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					      GOVERNMENT OF PAKISTAN


             PC-I (Revised)

                   FOR
  Hospital Management Information System
                 (HMIS)
                   and
            Networking Facilities
                   FOR
      ISLAMABAD HOSPITAL PIMS


      GOVERNMENT OF PAKISTAN
        IT &TELECOM DIVISION
ELECTRONIC GOVERNMENT DIRECTORATE



                July 2005
                                       Table of Contents
Revision                                                                               3
Part “A”:       Project Digest                                                      4-10
Part “B”:       Project Description and Financing                                  11-25
Part “C”:       Project Requirements                                               26-27
Annexure-I      Comparative Cost Estimates, Total Expenditure & Progress of work   28-29
Annexure-II     Summary of Capital Expenditure                                        30
Annexure-III    Actual Expenditure incurred till June 2005                            31
Annexure-IV     Cost of Products/Services                                          32-33
Annexure-V      Operating Expenditure during life of project                          34
Annexure-VI     Staff Salaries                                                        35
Annexure-VII    Network BOQ of PIMS                                                36-40
Annexure-VIII   Annual Recurring Expenditure                                       41-42
Annexure-IX     Brief History of PIMS                                              43-48
Annexure-X      Details of HMIS Software Applications                              49-53
Annexure-XI     Details of Compter Hardware                                        54-61
Annexure-XII    Details of Licensed Software                                       62-63
Annexure-XIII   Details of Training                                                64-69
Annexure-XIV    Project Plan                                                       70-71
Annexure-XV     Quarterly Phasing of Project                                          72




                                               -2–
Revision:

1.     The original PC-1 for this project was approved on 14th October 2004. EGD has
already completed competitive tendering process for procurement of following
services:
     Installation of Local Area Network (LAN)
     Provision and Installation of Hardware and Licensed Software

2.    The project director has been hired under the project.

3.    However, no amount has been spent on the project.

4.    The following changes have been made in the revised PC-I:

      a.     6 posts of trainers have been created in the revised PC-I and the cost
      mentioned in Original PC-I under the head of “Cost on Job Training” has been
      re-allocated to the Project Staff Salaries head. These resources will be responsible
      for providing on job training for a period of 13 months to 1183 existing staff of
      PIMS which include Doctors, Paramedical, support and administrative staff on
      the HMIS software applications gifted by CRM.

      b.   The annual software maintenance cost of HMIS applications has been
      removed from the annual recurring expenditure after completion of the project.

      c.    A provision of 5 KVA UPS has been made in revised PC-I to provide
      backup for 3 Servers.

      d.    Upgradation of RAM in servers is proposed in revised PC-I to provide
      speedy processing and retrieval of PIMS data.

      e.     The number of network nodes has been increased from 300 to 339 in the
      revised PC-I




                                          -3–
                                                          Code Number for Project---------------
                                                 (To be filled in by the Planning Commission)

                                    PART-'A'
                                PROJECT DIGEST

1. NAME OF THE PROJECT:                           Hospital Management Information System
                                                  and networking facilities at Islamabad
                                                  Hospital, PIMS.

2. AUTHORITIES RESPONSIBLE FOR:

(i) Sponsoring:                                   Ministry of Information Technology, IT
                                                  and Telecom Division
                                                  Government of Pakistan



(ii) Executing:                                   Electronic Government Directorate

(iii) Operation and Maintenance:                  Islamabad Hospital PIMS, Islamabad

3. TIME REQUIRED OF COMPLETION
OF THE PROJECT (IN MONTHS)                               Original               Revised
                                                        27 months              27 months
4. (a) PLAN PROVISION

(i) If the project is included in the current Not included
   Five Year Plan, Specify actual allocation.

(ii)If not included in the current Plan, how      NA
is it now proposed to be accommodated?
(Inter / Intra-Sectoral adjustment in
allocation) or other resources may be
included.

(iii) If the Project is proposed to be            The Project is proposed to be financed
financed out of block provision for a             through the PSDP allocation of IT &
program.                                          Telecom    Division   of  Ministry  of
                                                  Information Technology.

b) If the Project is not included in the plan,    PIMS is one of the largest public sector
what warrants its inclusion:                      hospital in Pakistan. It includes Islamabad
                                                  Hospital, Children Hospital, Mother and


                                               -4–
                                            Child Hospital (MCH) and College of
                                            Medical Technology, School of nursing
                                            and Quaid-e-Azam Postgraduate Medical
                                            College. The total number of beds are as
                                            follows:

                                                   Islamabad Hospital: 590
                                                   Children: 230
                                                   MCH: 125

                                            It is a center of excellence in Pakistan.
                                            However the hospital is managed on
                                            manual systems, which leads to sub-
                                            optimal utilization of resources. It is
                                            difficult to efficiently manage the more
                                            than 1000 patients who visit the IH daily.
                                            This is the case with all hospitals in
                                            Pakistan.

                                            The project focuses on improving patient
                                            care and performance of health facilities in
                                            Pakistan through the use of information
                                            technology by making a start with IH. At
                                            present there is no public sector hospital
                                            which has an integrated HMIS.             The
                                            project is the first of its kind in the public
                                            sector. Hospital computerization is critical
                                            if management and ultimately patient
                                            services are to be improved.

                                            The project is in line with the new Health
                                            Policy 2001, which aims at improving the
                                            patient healthcare at service delivery
                                            facilities.

                                            See Annex IX for details of PIMS.

5. Relationship of the project with the     The Health Policy 2001 provides an overall
objective of the sector.                    national vision for the Health Sector based
                                            on “Health for All” approach. Under the
                                            new    Health     Policy   health     sector
                                            investments are being viewed as part of
                                            the Government’s Poverty Alleviation



                                          -5–
                           Plan. The measures, programmes and
                           projects identified under the policy focus
                           on efficiency and effectiveness. However,
                           the health policy acknowledges the fact
                           that the key to the success lies in its
                           implementation.

                           Improving hospital performance and
                           quality of patient care which is a major
                           focus of the health sector reforms.
                           Decentralization and giving autonomy to
                           hospitals in order to improve their
                           workings is a major policy focus.
                           However enhanced powers require that
                           proper systems be in place so that the
                           process could be monitored and evaluated.
                           A proper management information system
                           is critical to support the policy. The project
                           is directly related with the scope and
                           objectives of PIMS, which is to lead the
                           way in the use of modern technology tools
                           in hospitals.      At present there is no
                           hospital in the public sector which has an
                           integrated HMIS. Other dividends of such
                           activities would be training of medical and
                           allied professionals in best use of IT as a
                           tool to improve their productivity.

6. Existing Facilities     PIMS      initiated the    process    of
                           computerization in its hospital in 1966.
                           However, work in earnest started only in
                           past few years.

                           Software
                           The current application software has been
                           donated by Center for Research and
                           Management (CRM) which has been
                           assisting PIMS in its computerization
                           efforts since 1996. The software modules
                           include Patient Registration, doctor
                           consultation, admissions, appointments,
                           operations, pathology, radiology, stores,
                           pharmacy, budget and accounts, and



                         -6–
  personnel. The details of the software are
  attached as Annex X:

  So far the Patient Registration, Pathology,
  Radiology, and Stores have been
  completed at PIMS and are fully
  operational. More than 1000 patients are
  being entered on computer everyday. The
  pathology department is paperless and
  caters to more than 300 patients a day.

  Networking
  Partial networking has been done in the
  wards and OPDs. See Annex VII for
  details of Networking.

  Hardware
   See Annex XI for details of computers
  available in Islamabad Hospital and the
  additional requirements.

  HMIS Department
  At present there is no HMIS department in
  PIMS. See Annex VI for details of HMIS
  Department staff and Annex V operating
  cost during the project life. See Annex VIII
  for HMIS Department details and
  recurring costs after completion of the
  project.

  Training
  There is no organized system for training
  of PIMS staff on existing HMIS. See Annex
  XIII for details of training.

  Current Status of Computerization
  The current status of computerization is as
  follows:

  Registration
  OPD                        (operational)
  Emergency                  (operational)
  PIMS staff                 (operational)
  Social Welfare Dept.       (operational)


-7–
                                          OPDs
                                          Nephrology               (data entry started)
                                          Cardiology               (data entry started)
                                          General medicine         (data entry started)
                                          Angiography              (hw/sw installed)
                                          Dental                   (hw/sw installed)
                                          Rheumatology             (data entry started)

                                          Current status of HMIS in Wards
                                          Medical ward 1(data entry started)
                                          Surgical ward 2(data entry started)
                                          Surgical ward 5     (hw/sw installed)
                                          Cariology ward      (data entry started)
                                          CCU                 (data entry started)

                                          Diagnostics
                                          Pathology (operational throughout IH)
                                          Radiology (operational)
                                          Blood bank (data entry started)

                                          Hardware, complete networking of
                                          hospital, licensed software, HMIS software
                                          maintenance, staff and training is now
                                          required under the project.

7. Location of the Project                Islamabad Hospital, Islamabad.

8. Capital cost of the Project
                                                    Original               Revised
                                              Rs. 37.807 Million     Rs. 39.000 Million
                                                                     (Annexure-II)
9. Annual recurring expenditure after
completion:                                         Original               Revised
                                              Rs. 4.576 Million      Rs. 3.969 Million
                                              for one year           for one year

                                          This will be met out by the IH after
                                          completion of project. See Annexure-VIII
10 Proposed date of:

Commencement:                             March 2005.



                                        -8–
Completion:                                     June 2007.


11. Objective of the project, preferably in     Objective and goal
quantitative terms.                             (Objectives of revised PC-I are same as of
                                                original PC-I)
                                                The overall objectives of the Hospital
                                                Management Information System are to
                                                improve patient services through better
                                                management and efficient use of available
                                                resources both human and financial.

                                                The IH Hospital, PIMS is interested in
                                                upgardining the existing HMIS application
                                                software establishing in order to assist the
                                                management of the Hospital in improving:

                                                       Planning
                                                       Implementation
                                                       Monitoring
                                                       Quality
                                                       Efficiency
                                                       Productivity

                                                The above objectives will be achieved by
                                                computerizing the following areas:

                                                    i) Patient Registration
                                                    ii) Doctor consultation
                                                    iii) Admissions and discharges
                                                    iv) Patient appointments
                                                    v) Operations
                                                    vi) Doctors roster
                                                    vii) Pathology
                                                    viii) Radiology
                                                    ix) Stores
                                                    x) Pharmacy
                                                    xi) Blood Bank
                                                    xii) Budget and Accounts
                                                    xiii) Procurement
                                                    xiv) Personnel




                                              -9–
Prepared By:          (Mr. Atif Ahmed)
                      Director Systems
                      Electronic Government Directorate



Checked By:
                      (Dr. Haroon Khan)
                      Associate Professor of Pathology
                      Pakistan Institute of Medical Sciences




                      (Syed Raza Abbas Shah)
                      Director General Projects
                      Electronic Government Directorate




                      (Dr. Syed Fazle Hadi)
Approved By:          Executive Director PIMS.
                      Pakistan Institute of Medical Sciences




                      (Mr. Seerat Asghar)
                      Programme Coordinator,
                      Electronic Government Directorate




               July, 2005




                  - 10 –
                                         PART "B"

              PROJECT DESCRIPTION AND FINANCING

12. Location of the Project.                     Islamabad Hospital, PIMS

(a) Give name of place and administrative        Islamabad Hospital, PIMS
districts in which the service center will be
provided

b) Indicate total area, which will be served. PIMS serves the entire Pakistan specially
                                              Punjab, NWFP and Northern Areas.

