ARAS - Delivering World Class Healthcare IT Solutions R SRISHTI Software progress through creation...
The Healthcare RevolutionRoadmapHealthcare is undergoing a distinct movement along a logical 2. Chronic Caretrajectory from its historical focus on Acute Care to Long TermCare. While Acute Care deals with immediate and severeoutbreaks of illnesses, Long Term Care focuses on continuous careover a significant span of time, ideally a life time covering both -episodes of acute illnesses and exacerbations of chronic illnesses. 1. Acute Care 3. Preventive CareThis shift leads us to Preventive Care, delivered through earlydetection & treatment, resulting in reduced morbidity load onindividual and society. And finally, this logical journey ends atPredictive Care, i.e. not waiting for early signs of illness but 4. Predictive Carepredicting and thwarting it before the illness has the chance to takeroot.We are moving towards a consulting/service based healthcare withfocus on lifestyle changes and behavior adaptation toprevent/cut-out the roots of any instance of illness.There are clear challenges within the current health-care ecosystem that must be overcome before realizing the benefits ofabove mentioned revolutionary changes.Current Challenges A. Alternative delivery model to multiply reach Low reach/inaccessibility as well as insufficiency (where available) of quality care Presence of specialist doctors is restricted to the metro and major cities Low focus/risk of under-utilization of capacity (beds, doctors, nurses) Care Beds / Population of 1000 8.00 5.00 Germany Cairo 7.00 4.00 6.00 Port-said Delhi 5.00 3.00 Alex. France 4.00 USA Spain 2.00 3.00 India Egypt UK 2.00 Egypt India 1.00 Monofeya 1.00 UP Kalyubya 0.00 0.00 B. Integrated Healthcare Information Fragmentation of patient data and medical know-how across entities Fulfillment in the ecosystem Specialist Lack of one-point complete patient record Orthopaedist, etc. High Cost/Low Productivity due to bottom-up recreation of diagnosis/analysis at every instance Healthcare Patient Data Entities
C. Alternative transaction models . 2. Chronic Care Business models are currently focused on Acute Care across the healthcare ecosystem. Models 1. Acute Care 3. Preventive Care catering to Chronic, and more advanced Preventive Care need to be explored by insurance companies and healthcare service providers The current payment 4. Predictive Care alike. models, focus mainly on Acute CareBut, at the base, are technologies ready to convert these challenges into opportunities - and make the revolution actually happen?PARAS - The Healthcare IT Suite from SrishtiSrishtis Healthcare IT solutions support modern healthcare service providers with future proof initiatives, best in class deliverymodels and emerging technology conformance. To address the need of various hospitals at different stages of their HealthcareInformatics deployment, Paras comes in three different configurations - Paras Lite, Paras and Paras Premium. This ensures thatour customers need not change their platform with their growing needs and changing work flows. Basic philosophy behindPARAS is to achieve integration of entire spectrum of healthcare technology enablers and is built using Srishtis powerful tool-kitapproach. This two pronged strategy ensures that healthcare services dont hit a technology roadblock as business modelschange. PARAS is the answer to the need for a one-stop technology solution for healthcare service providers. Healthcare Management IT Platform v 5.7 Public Portal Patient Portal Clinician Portal eGov Portal Bedside Monitors Specialty Formsets Clinical Protocols Isabel CDSS KPIs / QOFs Disease Registries Bio Terrorism Alerts DICOM Devices EHR - CPOE EHR Centric Modules - Nursing, Consultant, OT EHR - eMAR Disease Surveillance Lab Equipments RIS, PACS & Image LISIntegrated EHREB BB, CBB eMAR Pharmacy CSSD, eMAR Diet, Therapy Clinical Analysis RFID Tags ADTRF Mgmt IP - Bed / LIS Mgmt Ward IP - Billing Mgmt Plan & Payer Mgmt Business Analysis Smart Card Registration Mgmt OP - Clinic Mgmt OP - Billing Mgmt Help Desk Mgmt Actuarial Analysis Ambulances HR & Duty Mgmt Finance Mgmt Procurement & SCM Support Services Mgmt Program Effectiveness PACS Repository Application DB ICD 10 / SNOMED-CT Knowledge Repository PACS: Picture Archival and Communication System BB, CBB: Blood Bank, Cord Blood Bank RCM: Revenue Cycle Management eGov: Electronic Governance RIS: Radiology Information System LIS: Lab Information System CDSS: Clinical Decision Support System