YOU ARE NOW READING
Building A Digital Hospital: From The Ground Up
When I joined Medanta Medicity, it was in the project stage. A leading software vendor was finishing off consulting to Dr Naresh Trehan at that time by putting up a roadmap, from which we decided to deviate. We instead chose a staggered approach of building the IT infrastructure of the hospital.
We knew that Hospital Information System (HIS) was the key to a digital hospital, and so we went out and chose an HIS first. It is a pure transactional engine to do your patient care and to look at the patient outcome. But HIS can do billing and nothing beyond it. But how do you do your back office activities like material management, financial management and HR. So we went out and scouted for an ERP. The choice narrowed down to two solutions, with one needing around 7 percent of customization for a hospital while the other about 2 percent. We finally zeroed in on one, and pricing also played a critical role.
The next piece of the puzzle was putting in place a time and attendance system to manage the nurses. In any hospital, 60-70 percent of the staff is nurses. That is how Medicity was started.
While putting out a request for proposal (RPF) for HIS, we found out that none of the HIS outside of India has billing. This is because healthcare outside of US is the concern of the state. This is unlike in India where we have both public and private healthcare systems. So, we had a problem there. So while we zeroed implemented a solution, little did we realize that we were in for a rough ride. We later realized that they did not have package billing. None of the HIS could handle that. So, we took this journey with the vendor. We went around for eight months after going live to get billing settled out.
So the next challenge was Radiology, where we wanted replace film with a CD. So we scouted for Picture Archiving Communication System (PACS). Typically doctors like to do 3D and 4D imaging before they go for a lever or a kidney transplant. So, we got a solution which came in as a handy tool. And the best part was that the doctor didn't have to run down to Radiology. He might not get the diagnostics kind of image on his PC but he gets a first level of images on his PC which is enough to do his job. And then he can go to operation theatre (OT) and look at the diagnostics level of images. But he has a fair idea of what he is going to get into inside the OT.
Medicity was the first hospital in India to integrate HIS to SAP, Kronos and PACS. So if the doctor is sitting and looking at the record of a patient and he can click there and the diagnostic images will open up. He can click and check his reports through HIS. It is all integrated into one.
To make doctors and staff acclimatize to the HIS, we said that no radiology order or clinical lab order will be accepted manually, except in the case of emergency. So, if there is a road accident case, a manual order will be processed, other than that every order has to be placed through the system. So the usage increased. Every time the discharge summary had to be made, it had to be made in HIS. Unless, there is an increase in the use of HIS, Electronic Medical Record (EMR) will only remain a dream. So we had to put strategy around it to help the doctors use it.