13. Present facilities and their capacity.       PIMS has already initiated the process of
                                                 computerization.     The existing HMIS
                                                 software includes the following modules:

                                                      i)      Patient Registration
                                                      ii)     Doctor consultation
                                                      iii)    Admissions and discharges
                                                      iv)     Patient appointments
                                                      v)      Operations
                                                      vi)     Doctors roster
                                                      vii)    Pathology
                                                      viii)   Radiology
                                                      ix)     Stores
                                                      x)      Pharmacy
                                                      xi)     Blood Bank
                                                      xii)    Budget and Accounts
                                                      xiii)   Procurement
                                                      xiv)    Personnel

                                                 So far the Patient Registration, Pathology,
                                                 and Radiology have been computerized.
                                                 Stores and accounts are in the process of
                                                 being computerized.

                                                 Hardware      and     complete   network
                                                 connecting each department is now
                                                 required for the Institute. PIMS will be
                                                 expanding its computerization in order to
                                                 improve its decisions making process.



                                             - 11 –
14. Description of the Project.

Background and Rationale:

(a) Give brief history, proposed facilities
and justification of the project. Indicate the
basis for selecting the area of research and
justify the priority that should be given to
the area. Indicate the benefit of research to
the sector and the economy.

i) Brief History.                                PIMS was established in 1985 and since
                                                 then a serious effort to computerize the
                                                 institute has not been undertaken.
                                                 Majority of the work and record keeping is
                                                 based on registers, and paper files which
                                                 makes management, treatment and follow-
                                                 up of patients difficult for the 0.36 million
                                                 patients who visit Islamabad Hospital
                                                 yearly. The hospital is not able to cope
                                                 with the increasing workload and
                                                 information requirements in a systematic
                                                 and efficient manner.

                                                 See Annex IX for details of PIMS.

                                                 A brief history of Computerization at
                                                 PIMS is as follows:

                                                 Pathology Dept.
                                                 25 computers were donated and installed
                                                 along with networking in the Pathology
                                                 Department.

                                                 Database Server application software is in
                                                 place since 2000. The Department is now
                                                 fully computerized (paperless) since 2002.
                                                 The laboratory from its own resources has
                                                 arranged hardware and software support.

                                                 Other departments
                                                 HMIS was initiated        by   the   present



                                            - 12 –
    Executive Director.
    Standalone computers are available in
    some departments. These have been
    networked through the existing HMIS
    software.
    Networking has been provided to Out
    Patient Departments (OPDs), surgical and
    medical wards floors. Networking within
    the wards and OPDs has been arranged by
    the departments from their own resources.
    Hardware purchased by PIMS for OPD
    Registration counter.

    Children
    HMIS initiated in 1995. UNIX based
    application software, networking and
    computers provided under project.
    System discontinued from           2000 as
    application software was not upgraded
    over time due to lack of qualified staff. No
    HMIS system working at present.

    MCH
    HMIS was initiated in 1996. Networking
    and computers provided under JICA
    project.
    No software was provided under the
    project. HMIS was initiated but could not
    be sustained due to informal arrangements
    and lack of qualified staff. No HMIS
    system working at present.

    The main reasons for the poor track record
    are:

         -   lack of an integrated software
         -   lack of proper HMIS Department
         -   lack     of   resources    especially
             equipment
         -   lack of trained staff
         -   informal arrangements
         -   lack of information technology
             awareness



- 13 –
                                         -    apprehensions      about    changing
                                              system

(ii) Proposed facilities:       It is proposed to expand the current HMIS
                                implementation to the whole of the IH i.e.

                                         i)      Patient Registration
                                         ii)     Doctor consultation
                                         iii)    Admissions and discharges
                                         iv)     Patient appointments
                                         v)      Operations
                                         vi)     Doctors roster
                                         vii)    Pathology
                                         viii)   Radiology
                                         ix)     Stores
                                         x)      Pharmacy
                                         xi)     Blood Bank
                                         xii)    Patient billing
                                         xiii)   Budget and Accounts
                                         xiv)    Procurement
                                         xv)     Personnel

                                This would require:
                                  - purchase of Licensed Software (See
                                     Annexure IV & XII)

                                     -       installation of Networking           (See
                                             Annexure IV & VII)

                                     -       purchase   of     Hardware           (See
                                             Annexure IV & XI)

                                     -       establishment of HMIS Department
                                             at IH (See Annexure VI and VIII)

                                     -       training of staff (See Annex XIII)

(iii) Justification             This project will greatly enhance medical
                                treatment and improve management of
                                patients at IH. It will improve record
                                keeping, training of manpower and
                                management in the following.




                            - 14 –
                                          Medical and surgical follow-up and
                                           medication checks;
                                          Routine consultations and second
                                           opinions based on history, physical
                                           exam findings, available test data;
                                          Transmission of diagnostic images;
                                          Extended diagnostic work-ups or short-
                                           term management of self-limited
                                           conditions;

 (iv) Basis for selecting the area       Computerization,     networking       will
                                         revolutionize patient management and
                                         research at IH. IH has been selected, as it
                                         is at a fairly advanced stage of
                                         computerization as compared to CH and
                                         MCH.

 (v) Priority                            Large volume of patients, operations,
                                         dialysis,    transplants and    research
                                         conducted at IH deemed it essential to
                                         computerize the whole system.       The
                                         priorities are:
                                         - Hardware
                                         - Networking and connectivity
                                         - Application Software Up gradation
                                         - Training
                                         - Implementation
                                         - Maintenance & modification
Maintenance & modification

 (vi) Benefit                            Computerization will be of immense
                                         benefit to IH Hospital PIMS. The Hospital
                                         HMIS will assist the staff of IH Hospital,
                                         PIMS in managing and monitoring the
                                         complete activities of hospital. At present
                                         it is difficult to efficiently handle the data
                                         and information workload manually.
                                         Computerization will allow the hospital
                                         management to analyze the problems
                                         quickly and take corrective action in time.

                                         In PIMS the current computerization has
                                         changed the nature of the work of the


                                     - 15 –
    officers. They are now spending more time
    in analyzing information than on
    collecting and processing it.       With the
    implementation of this scheme the
    patients, institution in general, doctors and
    students in particular will be benefited in
    the following manner.

    Management
    - Employment opportunities will be
      created directly and indirectly; persons
      trained can be accommodated in the
      medical field.
    - IH would be able to give more attention
      to patients due to time saved in
      retrieving reports and results.
    - Better image of the Institute.
    - Reduced human errors.
    - Interaction between doctors and
      patients will improve.
    - Less support & maintainability.
    - Reduces professional isolation, provides
      collaborative consultation avenues,
      clinical education.
    - Access patient’s information from any
      workstation.
    - Reduce wastage of time spent on most
      of the inquiries.

    Budget
    - Reduced paper work.
    - Reduce costs.
    - Per Patient cost will be easily calculated
      including cost of medicine, Lab Test,
      Radiology and others.
    - Based on the collected historical data
      forecasting can be used to prepare a
      well manageable budget.
    - Duplicate lab/radiology test will be
      avoided.

    Patient
    - Quality    of   patient’s   care   will   be



- 16 –
                                                 improved due to close monitoring.
                                               - Research facilities will be improved and
                                                 the student doing the research will be
                                                 able to access the required information.
                                               - Quality health care will be made easily
                                                 accessible to underserved areas.
                                                 Increasing      speed     of    diagnosis,
                                                 treatment, and allowing access to
                                                 specialty care.
                                               - Quality of care will increase by
                                                 consultation decision being made
                                                 through collaborative technologies and
                                                 may increase patient involvement.

                                               Data
                                               - Cost of management and the burden of
                                                 patient’s information on the institution
                                                 will be reduced.
                                               - Centralized Data.
                                               - More integrity of information
                                               - Build up historical data that aids with
                                                 various decisions.
                                               - Store & retrieve Ultrasound, X-rays,
                                                 MRI, CT-Scan images, its helpful in
                                                 research and rapid diagnostics.
                                               - Accuracy/reliability of data will be
                                                 increase.
                                               - Generate different reports in less time.
                                               - Increase output & efficiency.
                                               - Easily access of Patient’s history.

       Before Computerization                            After Computerization
Difficult to trace previous Lab                Only few keystrokes will provide the
Investigation.                                 required information.
Lab Technicians are always busy making         No registers required. No duplication of
entries in multiple registers.                 data.
Human error is always a possibility when       Results are directly transferred from the
a report is being copied from machines         machine to the database.
manually.
Number of test by a person is limited due      Technicians / Doctors access the Lab
to time spent in filling registers and paper   information from the workstation.
work
Comparisons between different results are      Done by the computer in shortest possible


                                           - 17 –
very difficult and time consuming.             time.

(b) Indicate relationship with other           As indicated in the objectives, the
programs in the same sector studies and in     increasing     clinical    workload     and
other sectors.                                 excellence at IH brings with itself a
                                               responsibility to benefit the others beyond
                                               confines of the IH building. We believe in
                                               improvement of patient care within IH
                                               and at places outside it. Experience of IH
                                               will be shared with other hospitals and the
                                               system will be replicated throughout
                                               Pakistan.

                                               At present there is no public sector
                                               hospital, which is computerized. This is a
                                               pioneering effort, which will be an
                                               example for other hospitals to follow.

(c) The employment prospects of the            It is projected that 12 new permanent
persons to be trained in terms                 vacancies will be created and up to 1183
                                               staff at IH will be trained. In addition
                                               employment will be provided for 6
                                               computer trainers for a period of 13
                                               months each. 9 temporary vacancies are
                                               created for the period of 24 months which
                                               will be responsible for the successful
                                               running of the project.

d) Give details of the type training or        The focus of the training would be on
education, to be imparted. The syllabus        HMIS. Course on basics of computers and
and subjects in emphasis will be placed.       internet will also be provided to the staff.
Indicate availability of teaching staff.       Other specialized hospital management
                                               training would also be conducted once the
                                               system is fully functional. These would
                                               include:
                                                  - Complete hospital management
                                                  - Pathology management
                                                  - Radiology management
                                                  - Personnel management
                                                  - Inventory management
                                                  - Budget and Accounts management
                                                  - Development of policies based on
                                                     hospital data



                                           - 18 –
                                                     -      Referral system
                                                     -      Disease early warning system

e) Administrative arrangements for              Project office will be located at EGD/IH
conducting the project. Give availability       A full time Project Director will be hired
of manpower in dissemination of                 who will manage all the project
information/ data.                              implementation activities under the
                                                supervision of EGD and will have the
                                                overall responsibility for the project. A
                                                close contact will be established between
                                                EGD & IH in execution of the project. All
                                                the project staff will be recruited from the
                                                open market through advertisements.

                                                The details of project staff are at Annexure
                                                VI & VIII.

