Hospital

Patients, appointments and the queue from triage to the doctor, the lab, the pharmacy and the cashier. Wards with admissions, bed days and deposits, the theatre list and imaging. Bills split between the patient and their insurer, with claims and reports. The Pharmacy module is included.

Getting started

Hospital is an add-on module and includes the Pharmacy module. Your account owner adds it from Settings, then Modules.

1. Open Hospital, then Hospital settings. Set the Hospital number prefix and the Consultation fee. Only an admin sees this page.
2. Under Clinics and departments, add each clinic you run (OPD is there already).
3. Under Who pays, add the insurers and company schemes you accept, with the Patient co-pay % each one leaves to the patient. Cash and NHIF are there already. Press Prices next to an insurer to enter its own tariff or the items it doesn't cover.
4. Open Laboratory, then Test list and prices, and press Add the common tests. Check each price and normal range against your own lab.
5. If you dispense medicines, add them under Pharmacy, Medicines, and receive the stock.
6. If you admit patients, open Wards and add each ward with its Price per day and number of beds.
7. Register patients under Patients, then check them in from their chart.

To register and check in patients, record vital signs and write notes, a role needs to be able to enter documents. To limit what a receptionist, nurse or doctor can open, give them a role restricted to the Hospital sections they need under Settings, Roles.

How to

Register a patient

1. Open Hospital, then Patients, and press Register a patient.
2. Enter the First name, Last name and Sex. Add the Date of birth, or the Age in years if they don't know it.
3. Choose Who pays. For NHIF or an insurer, enter the Membership number and the date the card expires.
4. Enter any Allergies. They show in red on every screen for this patient.
5. Tick that the patient agrees to their details being kept, and press Register, or Save and check in.

If a patient with the same phone, or the same name and date of birth, is already registered, Mifumo shows them first. Open the one that is the patient, or tick This is a new patient and save again.

Check a patient in

1. Find the patient under Patients and open their chart.
2. Open Check in, choose the Clinic, the Doctor (or leave it for the next free doctor) and Who pays.
3. Enter the Reason for the visit and press Check in.

The patient joins the queue, waiting for triage, and the consultation fee is charged to the visit. Tick No consultation fee this time for a review visit.

Record vital signs

1. Open Queue and press the patient's card.
2. Fill in the readings under Vital signs and press Save vital signs.

Readings outside the usual adult range show in red. The patient moves on to wait for the doctor.

Write the doctor's notes and diagnosis

1. Open the visit from the Queue.
2. Fill in Complaint, History, Examination and Plan, and press Save notes.
3. Under Diagnosis, start typing a condition or an ICD-10 code, pick it from the list (or type your own) and press Add.

Charge a service

1. On the visit, under Charges, choose the service or product.
2. Change the Qty or Price if needed and press Add.

Services are your items. Add new ones, such as a dressing or an injection, under Sales, Items.

Order lab tests

1. On the visit, under Lab tests, tick the tests.
2. Press Order the tests. Each test is charged to the visit and the patient is sent to the lab, unless you untick Send the patient to the lab.

Results show on the visit once the lab has checked and released them. A result outside the normal range is flagged, and a critical one is marked in red. Press Print the lab report for a copy.

Take samples and enter results

1. Open Laboratory. Samples to take lists the tests waiting.
2. Press Sample taken when you have the sample. It gets a number, such as L261020-001, for the tube.
3. Open Results to enter, fill in each value and press Save the result. Values are flagged against the range for the patient's sex.
4. Another lab user opens Results to check and presses Checked: release to the doctor. When every test for the patient is released, the patient goes back to the doctor.

A test can be cancelled until its result is entered; it comes off the bill.

Add or change a lab test

1. Open Laboratory, then Test list and prices.
2. To add one, fill in Add a test and press Add the test. To change one, press Edit.
3. Under What it measures, add each thing the test measures with its unit and its normal and critical limits. For an answer such as Positive or Negative, choose Choice and list the answers, with a star after the abnormal ones: Negative|Positive*.

Order and report imaging

1. On the visit, under Imaging, tick the studies, such as a chest X-ray or an obstetric ultrasound, add the Clinical details and press Order imaging. Each study is charged to the visit.
2. Open Imaging. Studies to do lists what is waiting; press Study done once the scan is taken.
3. Under Reports to write, write the Findings and the Impression and press Save the report. The doctor sees the impression on the visit; press Open the report to read or print it.

A study can be cancelled until it is done; it comes off the bill. A saved report can't be changed. To set up the list, open Imaging, then Study list and prices, and press Add the common studies or add your own.

Prescribe

1. On the visit, under Prescription, choose the Medicine.
2. Enter the Dose (such as 1 tab), How often (OD, BD, TDS, QID) and Days. Leave Qty to give blank and Mifumo works it out: 1 tab TDS for 5 days is 15.
3. Press Prescribe. The patient appears in the Pharmacy queue.

If the patient is allergic to something the medicine's name or generic name mentions, Mifumo stops and asks you to tick Prescribe anyway after checking.

Give medicines at the pharmacy

1. Open Pharmacy queue. Each patient's prescriptions show with the stock on hand that hasn't expired.
2. Change the quantity if you give less, and press Give. The medicine is charged to the visit.
3. Press Not available if you can't give it.

The medicine leaves stock when the cashier bills the visit, earliest expiry first, from the store set in the Pharmacy settings.

Bill a patient at the cashier

1. Open Cashier. Patients with something to pay are listed, those sent to the cashier first.
2. Press Bill. The page shows each charge, what the insurer pays and what the patient pays.
3. Enter what the patient Paid now, choose the account it went Into and add the Reference (such as the M-Pesa code).
4. Press Bill.

Mifumo makes an invoice to the patient for their part and records their payment. For an insured patient it also makes an invoice to the insurer for its part, which goes into the next claim. Medicines leave stock on the bill, earliest expiry first. Whatever the patient doesn't pay now stays on their account; record a later payment under Sales, Receipts.

To take payment for a prescription before the pharmacy gives it, tick it on the bill. The pharmacy then just hands it over.

A bill made by mistake can be cancelled from the bottom of the same page, until it is in a claim. Its invoices and payment are voided and the charges can be billed again.

Admit a patient

1. Open the patient's visit from the Queue.
2. Open Admit, choose a free bed, the doctor in charge and the reason.
3. If the patient leaves a deposit, enter it and choose the account it went into.
4. Press Admit.

The patient leaves the queue and shows on the bed board under Wards. Lab tests, prescriptions and services are added to the same visit as usual. Each night on the ward is charged as a bed day at the ward's price, or at the insurer's own price for it.

To move the patient, choose a free bed under Move to another bed on the visit. Days so far are charged at the old ward's price first. An admission made by mistake can be cancelled while none of its bed days are billed and no deposit is held.

Keep the ward chart

On an admitted patient's visit, Medication round lists each medicine prescribed on the stay with how many doses it calls for today. Choose the medicine, whether the dose was Given, Refused, Held or Missed, and press Record the dose. Leave Time blank for now, or enter an earlier time today such as 08:30. A dose that wasn't given needs a note saying why.

Write Nursing notes under the round: observations, care given, a Handover at the end of a shift, or an Incident (incidents are also kept in the audit log). Notes stay as written; add a new note to correct one.

Medicines are billed once, when the pharmacy gives them to the ward. Recording doses doesn't charge anything again.

Discharge a patient

1. Open the visit, choose How the patient left, and write the Discharge summary and Follow-up.
2. Press Discharge.

The last bed days are charged (at least one day) and the patient goes to the cashier. Print the discharge summary from the visit or from Wards.

Book and write up a procedure

1. Add each procedure you do (an incision and drainage, a caesarean section, a circumcision) as a service item under Sales, Products and services, with its price.
2. On the patient's visit, open Book a procedure. Choose the procedure, the date and time, how long it takes, the theatre or room, the surgeon and the anaesthesia, and press Book.
3. When the patient has signed the consent form, press The patient has signed consent on the procedure (or tick it when booking).
4. Press Into theatre when it starts. Afterwards write the Findings, What was done and After the procedure, and press Save the operation note.

The procedure is charged to the visit when the operation note is saved, at the item's price or the insurer's own price for it. A theatre can't be booked twice for the same time. Theatre lists each day's procedures; print the operation note from the procedure's page. A booking can be cancelled until the note is saved.

Take, use or refund a deposit

Take a deposit when admitting, or on the patient's page at the Cashier under Deposit. It is held in Patient deposits, not counted as income.

When the cashier bills the patient, Use the deposit held pays their invoice from the deposit first; enter the rest under Paid now. Bill part of a long stay early the same way. Refund what is left with Refund the patient. A deposit or refund recorded by mistake can be cancelled; its entry is reversed.

Claim from an insurer

1. Open Insurance claims. Not yet claimed shows each insurer's bills waiting.
2. Choose the insurer and the dates, and press Make the claim.
3. Check the bills. Press Take out for any you don't want to send now; they go into the next claim.
4. Press Print, send the claim, and press Mark as sent.

When the insurer pays, record a receipt for it under Sales, Receipts against its invoices. The claim shows what is still owed.

Record a rejected claim

1. Open the claim and, under The insurer rejected part of a bill, choose the bill.
2. Enter the Amount and the Reason the insurer gave.
3. Tick Bill the patient for it if the patient should pay instead, and press Record the rejection.

Mifumo credits the insurer's invoice and books the amount to Insurance claims rejected. If you bill the patient, the patient is invoiced for it and nothing is lost.

See the hospital's figures

Open Hospital reports and pick the dates. It shows visits by clinic and doctor, what was billed by service and by payer, the lab's work and time taken, the top diagnoses, and what each insurer owes.

Send a patient on and close the visit

Use the Send to buttons on the visit to move the patient to the doctor, lab, pharmacy or cashier. Press Close the visit when they leave. An admitted patient is discharged instead. A visit checked in by mistake can be cancelled while nothing on it is billed.

Book an appointment

1. Open Appointments and pick the day.
2. Open Book an appointment, choose the patient, time and doctor, and press Book.

You can also book from a patient's chart. When the patient arrives, press Check in on the appointment.

Settings

• Hospital number prefix: the letters in front of each new patient's number, such as UHA-000042.
• Charge a consultation fee at check-in: adds the fee to each new visit.
• Consultation fee: the price of the Consultation item, billed to Patient services income and exempt from VAT.
• A second person checks each lab result: the person who enters a result can't release it. Turn it off if one person runs the lab.
• Cash patients pay before the lab and the pharmacy: the lab can't take a sample, and the pharmacy can't give a medicine, for a cash patient until the cashier has billed it.
• Cashier's till: where payments at the cashier go unless the cashier chooses another account.
• Clinics and departments: the clinics patients are checked in to.
• Who pays: cash, NHIF, insurers and company schemes, each with the patient's co-pay percentage. Each one other than cash is also a customer, so what it owes shows in receivables.
• Wards (on the Wards page): each ward's name, kind, price per day and beds. A bed can be renamed or taken out of use while it is empty. Bed days are billed to Patient services income and exempt from VAT.
• Prices (for each insurer): its own price for an item, or that it doesn't cover the item. A change applies to charges made from then on.

Questions

Where do insurer bills go in the books?

Each insurer is a customer. Its invoices are in receivables, and its payments are receipts against them. Rejected amounts reduce revenue through Insurance claims rejected.

Where does lab income go?

Each lab test is a service item, billed to Laboratory income and exempt from VAT. Change its price under Test list and prices. Imaging studies are billed to Laboratory income too; change their prices under Study list and prices.

Where do the patient's bills go?

Each patient is also a customer with the same name, so bills, receipts and statements are in their name. Open Bills and payments on the patient's chart.

Where do deposits go in the books?

A deposit is money owed back to the patient until it is used, so it is held in Patient deposits (a liability): the till or bank goes up and Patient deposits goes up. Using it on a bill moves it from Patient deposits to pay the patient's invoice. A refund takes it from Patient deposits back out of the till or bank.

When are bed days charged?

Every night at 00:20 each patient on a ward is charged the nights since their last charge. Moving ward and discharge charge the days up to then. Charge bed days to today on the visit does it straight away.

Can another system read patient records?

Yes, on a plan with the API. In Settings, API and webhooks, make a key with the Patients, Visits or Lab results scopes. It can register and update patients, read visits with their vital signs, diagnoses, results, imaging reports and charges, and read released lab results. The doctor's free-text notes aren't shared. The key acts as the person who made it, so it sees only what their role allows. Each chart it reads is listed among the chart's openings, marked through the API. Webhooks can tell the other system when a patient is registered, a lab result is released or a visit closes.

