Emergency Department (ER) Management

When minutes decide outcomes, your ER cannot wait for paperwork. EloHIMS gives the emergency department a live board with locked triage, STAT orders and a running bill on every visit, a treat-first file for the patient nobody can name yet, MLC records that keep their history, and ambulance runs charged by the kilometre.

The sickest patients seen first, every charge on the visit

Acuity that can't be quietly softened, clocks that measure the right thing

Incoming patients are assigned a triage category the instant they present, and that category is recorded immutably. Acuity decisions cannot be back-dated or softened after the fact, so the sickest patients are impossible to miss.

Door-to-doctor is measured from the moment a doctor — or a diagnosis — is first recorded on the visit, not from triage. Door-to-triage is shown as its own figure, and both appear on the ER dashboard, the command centre and the wait-time report, so a quick triage cannot hide a long wait for the doctor.

Treat now, bill once

The ER visit screen has Order Lab, Order Imaging, Prescribe and Procedure. Orders go to the laboratory and radiology worklists as STAT unless changed, and sort to the top. Every order, the ER fee and each procedure lands on the visit's running bill instead of a separate cash slip.

When the patient is admitted, the running charges move onto the admission and still show which ER visit they came from. When the patient goes home, is referred or leaves against advice, the same charges become the ER final bill. Either way, each charge is billed once.

Treat first — merge into the real file later, with every charge kept

Switch the ER to treat-first and the Register dialog offers an "Unidentified" option: the patient gets an "Unknown" file on the normal MRN scheme, with the gender and approximate age seen, and care starts at once — orders, charges, vitals and allergies all go on that file.

When the patient is identified, a banner on the ER visit merges the unknown file into their real MRN. Every record that belongs to the patient moves in one transaction, along with the bills' account; if anything clashes, nothing moves. Only an unknown file can be merged, only into a real one, by a user holding the merge right and with a reason. The unknown file is retired and the merge appears on the Merge Audit report.

Medico-legal records that keep their history

An MLC case keeps its medico-legal record on the ER visit. Each save stores the previous version in the record's history, so nothing is silently overwritten, and the record locks when the visit is closed. Reopening it needs the MLC-unlock permission and a written reason; it locks again on the next save.

A death in the ER writes a death record. It counts as medico-legal when the ER visit was an MLC or the patient carries an MLC alert. The certificate records the (a)/(b)/(c) and Part II cause chain, and an unnatural manner of death on a non-MLC case is stopped. An MLC death is intimated to the police — never dated before the death — and only then can the body be released to a named person with relation and CNIC. Certificate and intimation both print from the Deaths & Mortuary page; see hospital registers.

Every run dispatched, timed and charged to the right bill

Request an ambulance from the ER visit — the button appears once the hospital has a vehicle, and a referral fills in the receiving hospital — or from an admission, or at the desk. A patient has one open run at a time. Dispatch sends a free vehicle, never one already out, with its usual driver and crew, and each leg of the run is time-stamped in order.

On completion the run is charged at the hospital's ambulance tariff: the base fare for the vehicle type plus the per-km rate times the distance. The charge goes onto the open ER bill or the admission; otherwise it waits to be collected, and a user with the discount right can waive it. The ambulance board shows the fleet's state, runs in progress, runs to collect and the day's finished runs.