15. Sequence of Activities                      The sequence of activities for execution of
                                                the originally approved PC-1 and the now
                                                submitted revised PC-1 is as under:

                                                     (i)       Preparation       Completed in
                                                               and               May 2005
                                                               publication of
                                                               tender &
                                                               RFQs for
                                                               procurement
                                                               of Servers,
                                                               Hardware,
                                                               Licensed
                                                               Software and
                                                               Networking
                                                     (ii)      Response          Completed in
                                                               from bidders      June 2005
                                                     (iii)     Evaluation &      Completed in
                                                               award of          June 2005
                                                               contract
                                                     (iv)      Preparation       Completed in
                                                               and               March 2005
                                                               Publication of
                                                               advertisemen
                                                               t for hiring of
                                                               Project



                                            - 19 –
                  Director
          (v)     Shortlisting    Completed in
                  and             June 2005
                  Interviews of
                  Selected
                  Candidate
         (vi)     Deployment      Project will join
                  of Project      in August 2005
                  Director in
                  PIMS
         (vii)    Supply of     Within 6 weeks
                  Equipment of  of signing the
                  LAN           contract
         (viii)   Deployment    Within 8 weeks
                  of LAN        after supply of
                                equipment of
                                LAN
         (ix)     Successful    Within 4 weeks
                  Testing of    of deployment
                  LAN           of LAN
          (x)     Supply of     Within 6 weeks
                  Hardware      of signing the
                                contract
         (xi)     Installation  Within 3 weeks
                  and           after supply of
                  Configuration Hardware
                  of Hardware
         (xii)    Successful    Within 4 weeks
                  testing of    of installation
                  Hardware      and
                                configuration of
                                hardware
         (xiii)   Supply of     Within 6 weeks
                  Licensed      of signing the
                  Software      contract
         (xiv)    Installation  Within 3 weeks
                  and           after supply of
                  Configuration Licensed
                  of licensed   Software
                  software
         (xv)     Successful    Within 4 weeks
                  testing of    of installation
                  Licensed      and


- 20 –
                                                  Software        configuration of
                                                                  Licensed
                                                                  Software
                                              Preparation
                                          (xvi)                   To be completed
                                              and                 in July 2005
                                              Publication of
                                              advertisemen
                                              t for hiring of
                                              remaining
                                              Project Staff
                                      (xvii) Shortlisting         Within one and
                                              and                 half month
                                              Interviews of       after publication
                                              Selected            of
                                              Candidate           advertisement
                                      (xviii) Deployment          to be Completed
                                              of Project          in October 2005
                                              Staff in PIMS
                                       (xix) Training of          Within 13
                                              1183 staff on       months after
                                              HMIS                hiring of
                                              Applications        trainers.
                                       (xx) Preparation           Preparation of
                                              of Software         software
                                              Maintenance         maintenance
                                              Contract            contract for
                                                                  CRM will be
                                                                  completed in
                                                                  July 2005
                                          (xxi)   Signing of      Signing of
                                                  Contract with   contract with
                                                  CRM             CRM will be
                                                                  completed in
                                                                  August 2005.
16. Implementation Methodology
                                    The project will be divided into the
                                    following components:

                                           a. Networking
                                           b. Servers and Hardware
                                           c. Installation and Configuration of
                                              Licensed Software
                                           d. Training of PIMS staff on HMIS


                                 - 21 –
            software applications.
         e. Procurement of Furniture
         f. Hiring of Project Staff

        a. Procurement of Servers, Hardware,
        Licensed Software and Deployment
        of LAN
        RFP will be prepared on turnkey basis
    for the procurement of servers, hardware,
    licensed software and deployment of LAN
    with 339 nodes. A front end bidder will be
    selected for managing the subject project
    from end to end.

         b. Training of PIMS Staff on HMIS
             Applications
            8 trainers will be hired during the
    life of the project. These training resources
    will be responsible for providing on job
    training for a period of 13 months to 1183
    existing staff of PIMS which include
    Doctors, Paramedical, support and
    administrative staff on the HMIS software
    applications gifted by CRM.

        c. Procurement of Furniture
          A vendor will be selected through a
    separate tender who will be responsible
    for supplying 17 computer tables and 17
    chairs.

         d. Hiring of Project Staff

         The project director will be hired in
    the project in the first phase. The project
    director will be responsible for hiring the
    remaining project staff against the
    following posts:

     S.No. Posts                      Number
     1     Assistant Manger              1
           MIS/System
           Administrator



- 22 –
                                              2       Assistant Network           4
                                                      /System
                                                      Administrator
                                                      (Shift)
                                              3       Trainers for                2
                                                      Computer Center
                                              4       Trainers                    6
                                              5       Computer                    1
                                                      Operator

                                             The work to be performed by these
                                             specialists    during    and      after   the
                                             development phase of the project will be
                                             as follows:
                                               The      project    director     will   be
                                                  responsible for both technical and
                                                  administrative activities of the project.
                                               Assistant Manger MIS / System
                                                  Administrator will assist the project
                                                  director in managing technical and
                                                  administrative matters of the project.
                                               4 Assistant Network Administrator
                                                  has been hired for managing the 339
                                                  nodes network at Pakistan Institute of
                                                  Medical Sciences (PIMS).
                                               8 trainers will be hired who will be
                                                  responsible    for providing on job
                                                  training for a period of 13 months to
                                                  1183 existing staff of PIMS which
                                                  include Doctors, Paramedical, support
                                                  and administrative staff on the HMIS
                                                  software applications gifted by CRM.
                                               The Computer Operator will be
                                                  responsible for data entry in the
                                                  HMIS application.

17. Arrangement for monitoring and           Ministry of IT (MoIT) will monitor the
evaluation of the Project during             implementation of the project.
implementation.

18. Give date when capital expenditure       July 2005
estimates were prepared:



                                         - 23 –
If prepared more than one year ago,
confirm if they are still valid.

19. Give summary of capital cost covering See Summary Annexure II
the whole of the investment period

20. Building/Civil works                        NA

21. Basic Of Cost Estimates                     Prevailing market rates in July 2005.


22. Financial Plan

1). Give complete sources of financing of       Rs. 39.000 Million (Annexure II) including
the project. Clarify sources of financing       annual recurring expenditure of Rs. 3.969
such as federal/provinces, foreign /local       Million (Annexure-VIII).     The annual
grant/loan.                                     recurring costs will be met by IH after
                                                completion of project.
                                                See Annexure VIII

ii).  Provide     details   of    recurrent
expenditure on the basis of fixed and
variable costs also specify the items such
as    establishment     charges,    interest
payments, depreciation and non-salary
items, maintenance charges etc. Indicate
the    operational     arrangements       of
implementation of the agency responsible
for meeting the recurrent cost.

iii). Give detailed profit and loss Not applicable
statements both on cumulative and
incremental basis over the life of project,
please indicate the source of subsidy, of
any,

iv) Give detailed statements of financial Not applicable
and economic analysis as a result of
changes in basic assumption relating to
cost, benefit, completion time and rate of
interest.

23. Social sector benefits.                     The project is to aid the institution in order
Give quantification of specific social sector


                                            - 24 –
facilities which will become available to       to provide efficient & modern system of
the people in the project locations:            medical services to the public. Health is a
                                                major area of focus in social sectors.
24. Annual phasing of physical work             See Annexure-XV
    financial requirements for the project:

25. Estimates of annual recurring          Rs. 3.969 million (to be met out by IH
Expenditure after completion of each itself).
phase of project (also indicate the source
of financing recurring expenditure)        See Annexure-VIII.

26. Authority responsible to meet the IH by it own resources.
recurring expenditure after completion of
the project

27. Financing of capital expenditure            NA
Government Loan:
Private subscription:

28. Provision for future expansion of
facilities.

Please indicate whether provision for           It is planned to replicate the system in CH
future expansion of infrastructure such as      and MCH and in other hospitals of
telephone exchange building has been            Pakistan.      A separate PC-1 will be
made or not?                                    prepared for the expansion to MCH and
                                                CH.




                                            - 25 –
                                           PART C

                           PROJECT REQUIREMENT

29. (a) Manpower requirement

Professional and Technical                       The staffing requirements are provided at
Administrative, executive and Managerial         Annexure VI and VIII.
Clerical and paramedical

b) Manpower required by sex                      See Annexure VI and VIII. Women will be
                                                 encouraged to apply.

c) Detailed list of skills required for          The qualified persons will be engaged
implementation of the Project                    from the market.

d) Efforts made in the project for skill         The project will train staff in design and
development                                      implementation of Hospital systems.

e) Likely shortage of manpower by                No shortage.
occupation

f) Steps to be taken to assure availability of   Some of the Staff is already available in IH
manpower                                         and more will be engaged after approval
                                                 from the field.

g) Approximate number of persons                 Approximately 1183 staff of IH will be
required to be trained per year (locally         trained in HMIS software.
and board) and the kind of skills to be
learnt

h) Give total capital outlay; give the           Not applicable
capital cost of mobilizing one worker for
one shift.

30. Physical and other facilities required       Physical facilities already exists
for project.




                                             - 26 –
31. Physical and other facilities              Already available
requirement for Project.

i) Total covered area of the building (basis   Not applicable
for determining the requirement) along
with line-plans
ii) If house provided, their number and        Not applicable
categories along with covered area and
line-plans
iii) Size of the plot, on which a building/    Not applicable
houses are to be constructed viz. the
percentage of open and constructed area
iv) Give description of already completed      Not applicable
or under construction building/houses viz.
the new proposed construction
v) Existing water supply and sewerage          Not applicable
arrangement in the area as well as for the
present project
vi) Unit cost supported by item-wise           Not applicable
detailed estimates of the building/houses,
separately for civil works; water supply
and sewerage; other utilities including
HVAC, (if present); external development
etc
vii) Percentage of contingencies,              Based on base-cost
departmental charges and escalation based
on base-cost

32. Materials supplies and equipment
requirement

A-I. Minimum total requirements for            Rs. 39.000 million (Annex- II).
execution


                                        PART D

1 ENVIRONMENTAL IMPACT
                                               Not Applicable
ASSESSMENT:




                                          - 27 –
                                                                                                  Annexure-I

1. Comparative cost estimate of the last sanctioned and revised schemes :                             (Million Rs)

Items                                           Last Sanctioned cost                     * Revised Cost
                                                      Foreign                             Foreign
                                             Local    Exchange      Total       Local     Exchange        Total
a) Local Area Networking                      3.412       Nil         3.412      6.898       Nil           6.898
b) Software/Applications                      4.371       Nil         4.371      2.097       Nil           2.097
c) Services/Training                          1.520       Nil         1.520      0.000       Nil           0.000
d) Hardware                                  17.398       Nil        17.398     19.328       Nil          19.328
e) Furniture & Fixture                        0.170                   0.170      0.170       Nil           0.170
f) Operating Expenditure                      3.914       Nil         3.914      3.807       Nil           3.807
g) Project Staff Salaries                     5.568       Nil         5.568      6.193       Nil           6.193
h) Miscellaneous & Contingencies              1.454       Nil         1.454      0.507       Nil           0.507
                                    Total:   37.807                  37.807     39.000                    39.000

Give reasons for revision in cost
estimates :

Items                                                 Reasons for the revision
                                                      A network survey of PIMS was carried out by EGD and as a
                                                      result the BOQ has been revised which was included in the
                                                      RFP floated with the tender. After competitive government
                                                      tendering process, the quotes received from the vendor are
a) Local Area Networking (LAN)                        higher than in the approved PC-1.
                                                      After competitive government tendering process, the quotes
                                                      received from the vendor are lower than in the approved
                                                      PC-1. The vendor has quoted for prices for licensed software
b) Software/Applications                              with discounted rates for educational institute.
                                                      After competitive government tendering process, the quotes
                                                      received from the vendor are higher than in the approved
c) Hardware                                           PC-1.
                                                      The training cost has been removed from the
                                                      Services/Training. 6 posts of trainers have been created in
                                                      the revised PC-I and the cost mentioned in Original PC-I
                                                      under the head of “Cost on Job Training” has been re-
d) Services/Training                                  allocated to the Project Staff Salaries head.
e) Furniture & Fixture                                Tables and chairs for PIMS
f) Operating Expenditure                              Cost for installation of DSL is included in the revised PC-I.
                                                      6 posts have been created in the revised PC-I for providing
g) Project Staff Salaries                             training to PIMS staff for the period of 13 months.
                                                      Provision for miscellaneous & contingencies has been
                                                      reduced in order to adjust the higher quotes received for
h) Miscellaneous & Contingencies                      other components.



