a href="#pharmacy"><i class="bi bi-capsule-pill"></i>Pharmacy POS &amp; Credit</a>
<a href="#hospital-stock"><i class="bi bi-box-seam"></i>Hospital Stock &amp; Indents</a>
<div class="toc-group-title">Billing &amp; Finance</div>
<a href="#billing"><i class="bi bi-receipt"></i>Billing, Invoices &amp; Shifts</a>
<a href="#finance"><i class="bi bi-bank"></i>Finance, Audit &amp; Payouts</a>
<a href="#insurance"><i class="bi bi-shield-check"></i>Insurance &amp; TPA Claims</a>
<div class="toc-group-title">National Standards</div>
<a href="#abdm"><i class="bi bi-qr-code-scan"></i>ABDM (M1, M2, M3)</a>
<a href="#reports"><i class="bi bi-graph-up"></i>Reports &amp; NABH Audits</a>
<a href="#admin-settings"><i class="bi bi-gear"></i>Admin &amp; Configuration</a>
<a href="#troubleshooting"><i class="bi bi-wrench-adjustable"></i>Troubleshooting</a>
</nav>
</aside>
<!-- Main Guide Content Area -->
<div class="guide-content">
<!-- ========================================================================= -->
<!-- 01: RECENT UPDATES -->
<!-- ========================================================================= -->
<section id="recent-updates" class="guide-section searchable-section">
<h2><span class="section-number">01</span>Recent Updates &amp; Enhancements (Version 2.5)</h2>
<p>The following features and certifications were recently developed and incorporated into the E-Atria HMIS platform:</p>
<div class="update-item abdm">
<strong>ABDM Milestone 2 (M2) HIP Certified Workflows <span class="status-chip success ms-1">NEW</span></strong>
<div>HIP-initiated care context linking via <strong>Method 4 Demographic Auth</strong> and <strong>Deep Link SMS Notifications</strong>. Instant care context discovery for newly generated OPD visit slips from reception, dual 14-digit numeric &amp; <code>@sbx</code> handle auto-resolution, and automated FHIR R4 clinical record publishing (OPConsultRecord, DiagnosticReportRecord, DischargeSummaryRecord).</div>
</div>
<div class="update-item abdm">
<strong>ABDM Milestone 1 (M1) Official Review Alignments</strong>
<div>Strictly normalized OTP verification error messages to <code>"Incorrect OTP"</code> (eliminating internal technical code leaks), complete removal of internal Bridge Request IDs from client view, and mandatory inclusion of Healthcare Worker Declaration &amp; Beneficiary Consent Name collection input fields.</div>
</div>
<div class="update-item">
<strong>Standardized Radiology Templates for Imaging Modalities <span class="status-chip success ms-1">NEW</span></strong>
<div>Complete seed of clinical reporting templates for <strong>Digital X-Ray</strong>, <strong>CT-Scan</strong>, and <strong>MRI</strong>, along with dynamically synchronized service charge links in the Hospital Tariff Master for direct billing-to-template injection.</div>
</div>
<div class="update-item">
<strong>Day Care &amp; Emergency (Casualty) Module</strong>
<div>ESI Triage Levels 1–5, Medico-Legal Case (MLC) police intimation registry, dedicated physical wards (ER-01 &amp; DC-01), clinical <strong>Convert to IPD</strong> escalation with SBAR handover notes, and unified IPD billing with distinct group sub-headers.</div>
</div>
<div class="update-item">
<strong>OT Surgery Queue &amp; WHO Safety Checklist</strong>
<div>End-to-end surgical lifecycle tracking: scheduling, call status, pre-op anesthesia assessment, WHO Surgical Safety Sign-In, Time-Out, and Sign-Out, recovery progress, and post-op signoff.</div>
</div>
<div class="update-item finance">
<strong>Billing Shift Cash Submission &amp; OPD Consultation Payouts</strong>
<div>Counter cashier shift-end cash handover statement to Accounts, accountant physical verification gate, audited payment corrections, and automated doctor OPD consultation fee share payout calculation.</div>
</div>
<div class="back-top"><a href="#top"><i class="bi bi-arrow-up-circle me-1"></i>Back to Top</a></div>
</section>
<!-- ========================================================================= -->
<!-- 02: ROLES & ACCESS -->
<!-- ========================================================================= -->
<section id="roles-access" class="guide-section searchable-section">
<h2><span class="section-number">02</span>Hospital Roles &amp; Permission Structure</h2>
<p>E-Atria HMIS enforces strict Role-Based Access Control (RBAC). What each user sees in the sidebar and which action buttons are clickable depend on their assigned roles and permissions:</p>
<div class="table-responsive">
<table class="table table-bordered table-guide">
<thead>
<tr>
<th>Role / Staff Area</th>
<th>Primary HMS Responsibilities</th>
<th>Accessible Menu Modules</th>
<th>Restricted Boundaries</th>
</tr>
</thead>
<tbody>
<tr>
<td><strong>Front Desk / Reception</strong></td>
<td>Patient search, registration, ABHA creation/verification, OPD visit tokens, bed inquiries, basic receipt printing.</td>
<td><code>Patient List</code>, <code>OPD Invoice</code>, <code>Bed Status</code>, <code>ABDM OPD Queue</code></td>
<td>Cannot prescribe medications, sign diagnostic reports, or execute financial ledgers.</td>
</tr>
<tr>
<td><strong>Doctor / Clinician</strong></td>
<td>Consultations, vitals, clinical examination, e-Prescribing, investigations ordering, OT requests, discharge summaries.</td>
<td><code>OPD Appointment List</code>, <code>Rx-Group</code>, <code>Clinical Templates</code>, <code>Doctor Documents</code>, <code>OT Queue</code>, <code>Discharge</code></td>
<td>Cannot collect cash, modify billing tariffs, or approve pharmacy stock indents.</td>
</tr>
<tr>
<td><strong>Nursing Staff</strong></td>
<td>Bedside care, vitals charting, medication administration, OT prep, nursing notes, pre-op safety checks.</td>
<td><code>IPD Patient List</code>, <code>OT Surgery Queue</code>, <code>Doctor Documents</code></td>
<td>Cannot discharge patient without doctor summary or edit finalized bills.</td>
</tr>
<tr>
<td><strong>Pathologist / Radiologist</strong></td>
<td>Sample tracking, parameter entry, imaging study review, findings drafting, digital signature.</td>
<td><code>Diagnosis (Pathology, X-Ray, CT, MRI, USG, Echo)</code>, <code>Diagnosis Report</code></td>
<td>Cannot modify verified reports without audited edit reason and permission.</td>
</tr>
<tr>
<td><strong>Pharmacist</strong></td>
<td>Prescription dispensing, batch/expiry selection, counter sales, returns, stock indents, supplier receipts.</td>
<td><code>Pharmacy (Medical Store)</code>, <code>Pharmacy Reports</code>, <code>Hospital Stock</code></td>
<td>Cannot approve financial payouts or modify OPD consultation fees.</td>
</tr>
<tr>
<td><strong>Billing Cashier</strong></td>
<td>Diagnostic invoicing, bed charge billing, advance deposits, Ayushman/TPA claims, shift cash closure.</td>
<td><code>Charges Invoice</code>, <code>IPD Billing</code>, <code>Org Packing</code>, <code>Cash Submission</code></td>
<td>Cannot accept their own cash submission or edit doctor clinical notes.</td>
</tr>
