by July 4, 2009 0 comments

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

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.

Before Deployment
  • Hospital Information System and back-office processes such as
    accounts, inventory, billing, etc were not integrated.
  • Patients, doctors and mgmt did not have seamless access to data.
After Deployment
  • HIS integrated with SAP ERP.
  • Single point data entry; duplicacy of work avoided.
  • Better control over accounts payables and receivables, wide variety in
    MIS reports, better mgmt of corporate and TPA customers.
Implementation Partner

Suhail John, IBM

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.

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