                                                 - 28 –
2. Total expenditure occurred so far (See Annex III)
Items                                                                  Expenditure

                                                                               Foreign
                                                               Local           Exchange      Total
a) Local Area Networking (LAN)                                      Nil            Nil         Nil
b) Software/Applications                                            Nil            Nil         Nil
c) Hardware                                                         Nil            Nil         Nil
d) Services/Training                                                Nil            Nil         Nil
e) Operating Expenditure                                            Nil            Nil         Nil
f) Project Staff Salaries                                           Nil            Nil         Nil
g) Miscellaneous & Contingencies                                    Nil            Nil         Nil
                             Total                                   0.000           Nil      0.000
3. Progress of Work                            (a)             (b)             (c)
                                               As per
                                               schedule last   Actual          Reasons for
                                               sanctioned      achievements    delay
                                                               Competitive
                                                               Tendering
                                                               completed in
Local Area Network (LAN)                       Yes             June 2005       None
                                                               Competitive
                                                               Tendering
                                                               completed in
Software / Applications                        Yes             June 2005       None
                                                               Competitive
                                                               Tendering
                                                               completed in
Hardware                                       Yes             June 2005       None
                                                               Project
                                                               Director
                                                               hired for
Project Staff Salaries                         Yes             PIMS            None




                                                - 29 –
                                                                    Annexure-II
Summary of Capital Expenditure
 S.                                             Approve   Revised     Variation
No. Description                                  d Cost    Cost        in Cost



 1   Cost of Local Area Network (LAN)            3.412     6.898        3.486

 2   Cost of Software/Applications               4.371     2.097        -2.274

 3   Cost of Hardware                            17.398   19.328        1.930

 5   Furniture & Fixture                         0.170     0.170        0.000

 6   Operating Expenditure                       3.914     3.807        -0.107

 7   Project Staff Salaries                      5.568     6.193        0.625

 8   Cost on Job Training                        1.520     0.000        -1.520

 8   Miscellaneous & Contingencies               1.454     0.507        -0.947
     (Revised is 5% of capital cost)


     TOTAL CAPITAL EXPENDITURE (Rs.)             37.807   39.000        1.193




                                       - 30 –
                                                                     Annexure-III

Actual Expenditure Incurred Till June 2005
                                                                       Actual
S.No.                 Item                   Provision as per PC-1   Utilization

                                                 Rs. (Million )      Rs. (Million )
  1     Local Area Networking                         3.412               Nil
  2     Software/Applications                         4.371               Nil
  3     Services/Training                             1.520               Nil
  4     Hardware                                     17.398               Nil
  4     Furniture & Fixture                           0.170               Nil
  6     Operating Expenditure                         3.914               Nil
  7     Project Staff Salaries                        5.568               Nil
  8     Miscellaneous & Contingencies                 1.454               Nil
        Total                                        37.807              0.000




                                        - 31 –
                                                                                                                                                  Annexure-IV
Cost of Products/Services to be provided to the Pakistan Institute of Medical Sciences

                                                                  Approved                            Actual                          Revised Estimate
S.                                                               Unit       Total Cost           Unit Cost      Total Cost            Unit Cost     Total Cost
N.   Description                                        Qty    Cost (Rs)    (Rs.)          Qty     (Rs)         (Rs.)           Qty   (Rs)                (Rs.)
     Local Area Network
 1   Cost of networking (Nodes)                         300                   3,412,200    339                      6,898,104                        6,898,104
     (detailed BOQ attached on Annexure-VII)
                                           Sub-Total                          3,412,200                                                              6,898,104


     Software / Applications
 1   Server Operating System                             3        42,525        127,575     2         17,816           35,632                             35,632
 2   Server Operating System for Itanium Server                                             1              0                0
 3   Client Access License (CALs) for Server            213        1,691        360,183    213           268           57,084                             57,084
 4   Media for Server                                    1         2,310          2,310     1          1,737            1,737                              1,737
 5   Reporting Tool                                      2        29,610         59,220     2         29,444           58,888                             58,888
 6   Software Development Tool                           2        34,671         69,342     2          7,263           14,526                             14,526
 7   Database Server                                     3        42,000        126,000     3         13,947           41,841                             41,841
     Client Access License (CALs) for Database
 8   Server                                             213        8,663      1,845,219    213         1,495          318,435                            318,435
 9   Media for Database Server                           1         2,310           2,310    1          1,737            1,737                              1,737
10   Office Productivity Suite                           50       27,000      1,350,000     50         2,826          141,300                          141,300
     Office Productivity Suite Media Kit                                                     1         1,737            1,737                            1,737
11   Anti Virus plus media kit                          213        2,000        428,500    213                      1,423,818                        1,423,818
                                           Sub-Total                          4,370,659                             2,096,735                        2,096,735


     Hardware (specs. at Annexure-VIII)
 1   Server Itanium                                      1      2,100,000     2,100,000     1    1,548,909.42    1,548,909.42                      1,548,909.42



                                                                              - 32 –
2    Server Xeon                                      2          567,500    1,135,000    2      399,257.25     798,514.50                    798,514.50
3    Storage Area Network (SAN)                       1        2,500,000    2,500,000    1    1,401,518.12   1,401,518.12                  1,401,518.12
4    Tape Backup                                      1          400,000      400,000    1      974,083.34     974,083.34                    974,083.34
5    Rack for Server                                  1          350,000      350,000    1      342,368.54     342,368.54                    342,368.54
6    Workstation                                     164          40,000    6,560,000                                                      8,791,311.80
     Workstation with 17" Monitor                                                       154     52,446.95    8,076,830.30
     Workstation with 21" Monitor                                                        10     71,448.15      714,481.50
 7   Laptop                                            3        100,000       300,000     3    105,000.00      315,000.00                    315,000.00
 8   Laser Jet Heavy Duty                              5        130,550       652,750     5    106,111.11      530,555.55                    530,555.55
 9   Dot Matrix 132 Column                             5         19,700        98,500     1     45,000.00       45,000.00                     45,000.00
10   Dot Matrix 80 Column                             40         10,500       420,000    40     11,333.33      453,333.20                    453,333.20
11   Laser normal                                     70         19,000     1,330,000    70     20,526.32    1,436,842.40                  1,436,842.40
12   UPS 500 VA                                      142          6,000       852,000   120      9,333.33    1,119,999.60                  1,119,999.60
     Heavy Duty Multimedia for Computer Training
13   Center                                           2         350,000      700,000     2     257,472.22     514,944.44                    514,944.44
14   UPS 5 KVA                                                                                                               2   170,000    340,000.00
15   RAM for Xeon Server                                                                                                    16    20,000    320,000.00
16   RAM for Itanium Server                                                                                                 12    33,000    396,000.00
                                         Sub-Total                         17,398,250                         18,272,381                    19,328,381


     Furniture & Fixture (specs at Annexure-VIII)
1    Furniture etc. for New MIS Staff (per Staff)    17         10,000       170,000                                        17    10,000       170,000
                                         Sub-Total                           170,000                                                           170,000
                                                           Total Cost of
                                                             Products /
                                                               Services    25,351,109                                                       28,493,220




                                                                           - 33 –
                                                                                                        Annexure-V
Operating Expenditure During Life of Project

                                                 Approved                                    Revised
                                                     Unit         Total                       Unit         Total
S.N. Description                Qty     Months       Cost      Expenditure    Qty   Months    Cost      Expenditure
     Ribbon Dot Matrix 2 per
     month per printer (45
 1   printers)                  90        24         150            324,000    90     24       150           324,000
                                                                              225
                                225                                           per
      Toner Laser 1 per four    per                                           yea
 2    month (75 printers)       year      24        3,000         1,350,000     r     24      3,000         1,350,000
      Installation of DSL
      Connection (for
      Hospital's Library) 256
 3    K (one time charges)                                                     1              15,000          15,000
      Monthly DSL
 4    Connection Charges         1        24        25,000          600,000    1      24      22,000         528,000
                                                   180,000                                   180,000
      Software Support Cost                          (per                                      (per
      paid to CRM on                               quarter                                   quarte
 5    quarterly basis                     24         cost)        1,440,000           24      r cost)       1,440,000
 6    Advertisements                                                200,000                                   150,000
      TOTAL (Rs.)                                                 3,914,000                                 3,807,000




                                                      - 34 –
                                                                                                    Annexure-VI
Project Staff Salaries

                                            Approved                                      Revised
                          No. Monthly         Months        Total          No. Monthly    Months    Total
                              Salary          for which     Expenditure        Salary     for which Expenditure
S.N. Description
                              Package per     provision                        Package    provision
                              Employee        is being                         per        is being
                                              made                             Employee   made
 1    Project Director     1      75,000          24           1,800,000   1     75,000      22         1,650,000
 2    Assistant Manager    1      30,000          24             720,000   1     30,000      19           570,000
      MIS/System
      Administrator
 3    Assistant            4      20,000          24           1,920,000   4     20,000      19         1,520,000
      Network/System
      Administrator
      (Shift)
 4    Trainers for         2      20,000          24             960,000   2     20,000      19          760,000
      Computer Center
 5    Trainers                                                             6     20,000      13         1,560,000
 6    Computer Operator    1      7,000           24             168,000   1      7,000      19           133,000
      TOTAL (Rs.)                                              5,568,000                                6,193,000




                                                   - 35 –
                                                                         Annexure VII
Network BOQ for PIMS
  No.              Description                    Qty      Unit Cost       Total Cost

          Passive Fiber Component
   1    6 Core Indoor Armored Fiber Optic
        cable,filled loose tube construction
                                                  7,500         95.85       718,875.00
        with rodent protection. Multimode
        mode 50/125 micron (Qty in ft)
   2    Rack mounted Fiber Optic
        OFDF/LIU/Patch Panel including
                                                   2          8,923.52       17,847.04
        couplers (SC-SC) for the termination of
        24mm fibers
   3    Rack mounted Fiber Optic
        OFDF/LIU/Patch Panel including
                                                   13         8,923.52      116,005.76
        couplers (SC-SC) for the termination of
        6mm fibers
   4    Fiber Optic Pigtail duplex SC-SC
                                                   52         1,464.67       76,162.84
        connector (1.5 Meter)
        Fiber Optic Pigtail duplex SC-SC
   5                                               50          666.67        33,333.50
        connector (1.5 Meter)
                                      Sub Total                             962,224.14