<tr>
<td><strong>Accountant / Finance</strong></td>
<td>Cashbook verification, shift acceptance, bank deposits, statement reconciliation, doctor consult payouts.</td>
<td><code>Accounts And Finance</code>, <code>Payment Edit</code>, <code>Bank Audit</code>, <code>Payouts</code></td>
<td>Cannot alter medical diagnosis or delete clinical encounter history.</td>
</tr>
<tr>
<td><strong>Administrator</strong></td>
<td>User accounts, role permissions, tariff masters, template configuration, hospital settings, system audit.</td>
<td><code>All Menus</code>, <code>Admin Panel</code>, <code>Template Workspace</code>, <code>Charges Master</code></td>
<td>Clinical actions still record the administrator's individual audit footprint.</td>
</tr>
</tbody>
</table>
</div>
<div class="note"><strong>Access Denied Error:</strong> If an <code>"Access Denied: Missing Permission"</code> modal appears, note the exact module name and notify the Hospital System Administrator to review the user's role in <strong>Admin &rarr; User Management</strong>.</div>
<div class="back-top"><a href="#top"><i class="bi bi-arrow-up-circle me-1"></i>Back to Top</a></div>
</section>
<!-- ========================================================================= -->
<!-- 03: PATIENT MANAGEMENT & ABHA REGISTRATION -->
<!-- ========================================================================= -->
<section id="patient-management" class="guide-section searchable-section">
<h2><span class="section-number">03</span>Patient Management &amp; Registration Module</h2>
<p><strong>Sidebar Menu:</strong> <code>Billing &rarr; Patient List</code><br>
<strong>Intended Users:</strong> Front Desk Receptionists, OPD Registration Staff, Admission Clerks.</p>
<p>This module serves as the primary master registry for all individuals receiving healthcare services at the facility. It provides comprehensive duplicate prevention, ABDM ABHA creation and verification, quick search, and direct launching of OPD, IPD, and Emergency encounters.</p>
<h3>Screen 1: Search Tab</h3>
<p><strong>Purpose:</strong> Locate existing hospital patients within seconds and prevent duplicate file generation.</p>
<ul>
<li>Search by <strong>Patient Code (UHID)</strong> (e.g. <code>P26091000018</code>).</li>
<li>Search by <strong>10-Digit Mobile Number</strong>.</li>
<li>Search by <strong>Patient Full Name</strong> (supports partial matching, e.g. "Rahul").</li>
<li>Search by <strong>Aadhaar Number</strong> (12 digits) or <strong>14-Digit ABHA ID</strong>.</li>
<li>Search by <strong>ABHA Address Handle</strong> (e.g. <code>rahul@sbx</code>).</li>
<li><strong>Action:</strong> Clicking on any patient row opens their comprehensive <strong>Patient 360&deg; Profile &amp; Medical History</strong>.</li>
</ul>
<h3>Screen 2: New Person Registration Form</h3>
<p><strong>Purpose:</strong> Register a brand-new patient into the hospital master database. All fields are explained below:</p>
<div class="table-responsive">
<table class="table table-bordered field-table">
<thead>
<tr>
<th style="width: 25%;">Form Field</th>
<th style="width: 20%;">Format / Requirement</th>
<th>Operational Description &amp; Clinical Purpose</th>
</tr>
</thead>
<tbody>
<tr>
<td><strong>Aadhaar Number</strong></td>
<td>12 Digits (Numeric)<br><span class="text-muted">Optional</span></td>
<td>Government unique identity number. Used for duplicate checking across the database and mandatory for Ayushman Bharat (PM-JAY) claims and official schemes.</td>
</tr>
<tr>
<td><strong>ABHA Number / Address</strong></td>
<td>14 Digits or @sbx Handle<br><span class="text-muted">Auto-filled via ABHA</span></td>
<td>Ayushman Bharat Health Account national identifier. Prevents duplicate patient creation and links hospital files to national health ecosystem.</td>
</tr>
<tr>
<td><strong>Primary Mobile Number</strong></td>
<td>10 Digits (Numeric)<br><span class="field-req">Mandatory *</span></td>
<td>Primary communication mobile number. Used for SMS appointment alerts, OTP verification, billing invoice delivery, and ABDM discovery matching.</td>
</tr>
<tr>
<td><strong>Title &amp; Full Name</strong></td>
<td>Salutation Dropdown &amp; Text<br><span class="field-req">Mandatory *</span></td>
<td>Patient's legal name. Appears on all official medical records, prescriptions, diagnostic reports, and medico-legal documents.</td>
</tr>
<tr>
<td><strong>Gender</strong></td>
<td>Male / Female / Other<br><span class="field-req">Mandatory *</span></td>
<td>Clinical gender. Critical for ward bed allocation, diagnostic reference range calculations (e.g. Hemoglobin), and obstetrics/gynecology workflows.</td>
</tr>
<tr>
<td><strong>Date of Birth / Age</strong></td>
<td>Calendar Date or Years<br><span class="field-req">Mandatory *</span></td>
<td>Toggle between exact calendar DOB or estimated Age in years/months. System auto-calculates Year of Birth (YOB) required for ABDM and pediatric dosing.</td>
</tr>
<tr>
<td><strong>Relation &amp; Guardian / Relative Name</strong></td>
<td>Relation Type &amp; Full Name<br><span class="field-req">Mandatory *</span></td>
<td>Caregiver / Legal Guardian (S/o, D/o, W/o, C/o, M/o). Essential for pediatric and unconscious patients, informed consent, and billing authorizations.</td>
</tr>
<tr>
<td><strong>Blood Group</strong></td>
<td>Dropdown Selection<br><span class="text-muted">Default: 'Not Defined'</span></td>
<td>ABO &amp; Rh group (A+, B+, O+, AB+, etc.). Vital for emergency trauma resuscitation, surgery readiness, and blood bank compatibility.</td>
</tr>
<tr>
<td><strong>Referred By (Doctor / Hospital / Self)</strong></td>
<td>Searchable Autocomplete<br><span class="text-muted">Optional</span></td>
<td>Referring physician, healthcare provider, or outreach hospital. Automatically validates against active doctor list for referral accounting.</td>
</tr>
</tbody>
</table>
</div>
<h3>Screen 3: ABHA Management Tab</h3>
<p><strong>Purpose:</strong> Seamless national Ayushman Bharat digital health identity integration directly at the registration desk:</p>
<div class="quick-grid">
<div class="quick-item">
<strong><i class="bi bi-person-plus text-primary me-1"></i>1. Create / Find ABHA Record</strong>
<div>Assisted ABHA creation via Aadhaar OTP. Includes the required <em>Healthcare Worker Declaration</em> and <em>Beneficiary Consent Name Input</em> before sending OTP. Creates ABHA number and address handle in 30 seconds.</div>
</div>
<div class="quick-item">
<strong><i class="bi bi-shield-check text-success me-1"></i>2. Verify / Find ABHA Account</strong>
<div>Verify existing ABHA profiles via 14-digit number, <code>@sbx</code> handle, or registered mobile number. Retrieves verified demographic data and photo from ABDM.</div>
</div>
<div class="quick-item">
<strong><i class="bi bi-qr-code-scan text-info me-1"></i>3. Scan ABHA QR</strong>
<div>Uses handheld 2D barcode scanner or camera to read physical ABHA card or mobile PHR app QR code, populating demographics with zero manual typing.</div>
