Best Automation : Artemis Health Institute : Aadhar

Artemis is a new hospital in Gurgaon which became operational in 2007. Devoid

of the burden of legacy apps, the hospital went for the latest hospital

information system (HIS) package right from the word 'Go.' The HIS caters to the

front office operations like IP, OP, ER, pharmacy, billing, etc. However back

office operations like procurement, accounts payable, accounts receivables,

general ledger, trial balance, etc could not be carried out through the HIS and

documents related to these processes existed in independent silos. The lack of

automation for these processes and the 'disconnect' with HIS lead to delays in

monthly stock reconciliation, financial status information, profitability

analysis and cost center accounting.

To make these operations system enabled and to ensure seamless integration

with HIS, there was a need to implement an ERP package that catered to these

functions. Since the Group company, Apollo Tyres, was already using SAP for all

its functions, they decided to implement the ERP for back-office functions of

the hospital as well.

The deployment meets the functional requirements of Finance, Procurement and

Management Reporting.

Deployment challenges



Implementing SAP is a huge task keeping in mind the adoption of best practices
available in SAP. When it has to be integrated with another heterogeneous system

it becomes more complicated. Making the system integration online compounds the

challenges even further. To meet the functional requirements, there was a need

to implement certain modules in HIS while changing certain module processes to

ensure that both HIS and SAP talk to each other seamlessly.

Vinod Kalra Head - Finance Q What were the challenges and business problems that led to this project's implementation? The HIS implemented caters to the front office operations like IP, OP, ER, Pharmacy, Billing etc. However the back office operations like procurement, accounts payable, Accounts receivables, General Ledger, Trial Balance, P&L are not there in the HIS. Non availability of system enablement in these processes were leading to delay in Monthly stock reconciliation, Monthly Financial status, Profitability Analysis and Cost Center accounting. Q What according to you is the USP of this project? This is the first time in India that SAP has been integrated with HIS in seamless fashion to give the real-time picture across the systems. This project was also implemented in flat 4 months time having the huge complexity of integrating HIS (a heterogeneous system). We are planning to implement dash board reporting tool, which will be on top these 2 systems (HIS and SAP) and takes the data on line from these 2 systems and present the real-time picture to the top management and other decision making team. Q What were the key benefits gained after having deployed this project? Seamless access to both financial and medical data for each patient anytime, anywhere is the biggest achievement. We want all patients to have maximum comfort at our hospital and so have provided single-point access to information no matter where they are: in a ward, diagnostics lab, pharmacy counter, accounts dept or even at the reception.

As an example, while implementing the TPA module, there it was required that

the bills for patient and TPA insurance be interlinked to each other within HIS.

Also, there was a need to keep tab on the canceled invoices for which already

the original invoice generated had already been pushed to SAP Accounts

Receivables Modules. Implementation of International Patients Module was another

challenging task, wherein country-specific and patient-specific needs and

demands were to be met within HIS and accounted for the same in SAP.

There were multiple technical problems faced while making a seamless

integration between SAP and HIS.

Pushing data from one system to the other, for example, the billing

information from HIS to SAP, is one step and confirmation of delivery to SAP is

the next, confirmation of posting of this information into SAP is another step

and finally making this record as already 'read' and stopping it from pushing

the record again is the most important step. Here there are lot of technical

aspects involved like maintaining the sequencing of records, maintaining the

check on duplicate records, maintaining flag for read and unread records, and a

log of erroneous records.

Similarly, the request made in SAP for issuing medicines has to go into HIS

for actual issue to the patient and this information has to be made available





online to support the medicine supply to the patient on immediate basis.

Handling exceptions in this entire integration process was another major task

and the system has been designed very carefully to provision for the same.

This project has given the hospital a single system (given both HIS and SAP

are seamlessly integrated) for maintaining key information.

Technologies used



The SAP ECC 6.0 suite is hosted on IBM blade server. The blade server is
connected to SAN storage for its data and is also connected to the Tape Library

with Veritas backup software for online backups and reliable restorations. SAP

Netweaver & TOAD and the Oracle DB for HIS and SAP were also deployed. The

deployment was carried out in four months by a 20 member regular team, apart

from the project managers and functional leads.

Business benefits



It is a project envisaged to enhance the productivity and improve the
operational efficiency of the functions and reduces the time lag for getting

information to take key decisions. However, some of the benefits can be

quantified as under:

• Single point of data entry, avoiding duplicacy of work.
• Material Requirement Planning in SAP is done based on the stocks/inventory
  
  position in the HIS pharmacy locations.
• Since all departments and specialties are mapped in both HIS and SAP, the
  
  cost center details and Profit center wise analysis have become online.
• Better management of corporate and TPA (Insurance) customers.
• Easier inventory and financial results and reports.
• Reliable and secure data to meet the CIA (Confidentiality, Integrity and
  
  Availability) concept of Information Security.
• Since the two systems are integrated, the possibility of error in one
  
  system going unnoticed is eliminated

The project is expected to run smoothly over the next five years and upgrades

to systems should only be required post this period. In future, the hospital

plans to implement the dash board reporting tool, which shall sit on top of

these two systems (HIS and SAP) and take data online from them and present a

real-time picture of various departments to the top management.