The Indian Hospital industry is growing at 15% per annum.Due to Low industry maturity, the Health IT applications are still at basal level. Though there is lot of hype around Paperless hospitals, the presentation attempts to understand challenges of implenting a True Paperless Hospital
1. Paperless Hospitals
HOSPI ARCH, MUMBAI
3rd June 2012
Dr Dev Taneja
M.S.(Gen.Surgery),MBA – Healthcare Mgt. ( NUS Business School, Singapore)
Director
TachRoyal Healthcare Consultancy Services, Mumbai
2. Who are we?
We are a Startup team of senior professionals
from the healthcare industry who have a sound
understanding of the operational & business
challenges and other stakeholders issues related
to the healthcare delivery
We seek opportunities to make meaningful
interventions to improve the business
competitiveness in healthcare delivery segment;
thereby improving returns for the promoters &
other stakeholders
TachRoyal Healthcare Consultancy Services
3. Our Service Offerings
Strategic Business Healthcare & Hospital Leadership & Human
Consulting Planning Capital Development
• Planning & Positioning • Formation Reports • HR Strategy & OD
• Marketing Strategy • Commissioning • Leadership &
• Balanced Score Card • Roll Out Management
Development
• Training & HC
Development
Performance Quality & Service
IT in Health
Improvement Excellence
• Performance – Clinical, • HIS • NABH / NABL
Operations & Finance • ERP • JCI
• Utilisation Reviews & • Business Intelligence / • Service Excellence
Trend Analysis Health Analytics Culture
• Human Capital Review
• BPR / Change Mgt.
TachRoyal Healthcare Consultancy Services
4. Healthcare IT
Strategic Information Systems
Administrative Information Systems
Clinical Information Systems
Electronic Networking Systems – RFID, Mobile,
Telemedicine, Telemetry, Insurance etc.
TachRoyal Healthcare Consultancy Services
5. Data is captured; both electronically and manually
Transaction Data Non Transaction Aggregate Data
Data
ADT CLINICAL CARE FINANCIAL MGT.
LIS / RIS CLINCAL QUALITY RESOURCE
PHARMACY PATIENT UTILIZATION
SATISFACTION SERVICE LINE
BILLING
MARKETING EFFICIENCY
STORES
SUPPORT SERVICES CLINICAL QUALITY
HRMS RISK MGT.
ASSETS TRENDS
PROJECTS FORECASTING
An Enterprise Level Integration of Processes, KRAs. KPIs for MIS is Required
6. Why do we need Paperless Hospitals?
HCOs are looking for the killer applications
that will slash costs, improve outcomes &
send patient home more satisfied. The focus
of IT investment is shifting from financial
systems to clinical systems.
Digital transformation of healthcare meets
three important criteria for market
competition – it is better, faster and cheaper
TachRoyal Healthcare Consultancy Services
7. Drivers of Paperless Hospital
Coordination of Clinical Care Improved Customer Care
Profit, Growth
&
Competitive Advantage
Cost Containment,
Technological Advancements
Productivity Improvement,
Push from Govt. & Payers
Monitoring & Control
TachRoyal Healthcare Consultancy Services
8.
9.
10.
11. Coordination of Clinical Care
IOM Report, 1999 – To Err is Human: Building a safer healthcare system
Medication Errors Clinical Process Improvement
1. Ordering by physicians – 56% 1. Science of Error Reduction –
CQI
2. Admin. of medication by
2. EMR - virtual data warehouse
nursing staff – 34 %
3. Design around patients – Dis.
3. Transcription of medication mgt. programs – patient
orders by secretarial staff – 6% centered
4. Dispensation of medication by 4. Reduction in Medication Errors
the pharmacy dept. – 4% 5. Research Organisation – RIID
(Research, Investigate,
5. Practice variations – Cost of Innovate & Disseminate)
care in the last 6 mths. of life 6. Chronic illness Focus – CDM
were found to vary 7. Link to Financial Performance
tremendously – Report cards
TachRoyal Healthcare Consultancy Services
12. EMR / EHR
It is a database & decision support system
It addresses one of the greatest inefficiencies
of healthcare – the immobility of healthcare
records
It is built around Clinical Protocols
CPOE – Clinical Physician Office Entry
Clinical Information Systems & Clinical Decision
Support Systems
TachRoyal Healthcare Consultancy Services
14. IT in Care Process
Health plans that seek to better coordinate patient
care – particularly for chronic care patients – should
make sure all health care stakeholders have the same
Case Manager information when devising treatment strategies.