</div>
<div class="quick-item" style="border-top-color: var(--amber);">
<strong><i class="bi bi-link-45deg text-warning me-1"></i>4. Link Records to ABHA (HIP)</strong>
<div>Opens the M2 HIP Linking modal. Links patient visits directly to ABHA using Gateway Method 4 (Demographic Auth) or sends a Deep Link SMS to the patient's smartphone.</div>
</div>
</div>
<h3>Screen 4: Patient 360&deg; Profile Hub</h3>
<p>Once a patient is registered, their profile displays emergency and clinical shortcuts:</p>
<ul>
<li><span class="badge bg-primary">Appointment For OPD</span> &mdash; Generates OPD visit slip and assigns consulting doctor.</li>
<li><span class="badge bg-danger">Add Charge</span> &mdash; Directly books diagnostic tests (Pathology, X-Ray, CT, MRI, USG) or procedures.</li>
<li><span class="badge bg-danger"><i class="bi bi-ambulance"></i> Casualty</span> &mdash; Emergency admission under ESI triage.</li>
<li><span class="badge bg-warning text-dark"><i class="bi bi-clock-history"></i> Day Care</span> &mdash; Short-stay procedure admission (&lt;24 hours).</li>
<li><span class="badge bg-primary"><i class="bi bi-hospital"></i> IPD</span> &mdash; Standard inpatient ward bed admission.</li>
<li><span class="badge bg-outline-primary"><i class="bi bi-link-45deg"></i> Link Records to ABHA (HIP)</span> &mdash; Initiates instant care context linking.</li>
</ul>
<div class="back-top"><a href="#top"><i class="bi bi-arrow-up-circle me-1"></i>Back to Top</a></div>
</section>
<!-- ========================================================================= -->
<!-- 04: OPD WORKFLOW -->
<!-- ========================================================================= -->
<section id="opd-workflow" class="guide-section searchable-section">
<h2><span class="section-number">04</span>Outpatient Department (OPD) Workflow</h2>
<p><strong>Sidebar Menus:</strong> <code>Billing &rarr; OPD Invoice</code> | <code>Doctor's Work &rarr; OPD Appointment List</code></p>
<h3>OPD Check-In &amp; Token Generation</h3>
<ol class="workflow">
<li><strong>Reception Registration:</strong> Receptionist opens patient profile and clicks <strong>Appointment For OPD</strong>.</li>
<li><strong>Consultation Parameters:</strong> Select Department (General Medicine, Orthopedics, Cardiology, etc.), Doctor, Fee Category (Normal, Revisit, Free, Camp), and Organization/Insurance case if applicable.</li>
<li><strong>Receipt &amp; Token:</strong> System generates OPD Slip with unique visit token (e.g. <code>Token #14</code>) and care context reference <code>OPD-{PatientId}-S{OpdId}-{Date}</code>.</li>
<li><strong>ABDM OPD Queue:</strong> Patients scanning the hospital facility QR code via ABHA app appear automatically in the <strong>ABDM OPD Queue</strong> under Front Desk with pre-filled demographics for 1-click token creation.</li>
</ol>
<h3>Doctor OPD Consultation &amp; Prescription Desk</h3>
<p>Doctors access the consultation workspace from their daily appointment list. The screen contains dedicated clinical sections:</p>
<ul>
<li><strong>Vitals &amp; Physical Examination:</strong> BP (Systolic/Diastolic), Pulse, SpO2, Temperature, Respiratory Rate, Height, Weight, BMI, Waist circumference, and general examination tags (Pallor, Icterus, Cyanosis, Clubbing, Edema).</li>
<li><strong>Chief Complaints:</strong> Multi-select complaint box integrated with standard <strong>SNOMED-CT</strong> terminology. Allows entering duration and severity.</li>
<li><strong>Diagnosis:</strong> Provisional and Final diagnosis search powered by <strong>ICD-10</strong> and SNOMED-CT clinical coding.</li>
<li><strong>Prescription (Medicines):</strong> Search by brand or generic name. Specify dosage (e.g. 500mg), frequency (e.g. 1-0-1, TID), timing (After food, Empty stomach), route (Oral, IV, IM), and duration in days. Automated drug interaction alerts activate if duplicate molecules are prescribed.</li>
<li><strong>Investigation Orders:</strong> Prescribe pathology tests or radiology imaging with 1 click. Automatically creates unbilled investigation requests at the diagnostic billing desk.</li>
<li><strong>Advice &amp; Precautions:</strong> Standard diet, lifestyle, and recovery instructions. Supports inserting pre-defined advice snippets.</li>
<li><strong>Next Visit / Follow-up:</strong> Set scheduled review date (e.g. "After 7 Days" or specific calendar date).</li>
<li><strong>ABDM Push:</strong> When saving, clicking <strong>Share to ABHA</strong> automatically generates the HL7 FHIR R4 <code>OPConsultRecord</code> bundle and makes it available to the patient's ABHA app.</li>
</ul>
<div class="back-top"><a href="#top"><i class="bi bi-arrow-up-circle me-1"></i>Back to Top</a></div>
</section>
<!-- ========================================================================= -->
<!-- 05: IPD, DAY CARE & EMERGENCY -->
<!-- ========================================================================= -->
<section id="ipd-nursing" class="guide-section searchable-section">
<h2><span class="section-number">05</span>In-Patient (IPD), Day Care &amp; Emergency (Casualty)</h2>
<p><strong>Sidebar Menus:</strong> <code>In-Patient &amp; Nursing Care &rarr; IPD Patient List</code> | <code>Billing &rarr; IPD Billing</code><br>
<strong>Compliant Standards:</strong> NABH 5th Edition, ESI Triage Levels 1–5, PADSS Criteria, HL7 FHIR R4.</p>
<h3>1. Admission Categories &amp; Key Identifiers</h3>
<div class="table-responsive">
<table class="table table-bordered table-guide">
<thead>
<tr>
<th>Encounter Type</th>
<th>Identifier Prefix</th>
<th>Designated Ward</th>
<th>Clinical Purpose</th>
</tr>
</thead>
<tbody>
<tr>
<td><strong>Emergency / Casualty</strong></td>
<td><span class="prefix-badge prefix-er">ER-YYYY-XXXXX</span></td>
<td>Casualty &amp; Emergency Ward (<code>ER-01</code>)</td>
<td>Acute trauma, chest pain, stroke, resuscitation, and medico-legal admissions.</td>
</tr>
<tr>
<td><strong>Day Care (&lt;24 Hrs)</strong></td>
<td><span class="prefix-badge prefix-dc">DC-YYYY-XXXXX</span></td>
<td>Day Care Unit (<code>DC-01</code>)</td>
<td>Planned surgical/medical procedures (Cataract, Hemodialysis, Chemotherapy, Endoscopy).</td>
</tr>
<tr>
<td><strong>Inpatient (IPD)</strong></td>
<td><span class="prefix-badge prefix-ipd">A-YYYY-XXXXX</span></td>
<td>General / Semi-Private / ICU / HDU</td>
<td>Multi-day inpatient admissions requiring continuous hospital stay.</td>
</tr>
</tbody>
</table>
</div>
<h3>2. Emergency / Casualty Admission &amp; ESI Triage</h3>
<p>Casualty staff immediately triage arriving patients into 5 international Emergency Severity Index (ESI) tiers:</p>
<ul>
<li><span class="badge-esi badge-esi-1">ESI 1 (Resuscitation)</span> &mdash; Immediate life-threat (cardiac arrest, severe shock). 0 min door-to-doctor.</li>
<li><span class="badge-esi badge-esi-2">ESI 2 (Emergent)</span> &mdash; High risk, danger vitals, acute chest pain. &le;10 min door-to-doctor.</li>
