A Systematic Review of Hospital Management Systems: Technological Architectures, Implementation Strategies, and Outcomes
TL;DR
This systematic review, guided by PRISMA 2020 guidelines, synthesized evidence on Hospital Management Systems across six electronic databases from January 2000 to October 2023, examining their technological architectures, implementation challenges, clinical and administrative outcomes, and cost-effectiveness in diverse healthcare settings.
Abstract
This systematic review, guided by PRISMA 2020 guidelines, synthesized evidence on Hospital Management Systems (HMS) across six electronic databases (PubMed, IEEE Xplore, ACM Digital Library, Scopus, Web of Science, and CINAHL) from January 2000 to October 2023, examining their technological architectures, implementation challenges, clinical and administrative outcomes, and cost-effectiveness in diverse healthcare settings. From 8,427 identified records, 167 studies met inclusion criteria and revealed four distinct architectural eras monolithic systems (2000-2010), modular ERP-based systems (2010-2018), Service-Oriented Architectures with interoperability standards (2015-present), and cloud-native AI-enhanced systems (2020-present) with implementation success rates ranging from 42% in low-resource settings to 78% in high resource environments, driven by stakeholder engagement (89% of successful implementations), phased deployment (76%), and robust change management (82%). Clinical outcomes demonstrated significant improvements including a 45% reduction in medication errors (95% CI: 38-52%), reduced length of stay by 1.2 days (95% CI: 0.8-1.6), and 18.5% increased patient satisfaction (95% CI: 15.2-21.8%), though persistent challenges included interoperability gaps (65%), workflow disruption (58%), and cybersecurity vulnerabilities (47%).