Placing high-quality, patient-centered data at the
center of the “circle of care” is where IT systems
(EHR) can be of strong value.
Patient
Centered
Information
(EHR)
Health Care Team Patients/Consumers
TachRoyal Healthcare Consultancy Services
15. IT Vision
First Clinic/HQ
Community Health
Care Medical Case Worker
Consultant Officer Paramedics Manager Patients/
Consumers
Internet
Internet
Electronic Health Record
Quality Metric
Reports
Additional Centers
Central Data Repository in Future
16. IT Plan - Web Based Solutions
– Electronic Health Record(EHR)
• Can be accessed anywhere by Health Care Team
• Role specific screens that allows to see/collect information
about patient specific to the care provider’s discipline
– Patient Health Record(PHR) portal to facilitate
• Self management
• Open communication with health care team
• Delivery of patient specific education materials in different
formats (videos/web pages, etc)
TachRoyal Healthcare Consultancy Services
18. Direct Impact - Customer
Online Appointments
Reminders & Alerts
Automated Dispensing Machines
Digital Signage’s – Token Display, Patient Education materials
Patient Portals
Wireless Internet Access
Video Calling Devices in ICU
Telemedicine Health Communities
Mobile Health Patient Health Records
Online Payment Gateways
Smart Cards
Patient Entertainment Systems - Movies-on-Demand, Television, Music,
Games
19. Indirect Impact - Customer
Electronic Health Record
Clinical Decision Support Interoperability
Wrist bands – Barcode / RFID
Feedback collection
Robotic Devices
Surveillance
Real Time Location Tracking
TachRoyal Healthcare Consultancy Services
21. HIS, ERP & BI: Advantages & Limitations
HIS
Modules mostly capture Transactional Data Limited applications for all support Depts.
ERP
Modules cover transactions + support depts. Static MIS Dash boards.
But +/- Clinical Information Systems No Analytical capability
Business Intelligence / Health Analytics
Readymade Role based Actionable information available Interactive visualisation of data to support decision making.
No need to spend time for analysing data Transformation of Data to Information to Knowledge
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22. Technology Advancements
• Broadband Services
Internet Access • Convergence of ICT services
• Wireless Technology
Hardware, • Better Operating systems & Search engines
Middleware & • Web based systems, Cloud computing
Software • HTML to XML, Software Applications etc.
• HIPPA
Health IT Standards • DICOM
• HL 7 , LOINC etc
The technology to link software, hardware &
Costs telecommunications is rapidly becoming available
The
at affordable costs
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23. IT Solution + Connectivity
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24. Wi-Fi in Healthcare
• IP Phones
• Laptops / Tablet PC
• PDA / IPAD
• Computer-on-Wheels (COWS)
• Real-Time location services
• Wireless Data Transfer
– Wristband and pharmaceutical scanners
– Wireless glucose meters
• Bedside video conferencing
– Remote telemedicine
• Video surveillance
• Medical telemetry/monitoring
• Visitor and patient Wi-Fi access
TachRoyal Healthcare Consultancy Services
27. Current Status of Paperless Hospitals
There are perhaps few industries that have to
gain more from the internet revolution than
medicine…..(but doctors and) hospitals are
real laggards when it comes to the internet.
What e-health has to be used for is to
transform the whole process of delivering
care.
Russell Ricci, M.D, (Steinhauer, 2000)
TachRoyal Healthcare Consultancy Services
28. E – Organisation Culture
Ø The ultimate barrier and enabler of the digital
transformation are not technical – they are
cultural.
Ø A digital divide still exists between the e-users
and e-sceptics and healthcare is traditionally
slow to adopt new technology.
