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<div><h1 class="guide-title">E-Atria HMS Help &amp; Operations Guide</h1><div class="version-label">Version 2.0 &nbsp;|&nbsp; Updated 12 August 2026</div></div>
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<div class="p-3 border-bottom"><h2 class="mb-0">Contents</h2></div>
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<a href="#recent-updates">Recent Updates</a><a href="#getting-started">Getting Started</a><a href="#roles-access">Roles &amp; Access</a><a href="#patient-management">Patient Management</a><a href="#opd">OPD Workflow</a><a href="#ipd">IPD &amp; Nursing</a><a href="#ot-management">OT Management</a><a href="#diagnosis">Diagnosis &amp; Imaging</a><a href="#pharmacy">Pharmacy</a><a href="#billing">Billing &amp; Payments</a><a href="#finance">Finance</a><a href="#insurance">Insurance &amp; ORG Cases</a><a href="#abdm">ABDM &amp; ABHA</a><a href="#stock">Hospital Stock</a><a href="#reports">Reports &amp; Dashboards</a><a href="#admin">Admin &amp; System Operations</a><a href="#security">Security &amp; Compliance</a><a href="#backup">Backup &amp; Maintenance</a><a href="#troubleshooting">Troubleshooting</a>
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<section id="recent-updates" class="guide-section searchable-section">
<h2><span class="section-number">01</span>Recent Updates</h2>
<p>These functions were added or strengthened after the previous help guide was published.</p>
<div class="update-item"><strong>OT Management Phase 1 <span class="status-chip ms-1">NEW</span></strong><div>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.</div></div>
<div class="update-item"><strong>Department-specific pre-operative forms</strong><div>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.</div></div>
<div class="update-item"><strong>IPD Nursing and discharge controls</strong><div>Dedicated nursing access, clinical workspace improvements, configurable discharge content, diagnosis masters, and more reliable HTML/PDF template rendering are available.</div></div>
<div class="update-item finance"><strong>Controlled Payment Edit</strong><div>Authorized finance users can correct payment mode, amount, and recorded user. Zero-value corrections are supported; negative values remain blocked.</div></div>
<div class="update-item finance"><strong>Pharmacy credit payout workflow</strong><div>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.</div></div>
<div class="update-item security"><strong>Stronger session and permission controls</strong><div>Single-active-session protection, clearer access-denied pages, streamlined permission management, and dedicated permissions for payment editing, nursing, discharge, and OT actions are active.</div></div>
<div class="update-item"><strong>Clinical drill-down dashboards</strong><div>Management dashboards support navigation from summary indicators to underlying operational and clinical records.</div></div>
<div class="update-item"><strong>Pharmacy usability fixes</strong><div>Credit payout routes, Medicine Return labels, and the Org. Credit Invoice empty-grid behavior have been corrected.</div></div>
<div class="note"><strong>Deployment note:</strong> New database-backed features require their migrations and permissions to be applied by the system administrator.</div>
</section>
<section id="getting-started" class="guide-section searchable-section">
<h2><span class="section-number">02</span>Getting Started</h2>
<div class="quick-grid">
<div class="quick-item"><strong>1. Sign in</strong>Use only your assigned account. Shared accounts weaken clinical and financial audit records.</div>
<div class="quick-item"><strong>2. Select a module</strong>Use the sidebar for Patient, OPD, IPD, Diagnosis, Pharmacy, Finance, Stock, Reports, or Settings.</div>
<div class="quick-item"><strong>3. Search first</strong>Search by patient code, name, mobile, ABHA, invoice, IPD, or case code before creating a duplicate.</div>
<div class="quick-item"><strong>4. Verify context</strong>Confirm patient, encounter, department, payer, and date before saving clinical or billing data.</div>
<div class="quick-item"><strong>5. Complete the workflow</strong>Draft, verify, approve, print, or submit as required. A draft is not always final.</div>
<div class="quick-item"><strong>6. Sign out</strong>Use the profile menu, especially on shared workstations.</div>
</div>
<h3>Common screen behavior</h3>
<ul><li>Most pages open inside the main workspace without a full browser refresh.</li><li>Filters affect the current list. Clear them before concluding a record is missing.</li><li>PDF/print buttons may open a new tab; allow pop-ups for the HMS domain.</li><li>Red actions may cancel, delete, refund, reject, or finalize and require extra care.</li></ul>