<li><span class="badge-esi badge-esi-3">ESI 3 (Urgent)</span> &mdash; Stable vitals needing multiple resources (IV fluids, Labs, X-Ray). &le;30 min.</li>
<li><span class="badge-esi badge-esi-4">ESI 4 (Less Urgent)</span> &mdash; 1 resource needed (simple suture, uncomplicated UTI). &le;60 min.</li>
<li><span class="badge-esi badge-esi-5">ESI 5 (Non-Urgent)</span> &mdash; Medication refill, minor rash. &le;120 min.</li>
</ul>
<div class="note"><strong>Medico-Legal Case (MLC):</strong> For road accidents, poisoning, burns, or assault, toggle <strong>Is MLC</strong>. Enter Police Station, Constable Badge, and Brought-By details for official intimation.</div>
<h3>3. Clinical Escalation: Convert to IPD with SBAR Handover</h3>
<p>When a Casualty or Day Care patient deteriorates or requires prolonged admission, click <strong>"Convert to IPD"</strong>. The system enforces the <strong>SBAR</strong> clinical handover protocol:</p>
<div class="sbar-card"><span class="sbar-letter">S</span><strong>Situation:</strong> Immediate clinical justification for inpatient conversion.</div>
<div class="sbar-card"><span class="sbar-letter">B</span><strong>Background:</strong> Baseline clinical history, co-morbidities, presenting symptoms.</div>
<div class="sbar-card"><span class="sbar-letter">A</span><strong>Assessment:</strong> Current vital signs, Glasgow Coma Scale (GCS), stat lab results, emergency medications given.</div>
<div class="sbar-card"><span class="sbar-letter">R</span><strong>Recommendation:</strong> Target inpatient ward, ICU monitoring orders, scheduled specialist consults.</div>
<div class="warning"><strong>Unified Billing Guarantee:</strong> Converting to IPD automatically transfers all prior emergency or daycare charges into the unified Inpatient Bill under clearly demarcated sub-headers (<code>EMERGENCY CHARGES</code>, <code>DAY CARE CHARGES</code>, <code>ROOM CHARGES</code>). No charges are lost.</div>
<h3>4. Day Care Discharge &amp; PADSS Scoring</h3>
<p>Before discharge from Day Care, patients must be evaluated against the <strong>Post-Anaesthetic Discharge Scoring System (PADSS)</strong> across 5 clinical parameters (Vital signs, Ambulation, Nausea/vomiting, Pain control, Surgical bleeding). A score of <strong>&ge; 9 out of 10</strong> is mandatory for home discharge.</p>
<div class="back-top"><a href="#top"><i class="bi bi-arrow-up-circle me-1"></i>Back to Top</a></div>
</section>
<!-- ========================================================================= -->
<!-- 06: OPERATION THEATRE (OT) -->
<!-- ========================================================================= -->
<section id="ot-management" class="guide-section searchable-section">
<h2><span class="section-number">06</span>Operation Theatre (OT) Management</h2>
<p><strong>Sidebar Menu:</strong> <code>In-Patient &amp; Nursing Care &rarr; OT Surgery Queue</code></p>
<ol class="workflow">
<li><strong>Surgery Request:</strong> Treating surgeon submits surgery request specifying procedure name, operating surgeon, assistant, anaesthetist, required OT room, priority (Elective / Emergency), and requested date/time.</li>
<li><strong>Pre-Operative Assessment:</strong> Pre-anaesthetic checkup (PAC) recording airway grading (Mallampati), ASA physical status score (I–V), blood cross-match confirmation, and NPO status.</li>
<li><strong>OT Scheduling:</strong> OT supervisor allocates OT Table and timing, checking for equipment or instrument tray conflicts.</li>
<li><strong>Patient Call:</strong> Ward nurse updates patient status to <code>Called to OT</code> and performs pre-op surgical checklist (consent signed, jewellery removed, dentures removed, surgical site marked).</li>
<li><strong>WHO Surgical Safety Checklist Gates:</strong>
<ul>
<li><strong>Sign-In (Before Induction):</strong> Confirm patient identity, procedure, site marking, pulse oximeter attached, allergy checks, difficult airway risk, anticipated blood loss.</li>
<li><strong>Time-Out (Before Skin Incision):</strong> Entire team introduces themselves; surgeon, anaesthetist, and nurse confirm patient name, procedure, antibiotic prophylaxis given &le;60 min prior, essential imaging displayed.</li>
<li><strong>Sign-Out (Before Patient Leaves OT):</strong> Nurse verbally confirms instrument and sponge counts, specimen labeling, equipment malfunctions, post-op recovery plan.</li>
</ul>
</li>
<li><strong>Operative &amp; Anaesthesia Notes:</strong> Surgeon logs operative findings, implants used (with serial/lot numbers for tracking), sutures, drainage tubes, and post-op recovery orders.</li>
</ol>
<div class="back-top"><a href="#top"><i class="bi bi-arrow-up-circle me-1"></i>Back to Top</a></div>
</section>
<!-- ========================================================================= -->
<!-- 07: DOCTOR'S WORK & CLINICAL MASTERS -->
<!-- ========================================================================= -->
<section id="doctor-work" class="guide-section searchable-section">
<h2><span class="section-number">07</span>Doctor's Work &amp; Clinical Masters</h2>
<p><strong>Sidebar Menu:</strong> <code>Doctor's Work</code> (Appointments, Rx-Group, OPD Medicine, Clinical Masters, Clinical Templates, Document Issue, Immunization)</p>
<h3>1. Rx-Group Master (Prescription Protocol Sets)</h3>
<p><strong>Purpose:</strong> Build reusable multi-medicine prescription sets for 1-click prescribing during busy OPD hours.</p>
<ul>
<li>Create groups such as <em>"Acute Gastroenteritis Kit"</em>, <em>"Hypertension Starter"</em>, or <em>"Viral Fever Pack"</em>.</li>
<li>Each group contains pre-configured dosages, frequencies, and instructions. During consultation, picking one group populates all medicines instantly.</li>
</ul>
<h3>2. Clinical Master Workspace (Complaints, Profiles &amp; Advice)</h3>
<p><strong>Purpose:</strong> Maintain hospital-wide clinical dictionaries:</p>
<ul>
<li><strong>Chief Complaints Master:</strong> Frequently presenting symptoms mapped to standard clinical concepts.</li>
<li><strong>Investigation Master:</strong> Master catalog of diagnostic tests and individual laboratory parameters.</li>
<li><strong>Investigation Profile Master:</strong> Grouping individual tests into test batteries (e.g. <em>Lipid Profile</em> containing Total Cholesterol, Triglycerides, HDL, LDL, VLDL).</li>
<li><strong>OPD Advice Master:</strong> Standard dietary, physical therapy, and medication precautions.</li>
</ul>
<h3>3. Doctor Document &amp; Certificate Issuance Desk</h3>
<p><strong>Purpose:</strong> Issue legal and clinical certificates directly from the patient encounter:</p>
<ul>
<li>Medical Leave &amp; Fitness Certificates</li>
<li>Referral Slips to higher tertiary centers</li>
<li>Birth Intimation and Death Audit Slips</li>
<li>Emergency Travel Medical Clearance</li>
</ul>
<h3>4. Pediatric Immunization Tracker</h3>
<p><strong>Purpose:</strong> Track national vaccine schedules for infants and children:</p>
<ul>