QOFs: Quality Outcome Frameworks SCM: Supply Chain Management IP Mgmt: In-Patient Management OT: Operation Theatre KPIs: Key Performance Indicators Ref / FU: Referral / Follow up CPOE - Computerized Physician Order Entry CRM: Customer Relationship Management eMAR: Electronic Medication Admin Record ADT: Admission, Discharge, Transfer EHR: Electronic Heath Record EB: Eye Bank CSSD: Central Sterilization & Supply Dept. Salient Features Salient Features Fully compatible with NABH & JCI criteria Best in class image recording & communication platform Conforms to HL7, HIPAA & ITIH standards Clinical Pathways conforming to global standards Capable of integrating with standard CMVs like ICD 9, Integrated with ISABEL CDSS, world’s best clinical ICD 10, CPT 4, SNOMED CT etc. decision support system Internationalization & localization with multilingual Modular approach to deployment & implementation support Capable of generating clinical performance indicators Fully functional EHR integrated with relevant modules
Hospital Management Information System (HMIS) KPI Reports Isabel CDSS Clinical Pathways CPOE Module Integrated EHR Module eMAR Lab Investigation Order Handling Demographics Physician Ordering Radiology Request Management Allergies & ADRs Drug Interaction Validation ADT Order Handling History Details Pharmacist Dispersing Procedure & OT Request Episode & Problem Details Nursing Compliance Nursing Order Handling Review of Systems Nursing Station Charting Physical Examination Clinical Notes RIS Module Drawings & Image Management LIS Module Protocol Management Radiology Workstations Lab Admin Microbiology Specialty Specific Formsets Image Storage Management Lab Store Cytology Standing Orders Image Manipulation Haematology Histopathology Disease Registries Analysis & Reporting Biochemistry Immunology Pharmacy Module Support Services Module Pharmacy Store Management Operation Theater Management House Keeping & Laundry Pharmacy Request Management Central Sterilization [CSSD] Vehicle Management Pharmacy Cash Management Blood Bank Management Building Maintenance Cord Blood & Stem Cell Management Library Management Diet & Kitchen Management Eye Bank Management ERP Module Human Resource Management Material Management Finance Management Employee Database Stores Management Accounts Payable /Receivable Leave Management Equipment Management Statements of Accounts Payroll Management Inventory Management General Ledger Duty Roster & Personnel Asset Management Cash Flow Analysis Performance Management Vendor Management Profit & Loss Statement Purchase Management Trial Balance / Balance Sheet PAS & CRM Module Registration In-patient Management· Billing Patient Registration Admission Management General Billing Token Management Discharge Management Advance Payment Telephonic Registration Transfer Management Package Billing Web Registration HL7 CDA Documents Lab Billing Investigation Billing Ward Management Appointment & Scheduling Corporate Billing Bed wise patient details Clinician Appointment Insurance Billing Vacant bed status Lab Scheduling Final Settlement Bed utilization report Radiology Scheduling Bed / ward nurse roster OT SchedulingPARAS LitePARAS Lite, an out-of-box product has been created by retaining the essential PARAS modules & is targeted atSmall & Medium hospitals, and IT starters among big hospitals.PARASPARAS is an end to end customizable solution for a hospital providing Complete Clinical & Administrative Integrationacross the enterprise including highly sophisticated integrated EHR.PARAS PremiumThe PARAS Premium is a framework based solution and is targeted at hospital-chains with number of beds numbering inthousands. This high-end solution handles, at a centralized location, the heavy-duty data management and complexinformation access needs of all branch hospitals. Moreover provides Complete Clinical Informatics Framework conforming toInternational Standards.Tele Medicare SolutionTele Medicare is a rapidly developing aspect of clinical care where Medical & Health information is transferred via Telephone,Internet or other Networks to facilitate Consulting, Assessment or for Performing Procedures. Srishti’s Tele MedicareSolution, anchored at both ends to an integrated EHR & HMIS, provides Unfragmented and CompleteClinical & Administrative data to all stakeholders at point of care.Thus, PARAS products address all the segments of the market. This facilitates the customer to grow on the same platformwithout changing the solution as and when their business & IT needs grow.