<div class="warning"><strong>Before finalization:</strong> Recheck identifiers, dates, amounts, medicine batches, clinical findings, and print template. Final records may require permission and an edit reason to change.</div>
</section>
<section id="roles-access" class="guide-section searchable-section">
<h2><span class="section-number">03</span>User Roles &amp; Access</h2>
<p>Menus and actions are permission-based. Two users may open the same patient but see different buttons.</p>
<div class="table-responsive"><table class="table table-bordered table-guide"><thead><tr><th>Role area</th><th>Typical responsibility</th><th>Restricted actions</th></tr></thead><tbody>
<tr><td>Registration</td><td>Patient search, registration, appointment, token, admission support</td><td>Clinical verification and financial correction</td></tr>
<tr><td>Doctor / Clinical</td><td>Consultation, diagnosis, prescription, orders, discharge</td><td>Finance approval and stock administration</td></tr>
<tr><td>Nursing / OT</td><td>Nursing workspace, bedside care, safety checks, OT status, handover</td><td>Scheduling or signed assessment unless assigned</td></tr>
<tr><td>Diagnosis</td><td>Sample workflow, findings, imaging, verification, report printing</td><td>Verified-report edits without reason/permission</td></tr>
<tr><td>Pharmacy</td><td>Dispensing, returns, inventory, purchasing, supplier and credit workflows</td><td>Finance payout approval</td></tr>
<tr><td>Billing / Finance</td><td>Invoices, collections, refunds, reconciliation, payouts</td><td>Payment edits without <code>finance.payment.edit</code></td></tr>
<tr><td>Administrator</td><td>Users, permissions, masters, templates, integrations, operations</td><td>Infrastructure actions still require confirmation</td></tr>
</tbody></table></div>
<p>For <strong>Access denied</strong>, note the module and action and ask an administrator to review the role. Never use another person's login.</p>
</section>
<section id="patient-management" class="guide-section searchable-section">
<h2><span class="section-number">04</span>Patient Management</h2>
<ol class="workflow"><li><strong>Search first.</strong> Use UHID/patient code, name, phone, Aadhaar reference, old UHID, or ABHA.</li><li><strong>Review matches.</strong> Compare DOB, gender, guardian, address, and contact number.</li><li><strong>Create or update.</strong> Enter demographics, identity documents, photo, guardian/family data, and attachments.</li><li><strong>Open the profile.</strong> Use it for OPD, IPD, billing, diagnosis, documents, and health-record history.</li><li><strong>Link ABHA.</strong> Verify that the ABHA profile belongs to the same patient first.</li></ol>
<div class="safety"><strong>Duplicate prevention:</strong> Try alternate spelling, phone, old code, and family details before creating a new patient.</div>
</section>
<section id="opd" class="guide-section searchable-section">
<h2><span class="section-number">05</span>OPD Workflow</h2>
<h3>Appointment and check-in</h3>
<ol class="workflow"><li>Select patient, doctor, date/slot, or walk-in.</li><li>Confirm department, referral, consultation type, and organization/insurance case.</li><li>Generate the visit/token. Scan &amp; Share patients may arrive through the facility QR.</li><li>Collect or confirm consultation payment according to policy.</li></ol>
<h3>Clinical consultation</h3>
<ul><li>Record vitals, complaints, history, examination, allergies/ADR, medications, diagnosis, advice, and follow-up.</li><li>Add medicines with dosage, frequency, route, duration, and instructions.</li><li>Order pathology or imaging investigations and review previous visits.</li><li>Generate referral letters, prescription PDFs, and FHIR e-Prescription records when required.</li></ul>
<div class="note"><strong>AI assistance:</strong> AI can draft complaints, prescriptions, or extract report values where configured. A clinician must review all generated content.</div>
</section>
<section id="ipd" class="guide-section searchable-section">
<h2><span class="section-number">06</span>IPD Admission, Nursing &amp; Discharge</h2>
<h3>Admission and beds</h3>
<ol class="workflow"><li>Create admission with department, doctor, date/time, and reason.</li><li>Assign an available Department → Ward → Category → Bed.</li><li>Record HPI/admission history and treating doctors.</li><li>Use bed transfer instead of overwriting the bed to preserve history.</li></ol>
<h3>Nursing</h3>
<ul><li>Document shift notes and observations against the correct admission.</li><li>Post bedside consumables, nursing items, and doctor visits promptly.</li><li>Scan paper forms and use Surgery/OT for operative patients.</li><li>Check the patient/IPD banner before every entry.</li></ul>