<li>Pre-configured national immunization schedule (BCG, OPV, Hepatitis B, Pentavalent, Rotavirus, Measles, MMR).</li>
<li>Record administered date, batch number, manufacturer, and injection site.</li>
<li>System automatically schedules and alerts next due dates.</li>
</ul>
<div class="back-top"><a href="#top"><i class="bi bi-arrow-up-circle me-1"></i>Back to Top</a></div>
</section>
<!-- ========================================================================= -->
<!-- 08: DIAGNOSIS & IMAGING -->
<!-- ========================================================================= -->
<section id="diagnosis" class="guide-section searchable-section">
<h2><span class="section-number">08</span>Diagnosis, Laboratory &amp; Imaging Modules</h2>
<p><strong>Sidebar Menu:</strong> <code>Diagnosis</code> (Pathology, Biopsy, X-Ray, MRI, CT-Scan, Ultrasound, Echo)</p>
<h3>1. Pathology &amp; Biopsy Workflow</h3>
<ol class="workflow">
<li><strong>Sample Collection &amp; Accession:</strong> Phlebotomist collects sample, assigns unique Lab Accession Number / Barcode, and records collection time.</li>
<li><strong>Result Entry:</strong> Laboratory technician enters quantitative parameter readings. Values outside normal reference intervals automatically highlight in bold red.</li>
<li><strong>Pathologist Verification:</strong> Pathologist reviews values, adds clinical microscopic comments, and clicks <strong>Verify &amp; Sign</strong>. Finalized reports are locked against accidental modification.</li>
<li><strong>Digital Delivery:</strong> Reports can be printed on hospital letterhead, downloaded as PDF, or transmitted to ABDM.</li>
</ol>
<h3>2. Radiology &amp; Diagnostic Imaging Workflow</h3>
<p>Covers all major modalities: <strong>X-Ray</strong>, <strong>Ultrasound (USG)</strong>, <strong>CT-Scan</strong>, <strong>MRI</strong>, and <strong>2D Echocardiography</strong>.</p>
<ul>
<li><strong>Image / DICOM Upload:</strong> Attach patient scan images, high-resolution snapshots, or multi-frame study files directly to the examination entry.</li>
<li><strong>Template-Driven Reporting:</strong> Load pre-designed normal or pathological reporting templates with 1 click to draft standardized reports.</li>
<li><strong>Radiologist Sign-off:</strong> Consultant radiologist enters clinical findings and final impression, then signs off.</li>
<li><strong>ABDM DiagnosticReportRecord Push:</strong> Pushes verified imaging reports to ABDM Gateway for immediate viewing in the patient's ABHA app.</li>
</ul>
<div class="back-top"><a href="#top"><i class="bi bi-arrow-up-circle me-1"></i>Back to Top</a></div>
</section>
<!-- ========================================================================= -->
<!-- 09: TEMPLATE DESIGN GUIDE -->
<!-- ========================================================================= -->
<section id="template-design" class="guide-section searchable-section">
<h2><span class="section-number">09</span>Template Design &amp; Configuration Guide</h2>
<p><strong>Sidebar Menu:</strong> <code>Admin &amp; Settings &rarr; Template</code><br>
<strong>Intended Users:</strong> Radiologists, Pathologists, Chief Medical Officers, Hospital Administrators.</p>
<p>Standardized templates ensure clinical precision, reduce reporting turnaround time by over 70%, and ensure medico-legal compliance across all imaging and diagnostic disciplines.</p>
<h3>1. Diagnostic Modality Navigation &amp; Scope</h3>
<p>In E-Atria HMIS, pre-configured diagnostic report templates are organized into dedicated modality tabs under <strong>Admin &amp; Settings &rarr; Template</strong>:</p>
<div class="table-responsive">
<table class="table table-bordered table-guide">
<thead>
<tr>
<th style="width: 25%;">Diagnostic Modality</th>
<th style="width: 35%;">How to Access in System</th>
<th>Clinical Scope &amp; Typical Investigations</th>
</tr>
</thead>
<tbody>
<tr>
<td><strong>Ultrasound (USG)</strong></td>
<td>Click <strong>Admin &amp; Settings &rarr; Template</strong>, then select the <strong>Ultrasound</strong> tab.</td>
<td>USG Whole Abdomen, Pelvis, KUB, Obstetric / Antenatal Scans, Thyroid, Scrotum, Venous &amp; Arterial Doppler.</td>
</tr>
<tr>
<td><strong>Magnetic Resonance Imaging (MRI)</strong></td>
<td>Click <strong>Admin &amp; Settings &rarr; Template</strong>, then select the <strong>MRI</strong> tab.</td>
<td>MRI Brain (plain &amp; contrast), Cervical/Lumbar Spine, Knee / Shoulder Joints, MRCP, Whole Body MRI.</td>
</tr>
<tr>
<td><strong>Digital X-Ray (Radiography)</strong></td>
<td>Click <strong>Admin &amp; Settings &rarr; Template</strong>, then select the <strong>X-Ray</strong> tab.</td>
<td>Plain &amp; Contrast Radiography: Chest PA View, KUB, Extremities (Bones &amp; Joints), Spine AP/Lateral views, Barium studies.</td>
</tr>
<tr>
<td><strong>Computed Tomography (CT-Scan)</strong></td>
<td>Click <strong>Admin &amp; Settings &rarr; Template</strong>, then select the <strong>CT-Scan</strong> tab.</td>
<td>NCCT Head, HRCT Thorax, CECT Abdomen &amp; Pelvis, CT Angiography, PNS (Coronal/Axial views).</td>
</tr>
<tr>
<td><strong>2D Echocardiography (Echo) &amp; Special</strong></td>
<td>Click <strong>Admin &amp; Settings &rarr; Template</strong>, then select the <strong>Echocardiography / Special</strong> tab.</td>
<td>Transthoracic 2D Echo, Color Doppler, Left Ventricular Ejection Fraction (LVEF), Valvular regurgitation assessment.</td>
</tr>
</tbody>
</table>
</div>
<h3>2. How to Design a New Radiology Template (Step-by-Step)</h3>
<ol class="workflow">
<li><strong>Open Modality Template Workspace:</strong> Go to <strong>Admin &amp; Settings &rarr; Template</strong> and click on the desired modality tab (e.g. <em>X-Ray</em>, <em>CT-Scan</em>, <em>MRI</em>, or <em>Ultrasound</em>).</li>
<li><strong>Click "+ Add Template":</strong> Opens the rich-text template builder.</li>
<li><strong>Specify Template Title:</strong> Enter a clear, standardized name (e.g. <code>X-RAY CHEST PA VIEW - NORMAL STUDY</code> or <code>CT HEAD - NORMAL BRAIN STUDY</code>).</li>
<li><strong>Link Hospital Service / Billing Test:</strong>
<div class="note"><strong>Automatic Template Loading:</strong> In the <em>"Linked Charge / Test Item"</em> dropdown, select the corresponding test name from the Hospital Charges Master. When reception bills this service on an OPD or IPD slip, the system will <strong>automatically inject this template</strong> into the doctor's report editor without requiring manual search!</div>
</li>
<li><strong>Structure the Clinical Content:</strong> Adhere to professional NABH reporting standards by dividing the template into 4 standard sections:
<div class="form-desc-card my-2">
<div class="form-desc-header">Recommended Clinical Template Anatomy</div>
<div class="form-desc-body">
<pre style="background: #f8fafc; border: 1px solid #e2e8f0; padding: 12px; border-radius: 4px; font-size: 0.85rem; margin-bottom: 0;">
<strong>CLINICAL INDICATION:</strong>
Suspected chest pathology / Routine pre-operative medical evaluation.
<strong>TECHNIQUE:</strong>
Standard plain radiograph of the chest was obtained in the postero-anterior (PA) erect position at full inspiration.
<strong>FINDINGS:</strong>
&bull; Trachea is central in position.
&bull; Cardiothoracic ratio is within normal limits. Cardiac size, shape, and contours appear normal.
&bull; Both lung fields are clear with normal vascularity. No focal parenchymal consolidation, infiltrate, mass, or cavitation detected.
&bull; Both costophrenic and cardiophrenic angles are sharp and clear. No pleural effusion seen.
&bull; Mediastinal and hilar contours appear normal with no lymphadenopathy.
&bull; The visualised thoracic cage, ribs, clavicles, and soft tissues appear unremarkable.
&bull; Both diaphragmatic domes are smooth and normal in position.
<strong>IMPRESSION:</strong>
NO SIGNIFICANT ABNORMALITY DETECTED ON CHEST RADIOGRAPH.
NORMAL STUDY.
</pre>
</div>
</div>
</li>
<li><strong>Save &amp; Test Template:</strong> Click <strong>Save Template</strong>. The template is immediately active across all diagnostic report editors.</li>
</ol>
<h3>3. Pathology Parameter &amp; Reference Interval Design</h3>
<p>Pathology templates configure individual analytical parameters:</p>
<ul>
<li><strong>Parameter Name:</strong> e.g. <em>Fasting Blood Glucose</em>, <em>Serum Creatinine</em>, <em>Platelet Count</em>.</li>
<li><strong>Unit of Measure:</strong> e.g. <code>mg/dL</code>, <code>g/dL</code>, <code>/cumm</code>, <code>mmol/L</code>.</li>
<li><strong>Reference Ranges:</strong> Age and gender specific normal minimum and maximum thresholds. Readings outside these limits automatically flag as <strong>LOW</strong> or <strong>HIGH</strong> in red text.</li>
</ul>
<div class="back-top"><a href="#top"><i class="bi bi-arrow-up-circle me-1"></i>Back to Top</a></div>
</section>
<!-- ========================================================================= -->
<!-- 10: PHARMACY & MEDICAL STORE -->
<!-- ========================================================================= -->
<section id="pharmacy" class="guide-section searchable-section">
<h2><span class="section-number">10</span>Pharmacy &amp; Medical Store Module</h2>
<p><strong>Sidebar Menu:</strong> <code>Pharmacy &rarr; Medical Store</code></p>
<h3>1. Point of Sale (POS) Dispensing</h3>
<ol class="workflow">
<li><strong>Search Patient / Prescription:</strong> Enter patient UHID or fetch active doctor e-Prescription.</li>
<li><strong>Batch &amp; Expiry Selection:</strong> Scan barcode or search drug. The system enforces <strong>FEFO (First Expiry, First Out)</strong> by automatically suggesting the earliest expiring batch.</li>
<li><strong>Pricing &amp; Discounts:</strong> Calculates MRP, discounted rate, CGST/SGST taxes, and net amount payable.</li>
<li><strong>Receipt &amp; Label:</strong> Prints tax invoice with dosage frequency labels and Schedule H warnings.</li>
</ol>
<h3>2. Medicine Returns &amp; Credit Notes</h3>
<p>Unopened and non-expired medications returned by patients are processed with credit notes or cash refunds. Returned stock instantly increments the active batch inventory.</p>
<h3>3. Pharmacy Credit Payout Workflow</h3>
<p>For corporate and insurance empanelled credit dispensing:</p>
<ul>
<li>Open <strong>Credit Payout Request</strong> to review outstanding credit pool lines.</li>
<li>Select approved credit accounts, enter remarks, and submit request to Accounts &amp; Finance for reimbursement.</li>
</ul>
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</section>
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<!-- 11: HOSPITAL STOCK & INVENTORY -->
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<section id="hospital-stock" class="guide-section searchable-section">
<h2><span class="section-number">11</span>Hospital Stock &amp; Inventory Management</h2>
<p><strong>Sidebar Menu:</strong> <code>Hospital Stock &rarr; Hospital Stock</code></p>
<h3>1. Stock Indent &amp; Issue Workflow</h3>
<ol class="workflow">
<li><strong>Department Indent:</strong> Ward nurses, OT, or lab staff submit an electronic indent specifying required consumables (syringes, gloves, IV sets, gauze).</li>
<li><strong>Store Approval:</strong> Store manager reviews current stock levels and approves/adjusts requested quantities.</li>
<li><strong>Stock Issue:</strong> Storekeeper issues approved batches. Main store inventory automatically deducts, and sub-store/ward inventory increases.</li>
</ol>
<h3>2. Purchase Orders (PO) &amp; Goods Receipt Note (GRN)</h3>
<ul>
<li><strong>Purchase Order:</strong> Generate supplier PO based on minimum reorder levels.</li>
<li><strong>GRN &amp; Inward Inspection:</strong> Upon delivery, record received batch numbers, manufacturer, expiry dates, purchase rates, and GST. Discrepancies generate vendor debit notes.</li>
</ul>
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</section>
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<!-- 12: BILLING, INVOICES & CASHIER WORKFLOWS -->
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<section id="billing" class="guide-section searchable-section">
<h2><span class="section-number">12</span>Billing, Invoices &amp; Cashier Workflows</h2>
<p><strong>Sidebar Menu:</strong> <code>Billing</code> (OPD Invoice, Charges Invoice, IPD Billing, Org Packing, Cash Submission)</p>
<h3>1. Invoicing Types</h3>
<ul>
<li><strong>OPD Invoice:</strong> Consultation fee collection and receipt generation.</li>
<li><strong>Charges Invoice:</strong> Invoicing for diagnostic tests, day-care procedures, dressing, physiotherapy, and dental work. Supports split payments (Cash, Card, UPI, Cheque).</li>
<li><strong>IPD Billing:</strong> Running patient ledger tracking room rents, doctor visits, surgery fees, bedside medicines, and advance receipts. Supports interim provisional billing and final discharge invoice.</li>
</ul>
<h3>2. Shift-End Cash Statement Submission</h3>
<p><strong>Purpose:</strong> Guarantee 100% financial accountability at the end of every cashier's work shift.</p>
<ol class="workflow">
<li>At the end of the shift, the billing cashier opens <strong>Cash Submission</strong>.</li>
<li>System calculates total cash collections recorded under that cashier's user ID for the active shift.</li>
<li>Cashier enters physical currency breakdown (e.g. 500x10, 200x5, 100x20).</li>
<li>Click <strong>Submit Cash Statement</strong> to lock the shift and handover cash to the Accounts Department.</li>
</ol>
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</section>
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<!-- 13: ACCOUNTS & FINANCE -->
<!-- ========================================================================= -->