                 Active Components
   6    Core Switch                                 1     1,675,086.40     1,675,086.40
   7    Edge Switch                                21        83,288.00     1,749,048.00
                                    Sub Total                              3,424,134.40

               Passive UTP Component
        4 Pair Grey UTP Cat 6 Cable 1000 ft
                                                   78         4,666.67      364,000.26
   8    Box
   9    Patch Cord 3ft UTP Cat 6                  339          250.00        84,750.00
  10    Patch Cord 9ft UTP Cat 6                  339          472.22       160,082.58
  11    Cat 6 24 Port Patch Panel                  21       12,222.22       256,666.62
  12    Cat 6 Information Outlet (RJ-45)          339
  13      Dual Shutter Face Plate                 339          611.11       207,166.29
  14      Back boxes for face plates              339


                                      - 36 –
    15     42U Local Cabinet                           3        31,176.47      93,529.41
    16     12U Wall Mount Local Cabinet               11         7,647.06      84,117.66
                                     Sub Total                              1,250,312.82


           Network Services and Misc. Items
           Fiber Cable pulling/laying charges
                                                     7,500           3.33       24,975.00
           (PRF Cable)
           Fiber Termination Charges (Fusing)         104         350.00        36,400.00
           16 mm x 38 mm                             7,000         13.33        93,310.00
           40 mm x 40 mm                             5,000         32.22       161,100.00
           60 mm x 60 mm                             1,500         55.56        83,340.00
           100 mm x 100 mm                            150          86.67        13,000.50
           PVC Pipe
                                                     2,200           5.56       12,232.00

           UTP Cable and Duct Laying Charges
                                                    78,000           3.33      259,740.00
           Information Outlet and Patch Panel
           termination charges, Testing &             678         777.78       527,334.84
           Commissioning
           Overall Systems Integration Charges
                                                       1        50,000.00       50,000.00
           (Active & Passive Components)

                                        Sub Total                           1,261,432.34

                                      Grand Total                           6,898,104.00


Note: Quantities of all the above mentioned items are subject to change after the
finalization of revised BOQ, after the award of contract to selected vendor.


* Payment will be made at actual.




                                          - 37 –
                                                                                Annexure-VII A

 Item                Specifications                         Should support following standards
CORE      Layer 3 Managed & Modular Switch,                Layer 2 features support: VLAN, Link
SWITCH Should support at least 3 modules                    Aggregation Protocol (LACP), Unidirectional
                                                            link detection (UDLD) and aggressive
          No. of 1000 Base SX SFPs or GBIC                  UDLD, Jumbo frames, 802.1q, Q-in-Q pass
            modules: 12                                     through, Spanning tree root guard, dynamic
                                                            trunking protocol, IEEE 802.1s, 802.1w,
          No. of 1000 base TX Ports: 6                      802.3ad, Per-VLAN Spanning Tree, and Per-
                                                            VLAN Rapid Spanning Tree Protocol
          Switching Fabric: Not less than 60                Layer 3 features support: Static IP routing,
            Gbps                                            Routing Information Protocol (RIP) and
                                                            RIP2, IGMP versions 1, 2, 3, IGMP filtering
          Forwarding Rate: Not less than 45                 on access and trunk ports, IP multicast
            Mpps                                            routing protocols (Protocol Independent
                                                            Multicast, Source Specific Multicast, Distance
                                                            Vector Multicast Routing Protocol), Virtual
                                                            Route Forwarding, IPv6
                                                           Support for QoS features: IP differentiated
                                                            service code point (DSCP) and IP Precedence,
                                                            Classification and marking based on IP type
                                                            of service (ToS) or DSCP, Auto-QoS for
                                                            voice-over-IP (VoIP) deployment
                                                           Network Security: Standard and extended
                                                            ACLs on all ports, 802.1x user authentication
                                                            (with VLAN assignment and Guest VLAN
                                                            extensions), Router ACLs, VLAN ACLs, Port
                                                            ACLs, Private VLANs, Dynamic Host



                                               - 38 –
                                                          Configuration Protocol (DHCP) snooping,
                                                          Port Security, Secure Shell (SSH) Protocol
                                                          versions 1 and 2, Unicast MAC filtering,
                                                          Unicast port flood blocking, Dynamic
                                                          Address Resolution Protocol (ARP)
                                                          inspection, IP source guard
                                                         Management; Web, CLI, SNMP v1/v2/v3;
                                                          SSH
                                                         Support for Ethernet, Gigabit Ethernet and
                                                          10Gigabit Ethernet interfaces
                                                         Should support 10/100/1000 BaseTx
                                                          interface
                                                         Power over Ethernet (PoE) support
                                                         Should Support Hot pluggable Gigabit
                                                          Interfaces SX, LX, ZX, SFP Support
EDGE     Layer 2 Managed Switch, 24 ports                IEEE 802.1x support
SWITCH 10/100 Mbps with at least 2 x 1000                IEEE 802.1w
         Base SX Ports                                   IEEE 802.1s
                                                         IEEE 802.3x full duplex on 10BASE-T,
         Switching Fabric: Not less than 8 Gbps           100BASE-TX, and 1000BASE-T ports
         Forwarding Rate: Not less than 6                IEEE 802.1D Spanning-Tree Protocol
         Mpps                                            IEEE 802.1p class-of-service (CoS)
         MTBF: Not less than 500,000 hrs                  prioritization
                                                         IEEE 802.1Q VLAN
                                                         IEEE 802.3 10BASE-T specification
                                                         IEEE 802.3u 100BASE-TX specification
                                                         IEEE 802.3ab 1000BASE-T specification
                                                         IEEE 802.3ad
                                                         IEEE 802.3z 1000BASE-X specification


                                             - 39 –
UTP Standards                        Conforming to EIA/TIA (Electronics
                                      Industry Architecture / Telecommunication
                                      Industry Architecture ) 568 A/B Standards
                                     UL (Underwriter's Laboratory) Listed
                                     ETL (Electrical Testing Laboratory) Listed
                                      and Verified
                                     CMR (Communication Riser Rated) Rated
                                     Cat 6 UTP Cable with Cross Filler
                                     Cat 6 UTP Cable with 23 AWG (American
                                      Wire Gauge)



FIBER OPTIC Satandards               Conforming to EIA/TIA 568 B.3 Standard
                                     UL Listed
                                     ETL Listed and Verified
                                     RFP has been updated accordingly




                         - 40 –
                                                         Annexure-VIII
ANNUAL RECURRING EXPENDITURE (After Completion of the Project)

                                                            Approved               Revised
                                                                  Annual                 Annual
S.N. Description
                                                           Operating Cost         Operating Cost
                                                                     (Rs.)                  (Rs.)
 1    Staff Salaries                                            1,452,000              1,452,000
 2    Annual Software Maintenance                                 720,000
      Ribbon dot Matrix 2 per month per
 3    printer                                                       162,000                162,000
      Toner Laser 1 per four month (75
 4    printers)                                                     675,000                675,000
 5    Monthly DSL Connection Charges                                300,000                264,000
 6    Repair & Maintenance (5%)                                   1,267,555
 6    Hardware Maintenance Cost (5%)                                                       966,419
 7    LAN Maintenance Cost (5%)                                                            344,905
      Licensed Software Maintenance Cost
 8    (5%)                                                                                 104,837
      TOTAL (Rs.)                                                 4,576,555              3,969,161

  The Islamabad Hospital provides 24 hours service for 365 days a year. This requires
  that atleast one HMIS staff be available on every shift for user support. They will
  also look after the hardware and networking issues and provide the necessary
  support.

  An important section is the User support and Training section. Its main job would
  be to provide training to the staff in the computer training center, provide on the job
  training, assist the users in trouble shooting and ensure that quality of data is
  maintained.

  The salary package for the computer staff must be competitive and in line with
  market prices. An important function of the HMIS Department would be to support
  the hospital management in analyzing the data and reports generated by the
  software.

  Note: No additional data entry staff is required, as the same persons who are performing the task
  manually will now perform the job on a computer.




                                              - 41 –
Detail of Staff Salaries After Completion of the Project

                  Description                 Monthly      No.   BPS   12 months
                                               Salary                     (Rs.)
                                             Package per
S.N                                           Employee
       SALARY
  1    Manager MIS                               20,000     1    19       240,000
  2    Assistant Manager MIS / System            15,000     1    18
       Administrator                                                      180,000
  3    User Support Morning duty                 10,000     1    17       120,000
  4    Assistant Network / System                10,000     4    17
       Administrator (Shift)                                              480,000
  5    Trainers for Training Center              10,000     2    17       240,000
  6    Computer Operator                          6,000     2    10       144,000
  7    Naib Qasid                                 4,000     1     2        48,000
       TOTAL (Rs.)                                                      1,452,000




                                        - 42 –
                                                                         Annexure-IX

                                Brief Details of PIMS

CLINICAL SERVICES
It has Out Patient, In Patient Departments of Gen. Surgery & Allieds, Gen. Medicine &
Allieds, Paediatrics and Gynae & Obs., which are fully equipped. It has it’s own very
much improved diagnostic facilities i.e. Radiology, Pathology, Blood Bank, ECG, Stress
electrocardiography, Thallium Scan, Coronary Angiography, EMG, EEG and Nerve
conduction test, Bronchoscopy, Endoscopy and other GI procedures. PIMS has fully
equipped Accident & Emergency Centers as well as Surgical & Medical ICU, CCU, OT
and private wards at Islamabad Hospital, while NICU, PICU and Isolation wards at
Children Hospital with most modern and necessary facilities. Hospital has a yellow unit
for kidney patients and Head Injury unit in Neurosurgery and a Cardiac Crash
program. MCH provides obstetrics and Gynaecological services to the females and
expectant mothers. Moreover, they have a well established community out reach
program for maternal education and pregnant females.

MAJOR DIAGNOSTICS CENTRE

i)     Laboratories
       03 Laboratories are functioning in PIMS (01 in IH, 01 in CH and 01 in MCH
       Centre) This Department consists on Pathology, Histopathology, Microbiology,
       Clinical Pathology and Haematology Sections. Where routine tests, specialized
       tests and high specialized tests being done.

ii)    Blood Bank
       02 Blood Banks are functioning in PIMS (one in IH and one in CH) where HIV,
       HbV, HbC are screened. 12 Blood products are prepared in these Blood Banks.
       Capacity of storage is 800 points (bags) at all time to meet the Emergency at
       National level.

iii)   Radiology Department
       A well equipped and sophisticated Radiology Department is functioning in
       PIMS. 14 X-Ray machines are available. In this department routine X-Rays,
       Specialized tests, Ultrasound, Mammography and CT Scan are done.

OPERATION THEATRES

PIMS have 12 Major Operation Theatres and 08 Minor Operation Theatres in IH, CH
and MCH Centre. All Operation Theatres have very sophisticated equipment and
instruments where about 750 operations are performed during a month. In addition
about 275 emergencies are also dealt per day.