TachRoyal Healthcare Consultancy Services
31. Healthcare Executives Straddle the
“Digital Divide”
The healthcare system of tomorrow may
never be ‘paperless’ but progress is being
made despite the legendary reluctance of
physicians to accept changes in the way they
practice medicine.
The transformation process of building
electronically integrated systems that
manage patients with “seamless” care has
already gained traction across the globe.
TachRoyal Healthcare Consultancy Services
33. Indian HIS Vendors – Most Common Module Offerings
Modules NA Basic Intermediate Advanced
OPD
Outpatient & Emergency Inquiry System
OPD & Emergency Queue Mgt Sys
OPD & Emergency Billing & Charging Sys
OPD & Emergency Pharmacy Mgt. Sys
OPD & Emergency Physician Workstationt Sys
OPD & Emergency Nurse Workstationt Sys
IPD
IPD Registration / ADT Mgt Sys
IP Expense Mgt Sys
IP Bed Mgt Sys
IP Prescription Mgt Sys
IP Pharmacy Mgt Sys
IP Physician Workstationt Mgt Sys
IP Nurse Workstationt Mgt Sys
Clinical Examination Sub Sys
Pharmacy
Medication Inventory Mgt Sys
Medication Preparation Mgt Sys
Electronic Standard Prescription
Laboratory IS
Pathology IS
Radiology IS
PACS System
34. Indian HIS Vendors – Most Common Module Offerings
Modules NA Basic Intermediate Advanced
Electronic Medical History Records
Financial Mgt & Economic Acc MS
Costing Software
Client Relationship MS (CRM)
Hospital Resource Planning System (ERP)
HR Mgt Sub System
Logistic Mgt Sub Sys
Office Automation (OA)
Comprehensive Search & Analysis Sys
Clinical Decision Making support Sys
Medical Mgt & Quality Control Sys
Clinical Data Warehouse
Remote Medical Service Sys
Patients Enquiry Terminal
Knowledge Mgt Platform / BI
Patient online Service Platform
Medical Ins & Community HC interphase
Patient Card (Intra Hospital)
Patient Card (Inter Hospital)
Medical History Records & Statistics
35. TOP MNC HIS Vendors Clinical IS Financial IS
1 Meditech
2 Mckesson
3 Siemens
4 Cerner Corp.
5 Eclipsys Corp
6 Epic Systems
7 3M HIS
8 Dairyland HC Solutions
9 SCC Computer
10 Per-Se Technologies
11 Mediware IS
12 SoftMed Systems, Inc.
13 QuadraMed
14 MiSys
15 Lawson Software N ****
16 People Soft ****
17 SAP ****
18 SSA Global ****
19 SSI Group* N ****
Source: ClinicalSystemsHospitalMarket_HIMMS, DORENFEST (IHDS+Database) Institute 2006
36. Clinical Information Systems Comparision - Indian Vs MNC Vendors
Modules Basic Intermediate Advanced Not Available
1 Abstracting
2 Chart Deficiency
3 Chart Tracking Locator
4 Clinical Data Repository
5 Clinical Decision Support
6 Enterprise EMR
7 Enterprise Master Patient Index
8 Laboratory Information Systems
9 Pharmacy Management Information Systems
10 Point of Care
11 Radiology Information Systems
12 Surgery
37. Financial Information Systems Comparision - Indian Vs MNC Vendors
Financial Information Systems Basic Intermediate Advanced Not Available
1 Accounts Payable
2 Benefit Administration
3 Case Mix Management
4 Cost Accounting
5 Electronic Claims
6 Executive Information Systems
7 General Ledger
8 Materials Management
9 Patient Billing
10 Pay Roll
11 Registration / ADT
38. Lets interact
Thank You
Contact Info:
Dr Dev Taneja
Director,
TachRoyal Healthcare Consultancy Services
701, Viceroy Park
Plot No. 53, Sector 44A
Seawoods Darave, Nerul(W)
Navi Mumbai. 400706
Mobile: 09987708685
E-mail: drdevtaneja@tachroyalhcs.com