<section id="finance" class="guide-section searchable-section">
<h2><span class="section-number">13</span>Accounts &amp; Finance Management</h2>
<p><strong>Sidebar Menu:</strong> <code>Accounts And Finance</code> (Finance Dashboard, Accounts Verify Payment, Payment Edit, Bank Audit, Payouts)</p>
<div class="quick-grid">
<div class="quick-item">
<strong><i class="bi bi-patch-check text-success me-1"></i>1. Accounts Verify Payment</strong>
<div>Accountant verifies physical cash handed over by billing cashiers against system records and formally accepts the shift submission.</div>
</div>
<div class="quick-item">
<strong><i class="bi bi-pencil-square text-primary me-1"></i>2. Audited Payment Edit</strong>
<div>Authorized finance personnel can correct payment mode (e.g. Cash &rarr; UPI) or transaction references. Enforces mandatory audit remarks.</div>
</div>
<div class="quick-item">
<strong><i class="bi bi-building text-info me-1"></i>3. Bank Audit &amp; Statement</strong>
<div>Reconciles daily physical cash bank deposits with official bank statements. Flags clearing delays or discrepancies.</div>
</div>
<div class="quick-item">
<strong><i class="bi bi-cash-stack text-warning me-1"></i>4. Doctor OPD Consult Payouts</strong>
<div>Calculates doctor consultation fee shares based on contractual percentages or fixed rates, generating disbursement vouchers.</div>
</div>
</div>
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</section>
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<!-- 14: INSURANCE & TPA CASES -->
<!-- ========================================================================= -->
<section id="insurance" class="guide-section searchable-section">
<h2><span class="section-number">14</span>Insurance, TPA &amp; Ayushman Bharat (PM-JAY)</h2>
<p><strong>Sidebar Menus:</strong> <code>Billing &rarr; Org. OPD's Invoice</code> | <code>Billing &rarr; Org Packing</code> | <code>Report &rarr; Insurance Credit</code></p>
<ol class="workflow">
<li><strong>Case Registration:</strong> Patient admission is linked to an empanelled Corporate, TPA (e.g. Star Health, Medi Assist), or Ayushman Bharat scheme. Enter pre-authorization request number and approved initial amount.</li>
<li><strong>Tariff Packages:</strong> Pre-agreed package tariffs are applied automatically to line items, preventing unapproved billing.</li>
<li><strong>Org Packing:</strong> Consolidates invoices, diagnostic reports, discharge summary, and pharmacy slips into a single verified claim docket for physical or portal submission.</li>
<li><strong>Settlement &amp; Deductions:</strong> When the TPA settles the claim, record the approved amount, write off approved TDS/deductions, and reconcile outstanding patient co-pays.</li>
</ol>
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</section>
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<!-- 15: ABDM (AYUSHMAN BHARAT DIGITAL MISSION) -->
<!-- ========================================================================= -->
<section id="abdm" class="guide-section searchable-section">
<h2><span class="section-number">15</span>ABDM (Ayushman Bharat Digital Mission) Ecosystem</h2>
<p><strong>Sidebar Menu:</strong> <code>ABDM</code> (ABDM Task Board, ABHA Patient Request List, ABDM OPD Queue, ABDM Bridge Log)<br>
<strong>Compliant Standard:</strong> ABDM HIECM V3 Standard, FHIR R4 Bundle Specifications.</p>
<h3>1. Milestone 1 (M1): ABHA Creation &amp; Verification</h3>
<ul>
<li><strong>Aadhaar OTP Creation:</strong> Enter 12-digit Aadhaar &rarr; healthcare worker and beneficiary declarations are collected &rarr; OTP verified &rarr; ABHA Number &amp; Address generated.</li>
<li><strong>ABHA Verification:</strong> Retrieve verified demographic profile and photograph from ABDM via mobile OTP or ABHA number.</li>
<li><strong>Facility Scan &amp; Share:</strong> Generates hospital QR code displayed at reception. Patients scan QR via their ABHA app, populating their details directly in the <strong>ABDM OPD Queue</strong> for 1-click token creation.</li>
</ul>
<h3>2. Milestone 2 (M2): Health Information Provider (HIP) Linking</h3>
<div class="quick-grid">
<div class="quick-item">
<strong>HIP-Initiated Linking (Method 4)</strong>
<div>Hospital submits patient demographics to ABDM Gateway. Gateway returns a secure Link Token to link hospital care contexts directly.</div>
</div>
<div class="quick-item">
<strong>Deep Link SMS Notification</strong>
<div>Hospital dispatches an SMS containing a direct app link to the patient's smartphone for 1-tap care context linking in their ABHA app.</div>
</div>
<div class="quick-item">
<strong>User-Initiated Discovery</strong>
<div>Patient searches hospital in their PHR app using mobile number &rarr; HMS dynamically returns matching care contexts &rarr; verified with mobile OTP.</div>
</div>
</div>
<h3>3. Milestone 2 (M2): Health Information Exchange (FHIR R4 Data Transfer)</h3>
<p>When the patient requests their health records in their ABHA app, the HMS generates and transfers encrypted FHIR R4 bundles:</p>
<div class="table-responsive">
<table class="table table-bordered table-guide">
<thead>
<tr>
<th>Clinical Document Type</th>
<th>FHIR Resource Type</th>
<th>Care Context Reference</th>
<th>Clinical Content Transferred</th>
</tr>
</thead>
<tbody>
<tr>
<td><strong>OPD Consultation</strong></td>
<td><code>OPConsultRecord</code></td>
<td>Unique Visit Receipt Number</td>
<td>Encounter, Vitals, Chief complaints, ICD-10 diagnosis, prescribed medicines with dosage, doctor advice.</td>
</tr>
<tr>
<td><strong>Diagnostic &amp; Radiology</strong></td>
<td><code>DiagnosticReportRecord</code></td>
<td>Diagnostic Lab Requisition ID</td>
<td>Laboratory values, reference ranges, radiologist imaging findings, impression, and PDF study attachments.</td>
</tr>
<tr>
<td><strong>Discharge Summary</strong></td>
<td><code>DischargeSummaryRecord</code></td>
<td>Inpatient Admission Number</td>
<td>Admission/discharge dates, clinical course, procedures performed, discharge medications, follow-up advice.</td>
</tr>
</tbody>
</table>
</div>
<h3>4. Milestone 3 (M3): Health Information User (HIU)</h3>
<p>Allows hospital doctors to request digital consent from arriving patients to view their previous medical history and diagnostic reports from other hospitals across India via the <strong>ABHA Patient Request List</strong> (Digital Consent Management).</p>
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</section>
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<!-- 16: REPORTS & NABH AUDITS -->
<!-- ========================================================================= -->