                                         - 43 –
ANGIOGRAPHY & NUCLEAR CARDIOLOGY

PIMS has a separate Angiography and Nuclear Cardiology Department, which has been
equipped with modern and latest machinery and instruments, where cardiac diseases
are being treated. The standard of treatment is of very high.

DIALYSIS UNIT

The Nephrology Department also established Dialysis Unit where dialysis of the
patients are being carried out since many year. The funds for poor patients were
provided from National Dialysis Program, but the scheme has been abandoned and
presently the Dialysis cases are supported through Zakat Funds, while post transplant
patients are also supported by Pakistan Bait-ul-Mall.

03 Technicians and 08 Nurses work round the clock for Dialysis cases and average 550-
600 cases undergo Dialysis in a month. About 12 Dialysis machines are available and 05
of them have been allocated for B & C Positive cases.




                                        - 44 –
WARDS

32 wards are available in 03 components of PIMS. The break down is as under :

                                                        Children
S. #.         Wards           Islamabad Hospital                        MCH Centre
                                                        Hospital
1.  Medicine                           06                  02                    0
2.  Surgery                            06                  01                    0
3.  Gynae/Obs.                          0                   0                   02
4.  Isolation                           0                  01                    0
5.  PICU                                0                  01                    0
6.  NICU                                0                  01                    0
7.  ICU                                01                   0                    0
8.  CCU                                01                   0                    0
9.  Cardiology                         01                   0                    0
10. MICU                               01                   0                    0
11. SICU                               01                   0                    0
12. Critical Gynae                      0                   0                   01
13. Private                            03                  01                   01
14. EAC                                01                  01                   01
TOTAL                                  21                   8                    5




                                        - 45 –
INPATIENT DEPARTMENT

Bed distribution is as below:-

             Name of Specialty                    Total number of
                                                        beds
             Gyae & Obs (MCH)                            125
             Paeds Medicine                              124
             Paeds Surgery (incl. ENT, Eye,               50
             Dental)
             NICU                                        20
             PICU                                        14
             EAC Paeds                                   10
             Isolation Ward                              12
             Gen. Medicine                               40
             Cardiology                                  31
             Dermatology                                 11
             Gestroentrology                             18
             Neurology                                   26
             Nephrology                                  36
             Oncology                                    08
             Psychiatry                                  16
             Pulmonology                                 19
             Rheumatology                                13
             General Surgery                             62
             ENT                                         24
             Neurosurgery                                40
             Ophthalmology                               18
             Orthopedics                                 40
             Urology                                     32
             Plastic Surgery                             26
             Special Wards                               40
             Private Ward G/F                            19
             Private Ward F/F                            19
             ICU                                         12
             CCU                                         14
             MICU                                        09
             EAC                                         19
             GRAND TOTAL                                947




                                         - 46 –
DAILY PATIENT LOAD

According to patients statistics the daily workload in OPD is more than 1700 patients.
Daily average admission 115. The Accident & Emergency is more than 315 and Surgical
procedures done in Operation Theatre is 51. Component wise detail is as under;


                                  OPD             Indoor        EAC         Operation
  Sr. #       Component
                                 patients        Admission   Attendance     Procedures
  1.      Islamabad Hospital      1200              60           200            30
  2.      Children Hospital        400              30           100            15
  3.      MCH Centre               130              25            20            06


CATEGORY WISE OPD PATIENTS STATEMENT FOR THE YEAR 2002 - 2003


           Entitled   General   Zakat   New          Old      Male    Female     G.Total
 Yearly
           109571     180798    8418    171737      127050   156737   142050     298787
 Total
Monthly
            9131       15067     707    14311        10588   13061    11838       24899
Average
 Daily
             365        603      28      572          424     522         474      996
Average




                                        - 47 –
The following supporting services play an essential role in routine day to day
functioning of the Hospital :-


   1.     Administration.
   2.     Accounts Department.
   3.     Social Welfare Department.
   4.     Engineering Department.
          a) Civil.
          b) Electrical.
          c) Mechanical.
          d) HVAC.
          e) Electromedical.
   5.     Pharmacy Department.
   6.     Transport.
   7.     Medical Record & Statistical Department.
   8.     House Keeping Department.
   9.     Horticulture Department.
   10.    Security Department.
   11.    Laundry Department.
   12.    Food & Kitchen Department.
   13.    Audiovisual Section.
   14.    Purchase Department.
   15.    Library.




                                        - 48 –
                                                                                Annexure-X

                         Details of HMIS Software Applications

a.)    Software Features
       The Hospital Management Information System (HMIS) was initiated in 1996 after
       CRM donated the HMIS application software. The design of the software is
       based on the working of a large hospital. It is being implemented in PIMS. Most
       of the modules have been customized and are being operationalized. The HMIS
       software has been modified to the needs of IH Hospital PIMS. The current
       software tracks the patient from the time he reports at registration till the time he
       leaves the hospital. The software has the following modules:

i)     Patient Registration
            Complete details of the patient are recorded. This module covers
             registration of the patient. He is allocated a Patient Control Number
             (PCN). Different types of patients can be registered in registration module.
            Demographic data of the patient is entered in this module.
            For facilitating the research work and to standardize the details entered,
             the user has to select a pre-defined value for certain fields (e.g. city, tehsil,
             province etc.) rather than writing it every time.
            This module provides with the facility of finding a patient on the basis of
             different search criteria.
            Once a patient is registered, he is then sent to appropriate OPD.

ii)    OPD Visit
       This module covers the visits of the patient to the different OPDs.

iii)   Patient History
       The past history is recorded under this module.

iv)    Doctors Consultation
       This the heart of the software. Here the doctor enters his diagnosis and other
       clinical details. He is able to access the diagnostic facilities of the hospital i.e.
       Radiology and Pathology Department. He is also able to admit a patient, and
       give an appointment etc.

v)     Appointment system
       The software includes a complete module for tracking the appointments of a
       patient. This is an especially useful module for radiology department. Also it
       can be used to book the patients for major operations.




                                            - 49 –
vi)    Patient Admission and Discharge (Inpatient)
            This module covers the details of a patient’s admission and discharge
             within the hospital.
            Allocation and transfer of the patient from one bed to the other as well as
             history of his transfer are all covered in this module.
            Estimated length of stay, estimated cost of stay, estimated cost of drugs to
             be needed during his/her stay and expected cost of the procedures to be
             performed on him/her are also recorded.
            Non-formulary drugs that will probably be used on an admitted patient
             are also mentioned in this system.
            Discharge time, Patient Discharge Summary i.e. History, Investigations,
             Recommendations, and
            Discharge Time Drugs are also recorded Order Entry
            Physician can generate orders for all the services that are provided in the
             hospital, for example, Pathology, Radiology, and Radiation etc.
            Physician can make use of the Standard Coding facility (Predefined
             values) while giving order for a patient.
            The physician can order different types of drugs from this module as well.
             But the type of drug that any physician can order depends on his rights
             and the type of drug, i.e. whether its formulary, non-formulary or
             restricted.
            The result reports of the tests ordered through this system can also be
             viewed online. These reports are entered through their specific module.
             For example, Radiology reports, pathology reports etc.
            History of diagnosis and drugs ordered is also available from this module.

vii)   Pathology System
       The pathology system is the most complex as far as the software is concerned as
       there are many sections in the Department. Each section has multiple reports
       having different formats. The HMIS software has been thoroughly tested at
       PIMS and has been working 24 hours a day 365 days for the past two years. The
       workload in PIMS Pathology Department is more than 300 patients a day. The
       Department is totally paper less. The software also downloads data from the
       analyzers into HMIS automatically thus reducing data entry effort. It also
       ensures data accuracy and improves reliability of laboratory results.

       Pathology module is responsible for acknowledgement of the specimen, taken
       for the test ordered by the physician from Order Entry module. Specimen is then
       given a Section Number. Specimen are then delivered to the specified sections.
       The results of the tests performed are then either entered manually into our
       system or in some cases where tests are performed on automated machines; data
       is pulled directly through Special Interface, developed in-house, which directly
       communicates with machines, and data is incorporated in our system. Results


                                          - 50 –
        are then approved electronically and then reports based on these results are
        made available online to all the physicians.

viii)   Radiology
        The HMIS also includes a module for Radiology. It can cater to reporting of
        MRI, CT Scan and X-rays. Currently Radiology Department is using the
        software for patient management and generating reports.

ix)     Inventory Management
        This module includes a complete inventory management system. It consists of :
        -     Purchase orders generation
              o      Multiple dates delivery
              o      Multiple Stores delivery
        -     Receiving of items
              o      tracking of damaged items
              o      tracking of expiry dates
        -     Payment tracking
        -     User requests
              o      Requests by sections
              o      Requests by doctors for patients
        -     Issuing
              o      Automatic issuing against requests.
              o      Pharmacy issues to patients


All Hospital is maintained through HMIS system. All items are duly coded according to
their specific categories. Departments prepare electronic SOS (Supply Order Sheet).
According to SOS’s received Purchase Officers Make Purchase Orders to the listed
Suppliers. Item wise Suppliers are selected through Tenders floated through HMIS.
Items are received against Purchase Orders and Material Receipt Notes are prepared.
Bills to the suppliers are made through billing system.

At present the surgical store has been computerized. It has more than 700 items.

x)      Pharmacy


             When a doctor orders a medicine for a patient using the Order Entry
              Module, the pharmacist uses the pharmacy module to view that order and
              then dispense the medicines based on that order.
             Drugs are categorized in Formulary/Non Formulary, Restricted/Non
              Restricted and Therapeutic Groups.
             Drug Dispensing and Invoice Generation are some of the key features of
              this module.



                                         - 51 –
             Pharmacy Inventory is also maintained through this module.
             Yearly Stock Audit, Random Stock Checking is also being done through
              Pharmacy Inventory module.

xi)     Human Resources Module

             All the records of the employees including their promotions, demotions,
              designation, grades, duty locations, leave record is maintained in HR
              Module.
             All kinds of interactions with the employees including Explanation calls,
              warnings are made through Human Resources module.
             Employee’s duty record (attendance) is maintained through their
              allocated duty schedule.
             Human Resources module provides basic data to Payroll Module to
              calculate their monthly pays and all related benefits. This is where
              Administrative section is linked with the financial module.

xii)    Finance Module
        Finance Module covers the budget and accounts aspect of the Financial System.
        All the billing/financial details from the Order Entry module are merged in the
        financial module. This is the module that integrates the Financial and Clinical
        Modules.

xiii)   Reports and Searching
        Many different types of reports are available. Other reports as required by the
        hospital will be designed.

xiv)    Authority Files
        The HMIS software has a module for entering standard Information i.e.
        information which is fed only one time and does not change over time.

xv)     Security
        The software has extensive security features. Access to each form is through a
        Username & Password. The security access is provided by the system
        administrator as per requirement. Access restrictions can be at report level also.


        In view of the risks that Information Systems are exposed to nowadays, data
        security and privacy are essential prerequisites for any solution. For this
        purpose, two types of securities are maintained, one is the Software’s inbuilt
        security and the other is the Application Level Auditing. This consists to keeping
        track of all the transaction whether carried out at the front end by our clients or
        by the users at the backend.