<h3>Discharge</h3>
<ul><li>Complete diagnosis, course, procedures, condition, medication, advice, diet, and follow-up.</li><li>Select and preview the approved discharge template.</li><li>Reconcile pending charges, returns, package adjustments, and balance.</li><li>Verify PDF page breaks, placeholders, dates, letterhead mode, and signatures.</li><li>Generate/share the ABDM discharge summary when requirements are met.</li></ul>
</section>
<section id="ot-management" class="guide-section searchable-section">
<h2><span class="section-number">07</span>OT Management</h2>
<p>Available from IPD Nursing and OT Surgery Queue. Request, scheduling, examination, status, and post-operative actions have separate permissions.</p>
<ol class="workflow"><li><strong>Create request.</strong> Enter procedure, surgeon, priority, indication, and requested schedule.</li><li><strong>Complete pre-op examination.</strong> Use the department-specific form; revisions to completed forms require a reason.</li><li><strong>Schedule.</strong> Authorized OT staff assign date/time and coordination details.</li><li><strong>Call patient.</strong> Update the case when preparation begins.</li><li><strong>Complete safety gates.</strong> Confirm pre-op checks and WHO sign-in before starting.</li><li><strong>Record progress.</strong> Move through requested, scheduled, called, in progress, and completed; give reasons for cancellation or major changes.</li><li><strong>Sign post-op assessment.</strong> Record observations, outcome, instructions, and handover.</li></ol>
<div class="safety"><strong>Clinical integrity:</strong> OT actions create event history and use version checks. Refresh if another user changed the case.</div>
</section>
<section id="diagnosis" class="guide-section searchable-section">
<h2><span class="section-number">08</span>Diagnosis, Laboratory &amp; Imaging</h2>
<p>Supported workflows include Pathology, Biopsy, X-Ray, Ultrasound, MRI, CT, and Echo.</p>
<h3>Laboratory</h3><ol class="workflow"><li>Receive the OPD, IPD, or walk-in request and confirm patient/tests.</li><li>Record sample collection and lab number.</li><li>Enter values; review units, reference ranges, flags, and comments.</li><li>Save draft, then verify/sign according to policy.</li><li>Print individual or compiled reports using the correct template.</li></ol>
<h3>Imaging</h3><ul><li>Upload images, scans, or DICOM studies against the report.</li><li>Use the viewer/gallery and draft findings/impression.</li><li>Complete doctor verification; AI suggestions require radiologist review.</li></ul>
<div class="warning"><strong>Verified reports:</strong> Authorized edits require a meaningful reason retained in the audit trail.</div>
</section>
<section id="pharmacy" class="guide-section searchable-section">
<h2><span class="section-number">09</span>Pharmacy / Medical Store</h2>
<h3>Dispensing</h3><ul><li>Create counter, OPD, IPD, or organization-linked invoices in the correct context.</li><li>Confirm medicine, batch, expiry, stock, rate, tax, discount, and quantity.</li><li>Use <strong>Medicine Return</strong> or <strong>Medicine Return 2</strong> for the applicable return flow.</li><li>Use Org. Credit Invoice for corporate/insurance-linked medicine billing.</li><li>Finalize an IPD medicine account only after invoices, returns, discounts, and payments reconcile.</li></ul>
<h3>Inventory and purchase</h3><ul><li>Maintain drug, generic, formulation, category, company, supplier, batch, tax, and rate masters.</li><li>Create purchase orders, receive invoices/batches, and process purchase returns.</li><li>Monitor expiry, low stock, movement, and supplier ledger reports.</li></ul>
<h3>Credit payout request</h3><ol class="workflow"><li>Open Pharmacy → Credit Payout Request.</li><li>Review/filter the eligible pool.</li><li>Select valid lines, confirm amounts, add remarks, and submit.</li><li>Monitor status while Finance handles approval and payment.</li></ol>
</section>
<section id="billing" class="guide-section searchable-section">
<h2><span class="section-number">10</span>Billing, Invoices &amp; Payments</h2>
<ul><li>Bill OPD consultation, procedures, diagnostics, IPD charges, packages, and pharmacy links.</li><li>Apply discounts only with authority and supporting remarks.</li><li>Use payment/refund request workflows instead of informal adjustments.</li><li>Confirm organization/insurance case before posting payer charges.</li><li>Print/export daily collection and balance reports for reconciliation.</li></ul>
<h3>Payment Edit</h3><p>Authorized users can correct payment mode, amount, or recorded user. Amount may be <strong>0.00</strong> for a valid correction but cannot be negative.</p>