Integrated Electronic Health Record System (EHR)At the heart of Srishtis PARAS is an Integrated Electronic Health Record – EHR, a complete, updated and accurate onepoint patient clinical database across entities in the healthcare universe. Summary EHR Home Health Info Location EPR Social Workers Specialist EPR EHR GP Nursing EPR Aged Care EPR Large Hospital Path Lab Local Hospital Imaging LabRIS & PACS PARAS’s RIS can work as a stand alone module or with a PACS server - own or institution’s existing server. Remote Teleradiology DICOM Modality Workstation PACS Server Radiology DICOM Modality Workstation Radiology WorkstationeMAROver & above a standard eMAR module (diagram 1). Paras has a robust drug interaction alert generation (diagram 2). Interaction Level Alert Type Pharmacist: Dispenses medication Level 5Physician:Writes order for medication. The Staff Nurse: Fatalapplication in the background Is notified that orderedchecks for possible interaction medication is availableusing the “Drug Interaction Alert” for administration Level 4functionality Electronic Medication Administrative Record Level 3 Data: Staff Nurse: Is added to patient’s Verifies and cross electronic medical record checks against medication order(s) Level 2 Mild Staff Nurse: Completes medication administration and electronic documentation Level 1 eMAR diagram 1 eMAR diagram 2
Isabel: The Award-Winning Diagnosis Reminder SystemIsabel is a validated, web-based diagnosis decision support and knowledge mobilizing system with accuracy of morethan 91% designed to help reduce and manage diagnosis error at the point of care.Isabel addresses the causative factors that have a significant impact on the level and quality of patient care.Diagnosis error – a compelling patient-safety issueMedical diagnoses that are wrong, missed, or delayed make up a large fraction of all medical errors and cause substantialsuffering and injury. A 3-year project by the Cook Country Rush Developmental Center for Research in Patient Safety,funded by the Agency for Healthcare Research and Quality (AHRQ) and published in 2005, found that 10 – 30% oferrors are errors in diagnosis and the diagnosis errors far outnumber medication errors as a cause of claims lodged. Areview of 53 autopsy studies found an average rate of 24% missed diagnoses. A 2006 Medical Liability Insurance study found that errors in diagnosis were the leading allegations of closed claims. In Family Medicine, Internal Medicine, Pediatrics and Radiology more than 50% of lawsuits alleged a failure to diagnose. Source : ProMutual Group study reported in the American Medical Association Newsletter, March 2006.Failure to consider reasonable alternatives – single most common cause of misdiagnosisA 2005 Veterans Administration study funded by the National Patient Safety Foundation analyzed cases of diagnostic errorinvolving internists and found that cognitive factors contributed to diagnostic error in 74% of cases. Premature closure, i.e., thefailure to continue considering reasonable alternatives after an initial diagnosis was reached; was the single most common cause.Isabel addresses the very issue of premature closure and has been proven in clinical studies to minimize diagnosis error byreminding physicians to consider important diagnoses.Constructing a complete differential diagnosis – reinforcing basic medical trainingProfessor Arthur Elstein, PhD at the Department of Medical Education and the School of Public Health at the University ofillinois at Chicago, and expert on diagnostic reasoning in clinical medicine, spent a lifetimes work on answering questions suchas: How do physicians make decisions? How can we help them make better ones? Elstein has suggested the value of compilinga complete differential diagnosis to combat the tendency to premature closure, the most common cognitive factor identified tocontribute to diagnosis error. Medical students and residents are trained to construct a complete differential diagnosis for eachpatient. Diagnosis Reminder System Isabel, either as a standalone system or interfaced with PARAS EHR system gives dynamic clinical decision support, enabling clinicians to: Quickly obtain a list of likely diagnoses including bioterrorism diagnoses and causative drugs for a given set of clinical features Learn more on investigations and treatment for each diagnosis, either through a cursory quick-read, a more detailed read, or clinical information on bioterrorism from the CDC, USA Access the clinical lessons learned and errors that have been reported in relation to the diagnosis being considered View diagnosis specific annotated images or helpful list of investigations that can be performed to confirm or rule out a diagnosis Stay up to date with recent advances clinically sorted into diagnosis categories - and avoid time consuming office research using online and library resources