<section id="reports" class="guide-section searchable-section">
<h2><span class="section-number">16</span>Reports, Analytics &amp; NABH Quality Audits</h2>
<p><strong>Sidebar Menu:</strong> <code>Reports</code> (Collection Report, Old Payment Received, OPD Total, Diagnosis Report, Insurance Credit, NABH Audit)</p>
<div class="table-responsive">
<table class="table table-bordered table-guide">
<thead>
<tr>
<th>Report Title</th>
<th>Key Parameters &amp; Filters</th>
<th>Auditing &amp; Management Purpose</th>
</tr>
</thead>
<tbody>
<tr>
<td><strong>Collection Report</strong></td>
<td>Date Range, Cashier/User, Department, Payment Mode (Cash, Card, UPI, Cheque).</td>
<td>Daily hospital financial audit. Reconciles drawer cash with recorded system collections.</td>
</tr>
<tr>
<td><strong>Old Payment Received</strong></td>
<td>Date Range, Patient UHID, Invoice Number.</td>
<td>Tracks historical credit recoveries and settlement of past outstanding debts.</td>
</tr>
<tr>
<td><strong>OPD Total Report</strong></td>
<td>Date Range, Doctor, Department, Visit Category.</td>
<td>Clinical workload analytics, doctor patient volume, peak outpatient hours.</td>
</tr>
<tr>
<td><strong>Diagnosis Report</strong></td>
<td>Modality (Pathology, USG, X-Ray, CT, MRI), Doctor Referral.</td>
<td>Diagnostic department test volume, revenue generated, referring physician metrics.</td>
</tr>
<tr>
<td><strong>Insurance Credit Statement</strong></td>
<td>TPA / Company, Claim Status, Aging Days.</td>
<td>Tracks submitted insurance claims, pending approvals, deductions, and receivables aging.</td>
</tr>
<tr>
<td><strong>NABH Audit Report</strong></td>
<td>Reporting Period, Clinical Quality Indicators.</td>
<td>Mandatory quality KPIs: Bed Turnover Rate, Average Length of Stay (ALOS), Return to OT rate, Medication Error reports, Hospital Acquired Infection (HAI) monitoring.</td>
</tr>
</tbody>
</table>
</div>
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</section>
<!-- ========================================================================= -->
<!-- 17: ADMIN & CONFIGURATION -->
<!-- ========================================================================= -->
<section id="admin-settings" class="guide-section searchable-section">
<h2><span class="section-number">17</span>Admin, System Settings &amp; Master Configuration</h2>
<p><strong>Sidebar Menu:</strong> <code>Admin &amp; Settings</code> (Admin Panel, Template, Charges Master, Bed Status)</p>
<h3>1. Bed Status &amp; Ward Configuration (`setting/admin/bed-status`)</h3>
<ul>
<li>Configure hospital physical departments, wards (e.g. General, ICU, NICU, Day Care, Casualty), and rooms.</li>
<li>Define bed numbers, daily per-diem room tariff rates, and room amenities (Oxygen, Ventilator, AC).</li>
<li>Live real-time graphical bed census showing Occupied, Vacant, Cleaning, and Maintenance beds.</li>
</ul>
<h3>2. User Management &amp; Access Permissions</h3>
<ul>
<li>Create system users with individual usernames and secure passwords.</li>
<li>Assign users to system groups (Doctor, Reception, Nursing, Accounts, Pharmacy, Admin).</li>
<li>Grant granular operational privileges (e.g. Payment Adjustments, Radiology Template Setup, Bill Cancellation, Pharmacy Dispensing).</li>
</ul>
<h3>3. Hospital Charges &amp; Tariff Master</h3>
<ul>
<li>Configure hospital master rate list for consultations, investigations, surgical procedures, nursing care, and consumables.</li>
<li>Set differential pricing tiers for Private, General, and Empanelled Corporate/TPA patients.</li>
</ul>
<h3>4. Hospital Profile &amp; Letterhead Customization</h3>
<ul>
<li>Configure official hospital name, HFR ID (Health Facility Registry ID), registration number, and address.</li>
<li>Upload hospital logo and configure print letterhead modes (Printed Paper mode vs Blank Paper mode with auto-header).</li>
</ul>
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</section>
<!-- ========================================================================= -->
<!-- 18: TROUBLESHOOTING -->
<!-- ========================================================================= -->
<section id="troubleshooting" class="guide-section searchable-section">
<h2><span class="section-number">18</span>Troubleshooting Common Operational Issues</h2>
<div class="table-responsive">
<table class="table table-bordered table-guide">
<thead>
<tr>
<th style="width: 25%;">Observed Issue</th>
<th style="width: 35%;">Root Cause</th>
<th>Recommended Action &amp; Resolution</th>
</tr>
</thead>
<tbody>
<tr>
<td><strong>"Access Denied: Missing Permission"</strong></td>
<td>User account does not possess the required RBAC privilege.</td>
<td>Ask Administrator to open <em>Admin &rarr; User Management &rarr; Permissions</em> and assign the required permission flag.</td>
</tr>
<tr>
<td><strong>"Incorrect OTP" during ABHA</strong></td>
<td>Entered OTP digits do not match UIDAI or ABDM Gateway token.</td>
<td>Re-verify the 6-digit OTP on patient's mobile handset. Ensure OTP has not expired (&gt;10 min).</td>
</tr>
<tr>
<td><strong>Duplicate Identifier Alert</strong></td>
<td>Aadhaar number or ABHA ID is already linked to an existing patient file.</td>
<td>Click the prompt's <strong>"View Existing Patient Profile"</strong> link to open the already registered record.</td>
</tr>
<tr>
<td><strong>Care Context Not Appearing in ABHA App</strong></td>
<td>Patient searched in PHR app using a mobile number different from hospital record.</td>
<td>Verify that the patient's mobile number registered in hospital records matches the mobile registered on patient's ABHA account.</td>
</tr>
<tr>
<td><strong>PDF Print Preview Blank or Misaligned</strong></td>
<td>Browser popup blocker active, or paper size settings mismatch.</td>
<td>Allow popups for the HMS domain. In printer dialogue, ensure Paper Size is set to <strong>A4</strong> with Margins set to <strong>Default</strong>.</td>
</tr>
<tr>
<td><strong>Wrong Medicine Batch in POS</strong></td>
<td>Expired or depleted batch selected manually.</td>
<td>Ensure FEFO suggestion is accepted. Perform stock reconciliation in <em>Pharmacy &rarr; Medical Store</em>.</td>
</tr>
</tbody>
</table>
</div>
<div class="safety">
<strong>Technical Support Escalation:</strong> When reporting an unresolved issue to technical support, include:
<ol class="mb-0 mt-1">
<li>The active module/screen name and patient UHID (or invoice number).</li>
<li>Logged-in user role (never share passwords).</li>
<li>Screenshot of the error dialog and message.</li>
</ol>
</div>
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</section>
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