Who can see who opened a chart?

Admins see the last 10 openings at the bottom of each patient's chart. Every opening is recorded.

Help guides

• Getting started: Sign up, set up your company with its TIN and VRN, choose your modules, invite your team and get Mifumo on your phone.
• Team, roles and permissions: Add users, give each one a role per company, build your own roles with the permission grid, work together with mentions, and import or export spreadsheets.
• Approvals: Maker-checker on the documents you choose. People who can't approve submit, an approver posts or sends back with a reason, and nothing reaches the books before approval.
• Sign-in and security: Passwords, passkeys, two-step sign-in with an authenticator app, a text message or email, recovery codes, requiring two-step sign-in for everyone, and staying signed in.
• Group of companies: Run several companies under one login, give people a group role in every company, record intercompany entries once, and read consolidated reports with intercompany balances taken out.
• Accounting: Your books in one place. Invoices, receipts, bills, expenses, banking, journals, VAT returns and financial statements, all posting to one double-entry ledger in TSh.
• Inventory: Stock products, warehouses, adjustments, transfers and stock counts with a barcode scanner, landed cost on imports, purchase and sales orders, the point of sale till, and stock reports.
• HR and payroll: Employees, monthly payroll with PAYE, NSSF, SDL, WCF and HESLB worked out for you, payslips, salary advances, per diem, leave, staff attendance by phone with GPS or QR, a shift roster, and final dues for leavers.
• CRM: Leads, a drag-and-drop pipeline of deals, follow-ups, quotes from deals, a full customer timeline, SMS and email campaigns, and your own mailbox synced in.
• Asset management: Keep a fixed asset register, charge depreciation, track who has each asset, and record disposals with the right journal entries.
• Project management: Projects with their team, tasks, board and timeline, time logged on timesheets, milestone and time invoices, and the margin of every project.
• FTTx projects: Track fibre roll-out purchase orders from your clients, the work you pass to subcontractors, and the money in and out on each PO.
• Transport jobs: Record each cargo trip with its trucks, drivers and deliveries, attach the proof of delivery, see the margin on every delivery, and turn the job into an invoice.
• Construction: Run each building contract with its bill of quantities, interim payment certificates, advances, retention, completion certificates and site costs.
• Manufacturing: Write recipes for what you make, plan production runs, issue materials from stock and put finished goods into stock at what they really cost.
• Pharmacy: Counter dispensing with patient and prescription details, medicines with TMDA numbers, first-expiry-first-out batches, expiry write-offs and the prescription register.
• Motor vehicles: Sell imported vehicles from proforma to invoice, complete and approve the internal Sale Sheet, take instalment payments, and pay sales commissions.
• Property management: Properties and units, tenants, leases and rent billed as invoices, arrears, repairs and statements for owners you manage for.
• Law firm: Matters and case management (stages, parties, tasks, documents), time and costs, billing a matter in one step, the client (trust) account kept matter by matter, a court diary with reminders, the conflict check log and the advocate compliance register.
• Livestock: A register of every animal or batch of birds, with health records, withdrawal periods, breeding and births, milk and eggs, and sales invoiced to the buyer.
• Helpdesk: Customer problems and requests as numbered tickets, each with someone in charge, deadlines to answer and to solve, replies by email and internal notes.
• Mining: Run each mine as a project, record the money it receives, see spending against those funds, and get a profit and loss for every mine and for the company.
• Field Service: Jobs your technicians do at the customer's site, each with a time slot, a checklist, the parts used from stock, the hours worked, the customer's signature on the phone, and an invoice from the job.
• Hospital: Patients, appointments and the queue from triage to the doctor, the lab, the pharmacy and the cashier. Wards with admissions, bed days and deposits, the theatre list and imaging. Bills split between the patient and their insurer, with claims and reports. The Pharmacy module is included.
• Sign: Send a contract, lease or offer letter to be signed by link, on a phone or computer, and keep the signed copy with a record of who signed, when and from where.
• Event ticketing: Set up an event with its ticket types, publish it after paying a one-off fee, and sell tickets from your own sale page. Buyers pay you by Lipa Namba or online, and get QR tickets by SMS and email. Ticket money goes straight to you, never to Mifumo.