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Innovation in Hospital Management Systems       The AMS 2000 System EAST AFRICA HEALTHCARE FEDERATION             CONFEREN...
Metropolitan Hospital profileFounded in mid 1995 as a public limited liability company with adiverse group of shareholder...
The adversity• Growing revenues accompanied by growing losses• Losses due to poor credit control coupled with  collapse of...
The innovation• Creating a home grown and in house HMIS to  address the identified management needs• Focusing on financial...
AMS 2000 Enterprise Management            SystemAMS 2000 is a fully integrated hospital management systemBased on a modu...
AMS 2000 HMIS System ModulesPatient management (Out & In patient)oMedical Records(EMR-Electronic Medical Records)oNurse c...
AMS 2000 HMIS SystemModulesPayer managementoScheme membership & benefits validationoClaims managementFinance managemento...
AMS 2000 HMIS System Modules          (Continued)Operations managementoPayroll management & Human Resource managementoIns...
AMS 2000 Integration Capabilities)Medical Equipment e.g. ECG and U/soundNurse call systemImage Management linked with E...
AMS 2000 Claims ManagementcapabilitiesReal time financial data e.g. visit notification, admissionnotification, dispatched...
AMS 2000 Claims Managementcapabilities- Clinicians MgtDiagnostic profile and outcomeAdmission rateReferral rate : other...
AMS 2000 Claims Management Provider NeedsCash Flow/timely payments/reduced claim lossesBenefits administration(membershi...
AMS 2000 Claims Management  - Payer NeedsBenefits administration(membership & pre-authorization)Fraud prevention control...
AMS 2000 Claims Managementcapabilities- Cost MgtPerformance based parameter management reports suchas;Cost per Admission...
The benefits/pay backGrowing ICT driven competitivenessImproved market, financial and managerial performanceEvolution of n...
Dr. gakombe uganda health care federation ams presentation
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Dr. gakombe uganda health care federation ams presentation

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Dr. gakombe uganda health care federation ams presentation

  1. 1. Innovation in Hospital Management Systems The AMS 2000 System EAST AFRICA HEALTHCARE FEDERATION CONFERENCE Kampala Sheraton May 2012 Metropolitan Hospital ,Nairobi, Kenya KMA Presented by: Dr K.K Gakombe, MBCHB,MBA, CEO
  2. 2. Metropolitan Hospital profileFounded in mid 1995 as a public limited liability company with adiverse group of shareholders.Most comprehensively equipped private medical institution in theEastern part of Nairobi.The hospital was founded on the belief that it is possible to offerquality, cost effective and affordable health care services.70 bed hospital offers a diverse range of inpatient services and abusy outpatient .Leading user of ICT for quality healthcare. Has won several awardsfor ICT deployment .70% of clientele is corporateA preferred provider for insurance companies, parastatals and largecorporates
  3. 3. The adversity• Growing revenues accompanied by growing losses• Losses due to poor credit control coupled with collapse of HMOs• Lack of timely & poor management decision support information.• A growing feeling of being in charge but not being in control• Unable to afford imported hospital mgt systems
  4. 4. The innovation• Creating a home grown and in house HMIS to address the identified management needs• Focusing on financial management in order to save the resources to expand system into other areas• Leveraging open source tools available for system development in order to cut development cycle and cost• Raising the bar for ICT usage in hospital management
  5. 5. AMS 2000 Enterprise Management SystemAMS 2000 is a fully integrated hospital management systemBased on a modular designScalable from small to large hospitalsRobust and reliableUtilizes open source development resourcesDynamic and under constant development and improvementRuns on several platforms but Linux is the native environmentDeveloped in JavaEasily integrated with other 3rd party systems; Smart, messagingsystem, NHIF etc
  6. 6. AMS 2000 HMIS System ModulesPatient management (Out & In patient)oMedical Records(EMR-Electronic Medical Records)oNurse care managementoOn-line Outpatient clinical managementoPharmacyoLaboBlood bankoRadiology (X-ray & Ultra Sound)oTheatre managementoBooking managementoDentaloAnte nataloBirths & deaths registrationoNurse Call system integration
  7. 7. AMS 2000 HMIS SystemModulesPayer managementoScheme membership & benefits validationoClaims managementFinance managementoStock & Inventory managementoGeneral ledgeroDebtors ledgeroCreditors LedgeroConsultants /3rd party providers ledgeroOther ledgers; Loans , Cash book, Assets
  8. 8. AMS 2000 HMIS System Modules (Continued)Operations managementoPayroll management & Human Resource managementoInstant Messaging (SMS & Email)oSystem security including biometric identification of usersoCourier ManagementoFleet/Transport ManagementoShare registeroImportant documents mgt; cheque books, govt documents etc
  9. 9. AMS 2000 Integration Capabilities)Medical Equipment e.g. ECG and U/soundNurse call systemImage Management linked with EMRBenefits validation systemsClaims administrationBanks payment systems (receipts & payments)Mobile payment platforms (receipts & payments)Instant Messaging (SMS & Email)
  10. 10. AMS 2000 Claims ManagementcapabilitiesReal time financial data e.g. visit notification, admissionnotification, dispatched invoices etc. Electronic claim switchingcapableSystem based modes of identification & verificationPhoto cardsMagnetic strip cardsMember data base/membership lists (member & non member options)Online real time validation; membership & benefits-SMS and internet basedSmart Cards with biometric integration.
  11. 11. AMS 2000 Claims Managementcapabilities- Clinicians MgtDiagnostic profile and outcomeAdmission rateReferral rate : other doctors and institutionsLab utilizationDiagnostic imaging utilizationDrug utilizationSick off ratesCost per visitCost per diagnosis
  12. 12. AMS 2000 Claims Management Provider NeedsCash Flow/timely payments/reduced claim lossesBenefits administration(membership & pre-authorization)Fraud prevention controlDebtors & customer relations managementOperational cost control (paper based claim processing fromnotification to fund remittance)Payer management (claim management process, performanceevaluation & bench marking)Proper Service Agreement / ContractsHealth Industry Standardization
  13. 13. AMS 2000 Claims Management - Payer NeedsBenefits administration(membership & pre-authorization)Fraud prevention controlLiability management/timely claims administrationOperational cost control (paper based claim processing fromnotification to fund remittance)Provider management (appointment, performance evaluation& bench marking)
  14. 14. AMS 2000 Claims Managementcapabilities- Cost MgtPerformance based parameter management reports suchas;Cost per AdmissionCost per doctorCost per diagnosisCost per wardAverage cost per schemeAverage cost per memberCapitation costs/Capitation capable
  15. 15. The benefits/pay backGrowing ICT driven competitivenessImproved market, financial and managerial performanceEvolution of new revenue stream from sale of HMIS to other hospitals providers.Development of an ICT driven franchise business model.Standardization of contracting between payers & providersOpportunity to drive use of standard codes for diagnosis, procedures and consumables

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