Testimonials..."Isabel suggested the correct diagnosis in 98% cases. Decision-support systems can help doctors avoid falling victim to"premature closure" - the tendency to focus on one diagnosis that seems to explain all of the symptoms, then stopconsidering other possibilities." Mark Graber MD, Chief of Medical Service at the VA, Northport, NY, quoted in the Wall Street Journal. Nov 2006“There had been software products over the years ... but Isabel was the most sophisticated product I had ever seen," Leslie G. Selbovitz, MD, Senior VP for Medical Affairs & CMO, Partners Newton-Wellesley Hospital, interviewed Oct 2007"Isabel is a great tool for difficult to diagnose cases!" Mary Lynn Allen, MD, VA - Gainesville, FL"I am impressed with the concept and its execution. This is an innovative product that I think may soon be proved to havesignificant clinical utility, particularly if integrated into EMRs so that the system can operate in the background and beselected when needed, with minimal effort from the clinician. In a world of exploding biomedical knowledge, and limitedhuman cognition, the arguments in favor of Isabel and other decision support systems are compelling. I will watch for thepeer-reviewed results of further study with great interest. Institutional and individual buyers should definitely give it alook." Gary Kantor, MD. Case Western Reserve University February 2006"Several features I feel are innovative and useful for my practice as a pediatric infectious diseases consultant. TheDiagnosis Reminder System is useful to check my differential diagnosis list against. The regional preferences searchoption is one I like a lot, because of the importance of travel history and geographic exposure patterns to many of myconsults. For teaching and communicating with trainees and families, the Lessons Learnt and Whats New options giveme ready access to potentially interesting PubMed articles. I find Isabel unique and uniquely helpful" Jeff Mckinney, M.D. Ph.D. Assistant Professor In Pediatrics andMolecular Microbiology, Washington University School of Medicine, St. Louis, Missouri Dec 2005"Implementing PARAS has immensely enhanced the customer experience that we offer to our patients. Using PARAS, therelevant details of the patients of Narayana Nethralaya are recorded and preserved in computer systems and one canretrieve the same by just entering their name or registration numbers into the computer systems during their future visitsto the hospital. Thus resulting in effective utilization of the time and immediate treatment to the patients by having theirElectronic Medical Record available at finger tips to our doctors and other concerned staffs." Dr Bhujang Shetty, Director, Narayana Nethralaya, Bangalore.“Srishti Software has worked with us to improve every area of our hospital, from helping us to improve our productionflow and order entry processes, to reporting functions. All of this has helped us to provide excellent patient care." Dr. Manjunath, Medical Director, Sri Jayadeva Institute of Cardiology, Bangalore.“Srishtis Healthcare Suite Paras has helped us achieve full automation and better patient care. All administrative & supportprocesses like Registration, Billing, Store, Pharmacy, Labs; are now online. Optimal utilization of resources have reduced costs.Availability of pertinent information at point of care has improved clinical outcomes. Logical scheduling has reduced waitingtimes - leading to greater patient satisfaction. Dr. Jeetendra Kumar, Director, Mahavir Cancer Sansthan
Our Delighted Customers Include... Zydus Hospitals & Healthcare Research Pvt. Ltd., Isabel Clientele Ahmedabad- Multilocation Centre for Sight, New Delhi- Multilocation Rajiv Gandhi Cancer Institute & Research Center, New Delhi SUT Hospitals, Thiruvananthapuram- Multilocation KG Hospital, Coimbatore Narayana Nethralaya, Bangalore- Multilocation TATA Chemicals Hospital- Multilocation Sri Jayadeva Institute of Cardio Vascular Sciences & Research- Multilocation Mahavir Cancer Sansthan, Patna Prashant Memorial Charitable Hospital, Muzaffarpur Awards & Recognition Isabel has been extensively featured in Fox News (Dec 2006), Wall Street Journal (May 2005 & Nov 2006), CBS (May 2006), New York Times (Feb 2006), Forbes (Aug 2005) and CNN (Oct 2004). Isabel has had editorials and reviews in key medical journals, including The Lancet, the British Medical Journal, Journal of Intensive Care and Archives of Disease in Childhood. Peer reviewed articles and results of clinical studies have been published in Archives of Disease in Childhood, Journal of the American Medical Informatics Association, Medinfo 2004, Journal of Intensive Care Medicine, Health Management. Technology and BMC Medical Informatics and Decision Making. Winner of the 2005 Frost & Sullivan Healthcare Information Technology Product Innovation of the Year Award Stay up to date with recent advances clinically sorted into diagnosis categories – and avoid time consuming office research using online and library resources. Recognized as one of the "outstanding and innovative developments within the IT sector" at the 2002 British Computer Society IT Professional Awards. A few accolades... “For demonstrating excellence and growth in the IT channel business.” Channel World, Fast Track 100 Awards, Honouree 2008 "Consistently among the top 100 IT innovators in India” NASSCOM Survey, 2007 "Among the FIVE most promising Indian IT companies to look out for” Information Week, 2005 “One of the most innovative IT companies in India” NASSCOM, Feb 2005 R SRISHTI Software progress through creation... INDIA UK Srishti Software IntelliApp Solutions L-174, 6th Sector, HSR Layout Suite 5-6, 46 Dorset Street Bangalore - 560 102 London W1U 7NB Karnataka, India United Kingdom Ph: +91 80 4110 9060/ 61/ 62/ 63 Ph: +44 750 246 0465 Fax: +91 80 4110 9064 Fax: +44 207 224 3838 E-mail: firstname.lastname@example.org E-mail: email@example.com www.srishtisoft.com All trademarks & brands are the property of their respective owners.