                                           - 52 –
       Every change made to the database, i.e. insertion of new record, updating or
       deletion of old records, in any of the modules; the record along with the name of
       the user (users made at the application level, not the users), his/her terminal
       (computer name), and the date and time at which he made that transaction, is
       recorded in the system (HMIS). This way we can check and counter-check the
       activities of the users plus keep the track of data entered or changed in any
       module.

xvi)   Backup
       The back up feature is part of SQL database management system. The
       replication feature of SQL 2000 is being used to keep live data. In addition the
       server duplicates data on three SCSI drives.

xvii) Software interface with analyzers
      The software has been interfaced with those Analyzers/Equipment, which
      generate a text file of the results.

xviii) Software specifications
       The Database Management System (DBMS) is Microsoft SQL Server 2000. The
       development tool is VB 6.0. Reporting will be through Crystal Report 8.0.
       Windows 2000 is the network operating system. The details of the software to be
       purchased are mentioned in Annexure IV & XII

xix)   Software Support
       The existing HMIS software will need to be tested to meet the requirements of
       IH. This includes:
            Changes in HMIS modules not implemented as yet
            Changes in HMIS modules currently implemented
            Additional user reports
            Training of Master Trainers

       The software company has donated the HMIS application software. The software
       maintenance support is provided during the life of the project. The software
       maintenance contract includes:
            Data entry and validation
            Data analysis
            Data backup and security
            Hardware/Networking maintenance
            Source Code (as it is of the shelf package)

       The Cost of the annual maintenance is Rs. 720,000. The payment will be made at
       the end of each quarter. CRM will maintain the software support.


                                          - 53 –
                                                                          Annexure-XI

                             Details of Computer Hardware

The number of computer terminals depends on the flow of work and the actual
workload. The physical arrangement needs to be considered when determining the
number of terminals. Networking is also done according to the requirements. In PIMS
the Pathology Department alone has now about thirty computers.

It is recommended that a dedicated servers with dual processors be purchased.
Computers with P4 processors and at least 512MB Ram are recommended. UPS will
also be required for the server and other equipment. Generally the better the Hardware
the better will be the response.

The attached requirements are based on a careful analysis of the requirements of IH.

Workstations

Desktop PCs


      Intel ® Pentium ® processor 505 (2.66 Ghz LGA 775 Socket, 1 MB Cache)
      Intel ® 915G express chipset ATX desktop board
      LAN: 10/100 LAN (integrated)
      512 MB DDR Memory (2 x 256 MB)
      80 GB Serial ATA Hard Drive
      1.44 Floppy
      IDE 48 X CD
      Keyboard & Optical Mouse
      Graphics: Intel Graphics Media Accelerator 900 (integrated)
      Audio: Intel ® high definition Audio (integrated)
      Expansion slots: 2 PCI Express X 1, 4 PCI
      USB 2.0, 4 back ports, 4 ports via internal headers
      17 inch monitor or 21 inch monitor as specified in the quantities
      Licensed Microsoft Windows 2000 Operating System

OR

      AMD Athlon 64 processor 3200+ (Socket 754, 1 MB Cache)




                                         - 54 –
      VIA K8T800 -OR- SiS 760GX -OR- nVidia nForce3 250 Chipset, ATX desktop
       board
       LAN: 10/100 LAN
      512 MB DDR Memory (2 x 256 MB)
      80 GB Serial ATA Hard Drive
      IDE 48 X CD
      Keyboard & Optical Mouse
      Graphics: AGP 32 MB or more
      Audio: (integrated)
      Expansion slots: 1x AGP 4x PCI
      USB 2.0, 4 back ports, 2 ports via internal headers,
      17 inch monitor or 21 inch monitor as specified in the quantities
      Licensed Microsoft Windows 2000 Operating System


OR

Thin client

      Thin clients on server or blade-based technology sized to be equivalent to the
       functionality provided by the above description of Desktop PCs and their
       quantities specified
      Keyboard & Optical Mouse
      USB 2.0, 4 back ports, 4 ports via internal headers
      17 inch monitor or 21 inch monitor as specified in the quantities
      Microsoft Windows 2000 Operating System


Laptop
    Intel Pentium M:1.7 GHz with 1MB L2 Cache Integrated Wireless, 512MB DDR
      RAM, 40GB IDE HDD Ultra ATA, 15" XGA TFT Active Screen, Built in Video
      Controller, DVD & CD-Writer (COMBO Drive),
    Secure Digital Slot, Integrated 56Kbps modem, Integrated 10/100 Mbps, 85 Key
      keyboard, Touch pad 2 button, 3 USB 2.0 port, 1 infrared port (IrDA1.1),
      1Parallel port, 1S-Video port for TV output
    6-Cell Lion Battery,
    Software: Windows XP Professional Licensed OEM, Norton Anti Virus Symantec
      2004

Itanium Server

      2 x Intel ® Itanium ® 2 CPUs 1.6 Ghz with 6 MB or above cache
      2 way Itanium ® 2 CPU support Platform (Rack Mountable)


                                          - 55 –
      Redundant hot swap power supply
      Integrated ATI Rage with 4 MB (or more) of memory
      10/100/1000 Ethernet card
      DVD-ROM/CDRW
      4 GB ECC memory (2 x 2 GB).
      2 x 146 GB SCSI Drives
      HBA 2 GB Fibre Adapter x 2
      6.4 GB/S System Bus Bandwidth


XEON Server

      2 X Intel ® Xeon ® Processor 3.0 Ghz with 800 MHz FSB and 2MB cache
      Intel ® E7520 Chipset Server board support dual Xeons with 800Mhz FSB
      Dual Channel Ultra 320 SCSI RAID Controller
      Server Chassis with Hot-swap and fully redundant Power supply and Hot-swap
       HDD support
      Gigabit NIC on server (integrated)
      Integrated ATI graphics with 8MB of memory
      4 GB ECC memory 266 Mhz (1 GB X 4) with support for 12 GB
      5 X 72 GB ULTRA-320 SCSI HDD
      1.44 FDD
      DVD-ROM/CDRW
      HBA 2 GB Fibre Adapter x 2
      Rack Mountable


SAN (Storage Area Network)
   4U Rack Mount design combing controller and disk shelf.
   2 GB Fibre Channel Host Connections
   Dual 8 port 2 GB Fibre Switch (one for redundancy)
   Support for enterprise class Ultra 2, Ultra 3, Ultra 320 Universal 1” SCSI drives
   Scalable from 1 to 42 drives in drives enclosures for upto 6 TB storage
   14x146 GB 10K rpm U320 Hotplug Hard Drive
   Built-in RAID Controller (RAID 5 implemented) with at least dual channel and at
     least 128 MB cache

Tape backup
    400GB compressed storage capability.
    30-60 MB/sec Transfer Rate.
    Rack Mountable, Single drive installed in 3U rack mount kit.
    30 Data tapes


                                        - 56 –
      5 Cleaning tapes.
      Offline back-up tape library

RACK
   42U Rack with side wall panel.
   TFT Rack mount monitor
   Rack mount key board+Mouse+Drawer
   1x8 KVM Switch or IP-Based Console Manager
   All items within the rack should be same brand (other than server)

Printers

LASER (Heavy Duty)
Network printer,A4-45 PPM, 450 MHz or above processor, Minimum 64 MB RAM,
Minimum 1200 dpi, Minimum Input capacity 500 sheets, Minimum multipurpose tray
capacity 100 sheets, USB 2.0 compatible port, IEEE 1284-B compliant parallel port,
Windows XP Professional support, One Print Cartridge, USB cable, Power Cord.


LASER (Normal)
Network printer, A4-20 PPM, 133 Mhz or above processor, Minimum 16 MB RAM,
Minimum 1200 dpi, Minimum Input capacity 250 sheets, USB 2.0 compatible port, IEEE
1284-B compliant parallel port, Windows XP Professional support, One Print Cartridge,
USB cable, Power Cord.


Dot Matric Printers
   24 pin 80 column impact dot matrix printer, 8k byte input buffer, 8 bit parrallel
       interface, 337 cps, bidirectional, 1 black fabric ribon cartridge, Microsoft
       Windows platform support


      24 pin 132 column impact dot matrix printer, serial interface connectivity card,
       128k byte input buffer, 500 cps, bidirectional, 1 black fabric ribon cartridge,
       Microsoft Windows platform support


Multimedia




                                            - 57 –
Brightness: at least 3500 Lumens; Wire less Presentation capability (IEEE 802.11b-
Compliant), Computer Computability: XGA, UXGA; Pixels: 1024x786x3; On Screen
Menu, Digital Keystone correction, Auto Power Off, Power Cord. Carrying Bag, Remote
Control.


UPS-0.5 KVA
0.5-KVA, Line Interactive, Sine Wave output, USB and serial support, Management
Software, Battery type: Maintenance-free sealed Lead Acid battery with suspended
electrolyte, leak proof, Audible alarm, Network manageable, Adjustable voltage
sensitivity, Automatic Shutdown


UPS-5 KVA
5-KVA, Line-Interactive, Sine Wave output, USB and serial support, Management
Software, Battery type: Maintenance-free sealed Lead-Acid battery with suspended
electrolyte, leak proof, Audible alarm, Network manageable, Adjustable voltage
sensitivity, Automatic Shutdown. Rack Mountable




                                        - 58 –
                                                                                                           Annexure-XI (A)

                                         HARDWARE REQUIREMENTS IN ISLAMABAD HOSPITAL
                                                    COMPUTERS                        UPS                          PRINTERS
Sr. #            DEPARTMENTS                TOTAL                          TOTAL                         TOTAL
                                                    EXISTING    REQUIRED           EXISTING   REQUIRED           EXISTING    REQUIRED
                                            NEED                           NEED                           NEED

 1      General Medicine

 2      OPD (6 Doctors/6 Rooms)               6        2           4         6        0          6         6        0           6

 3      Medical Wards                        10        3           7         6        0          6         6        3           3

 4      Medical ICU                           2        1           1         1        0          1         1        1           0

 5      General Surgery

 6      OPD (6 Doctors/6 Rooms)               6        0           6         6        0          6         6        0           6

 7      Surgical Wards                       10        4           6         6        0          6         6        4           2

 8      Surgical ICU                          2        1           1         1        0          1         1        1           0

 9      Cardiology

 10     OPD (6 Doctors/6 Rooms)               6        0           6         6        0          6         6        0           6

 11     Cardiology Ward                       2        1           1         1        0          1         1        1           0

 12     Cardiology CCU                        2        1           1         1        0          1         1        1           0

 13     Angiography                           6        2           4         1        0          1         2        2           0

 14     ETT Room                              2        0           2         1        0          1         1        0           1
        Neurosurgery OPD (4 Doctors/4
 15     Rooms)                                4        0           4         4        0          4         4        0           4

 16     Neurology OPD (4 Doctors/4 Rooms)     4        0           4         4        0          4         4        0           4

 17     Orthopedic Surgery OPD 5 Rooms        5        0           5         5        0          5         5        0           5

 18     Pulmonary Medicine OPD                3        0           3         1        0          1         3        0           3