<div class="safety"><strong>Do not use Payment Edit to hide a refund or cancellation.</strong> Use the approved reversal workflow and retain the reason.</div>
</section>
<section id="finance" class="guide-section searchable-section">
<h2><span class="section-number">11</span>Finance &amp; Accounting</h2>
<div class="quick-grid"><div class="quick-item"><strong>Cash Book</strong>Daily department collections and opening/closing position.</div><div class="quick-item"><strong>Bank Deposits</strong>Deposit references, dates, amounts, and status.</div><div class="quick-item"><strong>Reconciliation</strong>Match statements to system transactions.</div><div class="quick-item"><strong>POS Settlement</strong>Track terminal settlements, charges, and differences.</div><div class="quick-item"><strong>Doctor Payouts</strong>Agreements, commission, approval, and disbursement.</div><div class="quick-item"><strong>Vendor Control</strong>PO, receipt, invoice, payment, and balance.</div></div>
<p class="mt-3">Review pharmacy payout line evidence, approve/reject according to policy, record payments, and retain remarks for each status change.</p>
</section>
<section id="insurance" class="guide-section searchable-section">
<h2><span class="section-number">12</span>Insurance &amp; Organization Cases</h2>
<ol class="workflow"><li>Create/select the case and verify patient, payer, policy, approval, and validity.</li><li>Link OPD, IPD, diagnosis, procedures, and pharmacy invoices.</li><li>Apply approved rates/packages, including Ayushman mappings.</li><li>Use contingent billing when liability depends on case outcome.</li><li>Prepare claim sheets and supporting documents.</li><li>Track submission, query, approval, deduction, payment, and balance.</li></ol>
<div class="warning"><strong>Case selection:</strong> Select a valid system case. Empty or placeholder identifiers are not payer cases.</div>
</section>
<section id="abdm" class="guide-section searchable-section">
<h2><span class="section-number">13</span>ABDM, ABHA &amp; Health Records</h2>
<h3>ABHA identity</h3><ul><li>Create ABHA through supported Aadhaar/mobile OTP flows.</li><li>Verify/fetch profile before linking to the HMS patient.</li><li>Display/download ABHA card and use facility QR for Scan &amp; Share.</li></ul>
<h3>Care context and sharing</h3><ol class="workflow"><li>Confirm verified ABHA and correct visit/admission.</li><li>Discover/link the care context.</li><li>Select e-Prescription, Discharge Summary, Diagnostic Report, Immunization, Wellness, Health Document, or supported invoice.</li><li>Preview FHIR R4 data: identity, dates, practitioner, coding, and attachments.</li><li>Share and monitor gateway/bridge status.</li></ol>
<h3>Consent and HIU</h3><ul><li>Request consent only for a legitimate purpose and date range.</li><li>Track requested, granted, denied, expired, and revoked status.</li><li>Fetch health information only after grant; data may contain FHIR documents and attachments.</li></ul>
<div class="safety"><strong>Privacy:</strong> ABDM access is purpose-limited and consent-driven. Use data only for authorized care.</div>
</section>
<section id="stock" class="guide-section searchable-section">
<h2><span class="section-number">14</span>Hospital Stock</h2>
<ol class="workflow"><li>Configure category, item, units, conversion, location, min/reorder, and expiry control.</li><li>Departments raise indents with quantity and purpose.</li><li>Authorized users approve, reject, or revise.</li><li>Storekeepers issue approved quantities and batches.</li><li>Create purchase orders and goods receipts.</li><li>Review consumption, issues, expiry, low-stock, reorder, and daily-use reports.</li></ol>
<div class="note">Purchase and issue units may differ. Wrong conversion causes incorrect stock and reorder quantities.</div>
</section>
<section id="reports" class="guide-section searchable-section">
<h2><span class="section-number">15</span>Reports &amp; Dashboards</h2>
<div class="table-responsive"><table class="table table-bordered table-guide"><thead><tr><th>Area</th><th>Examples</th><th>Review focus</th></tr></thead><tbody><tr><td>Clinical</td><td>OPD, diagnosis workload/TAT, discharge, OT queue</td><td>Completeness and delays</td></tr><tr><td>Billing</td><td>Collections, balances, refunds, credit invoices</td><td>Mode/user totals and exceptions</td></tr><tr><td>Finance</td><td>Cash book, bank audit, POS, doctor payout</td><td>Unmatched/unapproved items</td></tr><tr><td>Pharmacy</td><td>Stock, expiry, movement, sales, returns, supplier ledger</td><td>Negative stock and expiry risk</td></tr><tr><td>Insurance</td><td>Organization dues, claims, deductions</td><td>Aging and documents</td></tr><tr><td>Audit</td><td>NABH edits, billing logs, user actions</td><td>Who changed what, when, and why</td></tr></tbody></table></div>
