Recently, Fortis Hospital, Mulund was awarded the Asian Hospital Management Award (AHMA) 2015 for ‘Innovations in Healthcare IT’ for its effective use of IT to improve healthcare. Satish Sinha – HOD, IT, Fortis Hospital Mulund, speaks about how HIS has helped in improving efficiency within the hospital, in an interaction with Raelene Kambli
Congratulations on receiving the ‘Asian Hospital Management Award 2015.’ What does it mean to you to achieve this award?
The AHMA platform has provided Fortis Mulund IT team an enviable position in the IT space. To be able to showcase our work amongst the best hospitals in the Asia-Pacific Region is an honour to say the least. This award reinforces our efforts in working towards an efficient and IT-enabled healthcare unit. It reinforces that innovations in the back-end can impact process efficiency at the front-end and gives us and our user-departments a tremendous boost to continuously design solutions and leverage information technology to the fullest. What was truly remarkable is the culture change amongst end user and increased adoption, leading to new requirements coming from them.
Tell us about this award and the criteria for winning it?
The IT team won the AHMA 2015 for the category ‘Innovations in Healthcare IT.’ This award is given to hospitals in the Asia-Pacific region who have implemented innovative projects and best practices. The solutions developed facilitates the caregiver fulfilling their primary role of caring the patient. The criteria are centered around recognising initiatives working on the issues of patient safety/ quality/ operational efficiency of the healthcare delivery system with simple solutions to operational problems of healthcare provision.
Did someone nominate you? How did it happen?
The projects are selected at the hospital-level by the Zonal Director along with senior management group under various categories. The best projects and outcomes are uploaded on the AHMA website. These nominations then go through a rigorous round of selection (initial screening, comments by advisors and final selection). The judges are from healthcare industries. An esteemed panel is drawn from representatives of Joint Commission International (JCI), John Hopkins Medicine International, members of the advisory board, distinguished members of the hospital industry etc. This year, the awards committee selected winners from 361 entries out of 101 hospitals across 12 countries. The awards were presented at an awards ceremony in Yangon, Myanmar in the presence of more than 1500 hospital delegates attending the Hospital Management Asia Conference.
How did you manage to increase operational efficiency within the hospital?
Fortis Mulund is a multi-speciality, tertiary care hospital in Mumbai and part of the fast expanding Fortis network. One of the 2014-15 focus areas being patient care, Mulund Management lead by the Zonal Director undertook the challenge to enhance patient services across multiple touchpoints. Our team recognised that while patient-communication was crucial, there was dire need to improve data input points, especially at front-end employee-level. Data-sharing with management/ patients needed to happen with minimal human effort so that employees could focus on patient care/ service-delivery. Data-analysis/ MIS-generation through authentic system-generated data was crucial. At this point, our IT team’s role became vital, the situation was analysed to bring in-house solutions.
So, what objectives were set to bring about this change?
- Enhance patient experience with error-reduction
- Increase efficiency with minimum human-effort/ optimum use of technology
- Real-time data-tracking for reporting/analytics, enabling better operational management/governance
And how did you go about doing so?
We did it in the following manner:
We created a patient-interface.
Call centre: Creation of single point-of-contact improving accessibility by centralising doctor appointments/ health-checks/ diagnostic-tests
Diagnostic-tests tracker: The application displays all diagnostics OPD/ inpatient/ health-checkups in single platform helping in effective tracking reducing patients’ waiting time
Estimations/ financial counselling: Web-application tracks bills against estimations in real-time. Help in identifying financial-counselling need so that attendants could plan finances realistically
Bed management: Integrated with current HIS for beds-allocation. Admission waiting time reduced due to efficiency provided by the system
Billing updates: Relatives are informed regarding bill amounts payable everyday though an auto-SMS to primary patient-attendant
Refunds: Instant notification regarding TPA refunds
Pharmacy first indents: Nursing station alerted pharmacy about new admissions through phone. Tracking of first indents/ delivery was not happening on time. Automated spreadsheet integrated with HIS tracks data real-time and pharmacy is aware when medication is administered
Complaint management: Inpatient complaints picked by patient-care were escalated to user-departments. Module enables complaint-logging, if not closed is escalated to next level through system. Turnaround time tracked to improve patient satisfaction
Then we went on to create platforms for operational efficiency/ governance-perspective through:
Emergency alert: In case of RTA/ mob/ potential attack etc. SMS is sent through company-webpage to a user-group with customised content (location/ reason etc.) to be available for crisis-management
Doctor-wise consultation report for performance management
Pending purchase-orders: Purchase/ stores created manual POs. Online-tracker created showing pending POs.
Outgoing-calls tracking for cost-effectiveness
With success of these initiatives, IT was able to bring a paradigm shift in the hospital culture – moving from manual to an automated-mode of working at zero-cost.
Prior to developing the HIS system, what was the efficiency rate, if measurable? Can you explain to us in terms of patient flow, operational expenses, profits, waste management etc?
The hospital already has a HIS system. It flows from the process of patient admission till discharge including all tests, doctors consultations etc. The IT team, based on user-requirements, developed value-added plug-ins compatible with the current platform. e-ICU (all patient related data from the devises like ventilator, patient monitor, syringe pump) are centrally stored and can be seen anytime which has enabled ICU to become paperless. Patient first indenting alerts are available to the pharmacist which helps to start medication faster and in a safer manner. Features also include e-medical records (all records related to patients are available online which helps patients’ further medical care), reports are available online (PACS doctor can do reporting from anywhere and the report can be seen. Patient can be treated without any delay), OPD tracker (information is available with all departments for quick service to patients), the diagnostics tests tracker (reduce patient services time from department to department), web-application for bill estimates, and escalation matrix for complaint management. A lot of automated MIS reports analytics will help in delivering care. These are some of the innovations that the team has designed which reduced unnecessary manual work for staff and improved efficiency, giving them more time for serving the patients.
What were the benefits?
Effective manpower utilisation due the automation, analysis of real-time data, standardised information dissemination were just a few of the organisational benefits. Customers’ experience enhanced due to better accessibility, reduced waiting times, proactive approach of bill-updates, faster turnaround time of complaints closure etc. With these interventions, the hospital institutionalised a culture of leveraging technology. Employees across functions are conscious of the technology-advantage hence there is a constant need to explore ways to utilise IT for better performance/ outcomes.
You also speak of small innovations within the hospital. Can you throw some light on the same?
Fortis Mulund’s vision for ‘patient care’ transformed into a reality on the ground-level through innovative use of technology. With due diligence, the IT team converted manual/ conventional methods of performing tasks into automated systems, making lives of end-users simpler. Process efficiency was created through real-time data-capture, easy accessibility and error-reduction. Tracking mechanisms and analytical reports were incorporated for better management/ governance.
Seamless integration of the new applications with current HIS is the project’s USP, which makes the model-design easily replicable. The CIO is now exploring ways of replicating these apps across the Fortis network.
Lastly, do you think that e-health is poised to revolutionise healthcare delivery in India and why?
Digital health is top-of-mind for both consumers and providers these days, as patients increasingly demand online access and interactivity from their healthcare providers. Smart mobile devices and applications will be at the core of global healthcare transformation. Working hand-in-hand with cloud computing, social networking platforms and big data analytics, these transformative technologies will continue to lead the ways to rein in cost-efficient services, broaden accessibility, transform behaviour and improve outcomes. Ehealth is all set to revolutionise India.
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