 19     Plastic Surgery OPD                   3        0           3         1        0          1         3        0           3
20   Oncology OPD                       2   1   1            1   0   1   1   0   1

21   Urology OPD 5 Rooms                5   0   5            5   0   5   5   0   5

22   Nephrology OPD 4 Rooms             4   1   3            4   0   4   4   0   4

23   ENT OPD 3 Rooms                    3   0   3            3   0   3   3   0   3

24   Gastroenterology OPD 4 Drs         4   0   4            2   0   2   4   0   4

25   Ophthalmology OPD 6 Drs            6   1   5            6   0   6   6   0   6

26   Psychiatry OPD 3 Doctors           3   0   3            3   0   3   3   0   3

27   Dermatology OPD 3 Doctors          3   1   2            3   0   3   3   0   3

28   Anesthesiology OPD 6 Doctors       5   1   4            6   0   6   4   0   4

29   Rheumatology OPD 5 Doctors         5   3   2            5   0   5   5   2   3

30   Dental Department                  5   1   4            1   0   1   5   0   5

31   Pathology Department

32   Chemical                           2   2   0            1   0   1   1   0   1

33   Hematology                         2   1   1            1   0   1   1   0   1

34   Microbiology                       2   1   1            1   0   1   1   0   1

35   Histopathology                     2   1   1            1   0   1   1   0   1

36   Pathology Reception                6   4   2            2   0   2   3   2   1

37   Blood Bank                         9   6   3            3   0   3   4   3   1

38   Radiology Department               9   3   6            3   0   3   3   1   2

39   Physical Medicine                  2   0   2            2   0   2   2   0   2

40   Administration Department          2   1   1            2   0   2   2   0   2

41   Account Department                 2   1   1            2   0   2   4   2   2

42   Deputy Executive Director Office   1   1   0            1   0   1   1   1   0

43   Conference Room                    1   1   0            0   0   0   0   0   0

44   Senior Statistical Officer         3   1   2            2   0   2   2   1   1




                                                    - 60 –
45   Medical Store         3    1     2              2    0    2     2    1     1

46   Other Stores (6)     12    3     9             10    0   10    10    3     7

47   HMIS Department       8    4     4              8    0    8     3    2     1

48   Main Emergency        6    1     5              6    0    6     4    1     3

49   Training Center      20    0    20              5    0    5     4    0     4

50   LAPTOPS               3    0     3              0    0    0     0    0     0

             Sub-Total    213   56   157            142   0   142   147   32   115

          Miscellaneous   10    0    10              0    0    0     5    0     5

           Grand Total    223   56   167            142   0   142   152   32   120




                                           - 61 –
                                                                               Annexure-XII

                          Details of Licensed Software

S.N.   Item                      Description
   1. Server OS                  Windows 2003 Advanced Server
   2. Development &              Visual Studio Latest Version
       Reporting Tools           Crystal Report Latest Version
   3. RDBMS                      Microsoft SQL Server 2000
      MS
   4. R Office Productivity      Word Processing, Spread Sheets, Presentations
       Suite                     tools, Should have embedded feature of digitally
                                 signing the documents
   5. Internet Security          Software required for Threat protection through
       Software                  integrated          antivirus,   firewall,   and   intrusion
       Software based Firewall   detection for remote, mobile, and networked client
       +Antivirus +IDS           systems, managed through a central single console.
                                 Should be able to create centralized client security
                                 policies and their central deployment.
                                 Should be able of centralized Networking auditing
                                 of nodes which are unprotected and vulnerable to
                                 virus attack, as well as those protected by third-
                                 party antivirus products.
                                 Should be able to scan Email Attachments of
                                 incoming emails delivered through POP3 mail
                                 clients.
                                 Should be capable of Memory Scanning detects
                                 threats and terminates suspect processes in memory
                                 before they can cause damage.
                                 Should allow network administrators to ensure that
                                 remote and mobile users are in full compliance with


                                            - 62 –
corporate policies prior to accessing corporate
network resources.




        - 63 –
                                                                           Annexure-XIII

                                     Details of Training

Training is one of the difficult activity in the complete process. The main reason is the
non-availability of hospital staff for longer durations. In general they can only spare an
hour or two during the day as they are busy with their assigned work.

HMIS Training

In PIMS the training methodology adopted so far has been to provide the training on
the job. In the beginning the staff enters the data in the computer as well as in the
register that he maintains. Slowly overtime the registers are replaced as the speed picks
up and the system is running smoothly. A computer report is generated of the work
that a user is performing manually. In most case the workload is minimized as most of
the data has already been entered at a previous stage. This saves time and avoids
duplication of efforts by reentering the data again in a register.

The training strategy is that the staff will be provided the initial training on the job on
the exisiting HMIS software. This will be spread over 13 months. On job training of
1183 PIMS staff of HMIS application will be undertaken by 6 trainers which will be
hired by the executing agency (EGD) for the period of 13 months during the life of the
project. The HMIS Department will coordinate the training function during the 13
months. There are more than 18 Departments excluding Accounts, Stores etc.




                                           - 64 –
             DEPARTMENTS TO BE TRAINED

Sr. No.   Department
1         Budget and Accounts

2         Stores (6)

3         Pharmacy

4         Pathology

5         Radiology

6         Medical Wards (7)

7         Surgical Wards (6)

8         Private Ward (2)

8         CCU

9         Blood Bank

10        Emergency

11        Intensive Care Unit

12        OPDs (18)

13        Personnel and Administration

14        Purchase Department

15        Others




                                - 65 –
                                                                                        Annexure – XIII (A)

                                             Details of On job Training
RS.
                                                       WEEKS REQUIRED FOR ON JOB TRAINING
DEPARTMENTS                  1   2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21
General Medicine

OPD (6 Doctors/6 Rooms)
                             1   1   1   1     1   1    1   1    1   1   1   1
Medical Wards (6)            1   1   1   1     1   1    1   1    1   1   1   1
Medical ICU                  1   1   1
General Surgery

OPD (6 Doctors/6 Rooms)
                             1   1   1   1     1   1    1   1    1   1   1   1
Surgical Wards (6)           1   1   1   1     1   1    1   1    1   1   1   1
Surgical ICU                 1   1   1
Cardiology

OPD (6 Doctors/6 Rooms)
                             1   1   1   1     1   1    1   1    1   1   1   1
Cardiology Ward              1   1   1
Cardiology CCU               1   1   1
Angiography                  1   1   1
ETT Room                     1   1   1
Neurosurgery OPD (4
Doctors/4 Rooms)             1   1   1   1     1   1    1   1
Neurology OPD (4 Doctors/4
Rooms)                       1   1   1   1     1   1    1   1




                                                            - 66 –
Orthopaedic Surgery OPD 5
Rooms                        1   1   1   1   1   1   1   1    1   1
Pulmonary Medicine OPD       1   1   1
Plastic Surgery OPD          1   1   1
Oncology OPD                 1   1   1
Urology OPD 5 Rooms          1   1   1   1   1   1   1   1    1   1
Nephrology OPD 4 Rooms       1   1   1   1   1   1   1   1
ENT OPD 3 Rooms              1   1   1   1   1   1

Gastroenterology OPD 4 DRS
                             1   1   1   1   1   1   1   1
Ophthalmology OPD 6 Drs      1   1   1   1   1   1   1   1    1   1   1   1
Psychiatry OPD 3 Doctors     1   1   1   1   1   1
Dermatology OPD 3 Doctors    1   1   1   1   1   1
Anesthesiology OPD 6
Doctors                      1   1   1   1   1   1   1   1    1   1   1   1

Rheumatology OPD 5 Doctors
                             1   1   1   1   1   1   1   1    1   1
Dental Department 6 DRS      1   1   1   1   1   1   1   1    1   1   1   1
Pathology Department
Chemical                     1   1
Hematology                   1   1
Microbiology                 1   1
Histopathology               1   1
Pathology Reception          1   1
Blood Bank                   1   1   1   1   1   1   1   1
Radiology Department         1   1   1   1
Physical Medicine            1   1   1
Training Center



                                                         - 67 –
Administration
  Budget and Accounts       1    1   1   1   1   1   1   1    1    1    1    1
  Stores All 7              1    1   1   1   1   1   1   1    1    1    1    1   1   1   1   1   1   1   1   1   1
   Pharmacy                 1    1   1   1   1   1   1   1
   Purchase Department      1    1   1   1
   Personnel & Management   1    1   1   1   1   1   1   1    1    1    1    1
Emergency                   1    1   1   1
Telephone Exchange          1
Tailorshop                  1
Air conditioning            1
Miscellaneous               1    1   1   1   1   1   1   1    1    1    1    1
Library
                            4        3   2   2   2   2   2    1
TOTAL                       5   42   7   7   4   4   1   1    5   15   12   12   1   1   1   1   1   1   1   1   1




                                                         - 68 –
TIME FRAME
TOTAL WEEKS              304
TOTAL NUMBER OF
TRAINERS                       6
NO. OF WEEKS PER
TRAINER                    51
NO OF MONTHS PER
TRAINER                    13

STAFF TO BE TRAINED
DOCTORS                  933
NURSES
PARAMEDICS
SUPPORT STAFF            250
TOTAL STAFF             1183




                      - 69 –
               Annexure XIV
Project Plan




   - 70 –
- 71 –
                                                                                                                                Annexure-XV
                                                          Quarterly Phasing of Project

                                                                                                                                      Annexure-XV
QUARTERLY PHASING OF FUNDS

S.N.   Description                Apr-Jun      Jul-Sep       Oct-Dec         Jan-Mar          Apr-Jun      Jul-Sep      Oct-Dec      Jan-        Apr-
                                FY (2004-    FY (2005-     FY (2005-       FY (2005-        FY (2005-    FY (2006-    FY (2006-    Mar FY     Jun FY
                                      05)          06)           06)             06)              06)          07)          07)    (2006-    (2006-
                                                                                                                                      07)         07)
                                                                                      (In          (In          (In          (In       (In        (In
                                       (In          (In           (In            Million)     Million)     Million)     Million)   Million   Million)
                                  Million)     Million)      Million)                                                                    )
       Cost of LAN
                                  0.575        2.066         2.066               0.458
  1    (Annexure-IV)

       Cost of Software/          0.200        0.839         0.839               0.219
       Applications
  2    (Annexure-IV)
       Cost of Hardware
                                               7.531         7.531               3.766
  3    (Annexure-IV)
       Cost of Furniture &
                                  0.170
  4    Fixture (Annexure-IV)
       Operating
       Expenditures               0.055        0.579         0.509               0.464        0.464        0.464        0.464      0.464      0.464
  5    (Annexure-V)
       Project Staff Salaries
                                               0.696         1.056               1.056        1.056        1.056        0.816      0.696      0.696
  6    (Annexure VI)
  7    Misc. & Contingencies                   0.061         0.061           0.061           0.061        0.061        0.061       0.061      0.061
       TOTAL (Rs.)               1.000        11.773        12.063           6.024           1.581        1.581        1.341       1.221      1.221

Total FY 2004-2005 (in millions) =               Rs. 1.000
Total FY 2005-2006 (in millions) =               Rs. 31.441
Total FY 2006-2007 (in millions) =               Rs. 5.3655


                                                                        - 72 –
- 73 –

				
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