<p>Use drill-down links from totals to source records. Retain the same dates and filters while reconciling.</p>
</section>
<section id="admin" class="guide-section searchable-section">
<h2><span class="section-number">16</span>Administration &amp; System Operations</h2>
<h3>Application administration</h3><ul><li>Manage users, groups, permissions, passwords, and active access.</li><li>Maintain doctor, referral, insurance, bank/payment, charge, diagnosis, medicine, and stock masters.</li><li>Configure OPD, diagnosis, and discharge print templates.</li><li>Configure AI, HealthPlix, ABDM HFR/gateway/bridge, and report-doctor mappings.</li></ul>
<h3>System Operations</h3><ul><li>Review OS/uptime, CPU, memory, disk, RAID, database, web, PHP-FPM, and SSH health.</li><li>Use Update HMS only during an approved window and review its log.</li><li>Restart services only when needed. Reboot/shutdown require confirmation and coordination.</li></ul>
<div class="safety"><strong>Production safety:</strong> Confirm backup and rollback readiness before migrations, updates, restarts, or environment changes.</div>
</section>
<section id="security" class="guide-section searchable-section">
<h2><span class="section-number">17</span>Security, Audit &amp; Compliance</h2>
<ul><li>Never disclose passwords, OTPs, API keys, or tokens.</li><li>Single-active-session protection may end an older login.</li><li>Grant the least permission required and review access after role changes.</li><li>Clinical verification, payment edits, refunds, cancellations, OT changes, and completed-form revisions require audit evidence.</li><li>Verify SNOMED CT/ICD-10 codes against documented clinical meaning.</li><li>Follow NABH, ABDM/FHIR, NHCX, privacy, retention, and hospital policies.</li></ul>
</section>
<section id="backup" class="guide-section searchable-section">
<h2><span class="section-number">18</span>Backup &amp; Maintenance</h2>
<ul><li>Schedule database and uploaded-document backups and test restoration.</li><li>Retain an off-server/off-site copy according to policy.</li><li>Apply code updates and migrations in a controlled sequence.</li><li>After deployment test login, dashboard, patient search, billing, PDF, uploads, jobs, and integrations.</li><li>Monitor storage, database growth, logs, failed queues, ABDM tasks, and large attachments.</li><li>Keep production error display disabled; use protected logs.</li></ul>
</section>
<section id="troubleshooting" class="guide-section searchable-section">
<h2><span class="section-number">19</span>Troubleshooting</h2>
<div class="table-responsive"><table class="table table-bordered table-guide"><thead><tr><th>Problem</th><th>Check</th><th>Action</th></tr></thead><tbody>
<tr><td>Access denied</td><td>Role, permission, module</td><td>Ask Admin; do not borrow credentials.</td></tr>
<tr><td>Page/form does not load</td><td>Session, network, URL/status, console</td><td>Refresh dashboard, reopen, report exact URL/status.</td></tr>
<tr><td>Save does nothing</td><td>Required/invalid number or date fields</td><td>Correct highlighted fields; report console/network details.</td></tr>
<tr><td>DataTables warning</td><td>Empty table, screen URL, table ID</td><td>Report URL and table ID.</td></tr>
<tr><td>Unexpected token &lt;</td><td>HTML server error returned instead of JSON</td><td>Capture endpoint/status; Admin checks logs.</td></tr>
<tr><td>PDF mismatch</td><td>Template, paper mode, placeholders, pasted HTML</td><td>Preview intended template and report record/template.</td></tr>
<tr><td>Wrong stock</td><td>Batch, conversion, return, issue, receipt, transfer</td><td>Reconcile ledger before adjustment.</td></tr>
<tr><td>Payment mismatch</td><td>Invoice, mode, user, amount, refund/void</td><td>Use approved correction and document reason.</td></tr>
<tr><td>ABDM pending/failed</td><td>ABHA, consent, HFR/token, bridge/task log</td><td>Identify failure; preserve request ID.</td></tr>
<tr><td>OT changed elsewhere</td><td>Stale version warning</td><td>Refresh, review history, re-enter update.</td></tr>
</tbody></table></div>
<h3>Include in a support request</h3><ul><li>Exact URL and module</li><li>Date/time and user role, never password</li><li>Patient/IPD/invoice/case code through approved channels</li><li>Steps, expected result, and actual result</li><li>Screenshot and console/network status</li></ul>
</section>
<footer class="px-2 py-3 small"><div>For legal terms, see <a href="software-use-license.html">Software Use License</a>.</div><div>Hospital policy and permissions control which described workflows each user may perform.</div></footer>
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