Paperless Hospitals Dr Dev Taneja 3rd June2012


Published on

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 Like
  • Be the first to comment

No Downloads
Total views
On SlideShare
From Embeds
Number of Embeds
Embeds 0
No embeds

No notes for slide

Paperless Hospitals Dr Dev Taneja 3rd June2012

  1. 1. Paperless Hospitals HOSPI ARCH, MUMBAI 3rd June 2012 Dr Dev TanejaM.S.(Gen.Surgery),MBA – Healthcare Mgt. ( NUS Business School, Singapore) DirectorTachRoyal Healthcare Consultancy Services, Mumbai
  2. 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. 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. 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
  6. 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. 7. Drivers of Paperless HospitalCoordination of Clinical Care Improved Customer Care Profit, Growth & Competitive Advantage Cost Containment, Technological AdvancementsProductivity Improvement, Push from Govt. & Payers Monitoring & Control TachRoyal Healthcare Consultancy Services
  8. 8. Coordination of Clinical CareIOM Report, 1999 – To Err is Human: Building a safer healthcare system Medication Errors Clinical Process Improvement1. Ordering by physicians – 56% 1. Science of Error Reduction – CQI2. 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% centered4. 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
  9. 9. 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
  10. 10. Veteran Affairs Medication Error Reduction Error Reduction Strategy Percent Improvement(VA - developed Wireless POC medication administration system)1. Wrong time incidents 91.62. Wrong patient incidents 91.33. Wrong medication incidents 73.84. Omitted doses 69.65. Wrong dose incidents 56.6Source: IHC (2000) TachRoyal Healthcare Consultancy Services
  11. 11. 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
  12. 12. IT Vision First Clinic/HQ Community Health Care Medical Case WorkerConsultant Officer Paramedics Manager Patients/ Consumers Internet Internet Electronic Health Record Quality Metric Reports Additional Centers Central Data Repository in Future
  13. 13. 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
  14. 14. Information Sharing & Exchange
  15. 15. 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
  16. 16. 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
  17. 17. Future Healthcare – Social Media TachRoyal Healthcare Consultancy Services
  18. 18. 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 AnalyticsReadymade 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 TachRoyal Healthcare Consultancy Services
  19. 19. 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. • HIPPAHealth IT Standards • DICOM • HL 7 , LOINC etc The technology to link software, hardware & Costs telecommunications is rapidly becoming available The at affordable costs TachRoyal Healthcare Consultancy Services
  20. 20. IT Solution + Connectivity TachRoyal Healthcare Consultancy Services
  21. 21. 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
  22. 22. Technology Considerations in Healthcare TachRoyal Healthcare Consultancy Services
  23. 23. TachRoyal Healthcare Consultancy Services
  24. 24. Current Status of Paperless HospitalsThere are perhaps few industries that have togain more from the internet revolution thanmedicine…..(but doctors and) hospitals arereal laggards when it comes to the internet.What e-health has to be used for is totransform the whole process of deliveringcare. Russell Ricci, M.D, (Steinhauer, 2000) TachRoyal Healthcare Consultancy Services
  25. 25. E – Organisation CultureØ 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
  26. 26. PAPERLESS Vs PAPER TachRoyal Healthcare Consultancy Services
  27. 27. Semi Automated Systems TachRoyal Healthcare Consultancy Services
  28. 28. 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
  29. 29. Source:
  30. 30. Indian HIS Vendors – Most Common Module Offerings Modules NA Basic Intermediate AdvancedOPDOutpatient & Emergency Inquiry SystemOPD & Emergency Queue Mgt SysOPD & Emergency Billing & Charging SysOPD & Emergency Pharmacy Mgt. SysOPD & Emergency Physician Workstationt SysOPD & Emergency Nurse Workstationt SysIPDIPD Registration / ADT Mgt SysIP Expense Mgt SysIP Bed Mgt SysIP Prescription Mgt SysIP Pharmacy Mgt SysIP Physician Workstationt Mgt SysIP Nurse Workstationt Mgt SysClinical Examination Sub SysPharmacyMedication Inventory Mgt SysMedication Preparation Mgt SysElectronic Standard PrescriptionLaboratory ISPathology ISRadiology ISPACS System
  31. 31. Indian HIS Vendors – Most Common Module Offerings Modules NA Basic Intermediate AdvancedElectronic Medical History RecordsFinancial Mgt & Economic Acc MSCosting SoftwareClient Relationship MS (CRM)Hospital Resource Planning System (ERP)HR Mgt Sub SystemLogistic Mgt Sub SysOffice Automation (OA)Comprehensive Search & Analysis SysClinical Decision Making support SysMedical Mgt & Quality Control SysClinical Data WarehouseRemote Medical Service SysPatients Enquiry TerminalKnowledge Mgt Platform / BIPatient online Service PlatformMedical Ins & Community HC interphasePatient Card (Intra Hospital)Patient Card (Inter Hospital)Medical History Records & Statistics
  32. 32. TOP MNC HIS Vendors Clinical IS Financial IS1 Meditech2 Mckesson3 Siemens4 Cerner Corp.5 Eclipsys Corp6 Epic Systems7 3M HIS8 Dairyland HC Solutions9 SCC Computer10 Per-Se Technologies11 Mediware IS12 SoftMed Systems, Inc.13 QuadraMed14 MiSys15 Lawson Software N ****16 People Soft ****17 SAP ****18 SSA Global ****19 SSI Group* N **** Source: ClinicalSystemsHospitalMarket_HIMMS, DORENFEST (IHDS+Database) Institute 2006
  33. 33. Clinical Information Systems Comparision - Indian Vs MNC Vendors Modules Basic Intermediate Advanced Not Available1 Abstracting2 Chart Deficiency3 Chart Tracking Locator4 Clinical Data Repository5 Clinical Decision Support6 Enterprise EMR7 Enterprise Master Patient Index8 Laboratory Information Systems9 Pharmacy Management Information Systems10 Point of Care11 Radiology Information Systems12 Surgery
  34. 34. Financial Information Systems Comparision - Indian Vs MNC Vendors Financial Information Systems Basic Intermediate Advanced Not Available1 Accounts Payable2 Benefit Administration3 Case Mix Management4 Cost Accounting5 Electronic Claims6 Executive Information Systems7 General Ledger8 Materials Management9 Patient Billing10 Pay Roll11 Registration / ADT
  35. 35. Lets interact Thank YouContact Info:Dr Dev TanejaDirector,TachRoyal Healthcare Consultancy Services701, Viceroy ParkPlot No. 53, Sector 44ASeawoods Darave, Nerul(W)Navi Mumbai. 400706Mobile: 09987708685E-mail: