The key to a successful IT implementation is not using the best technology, but how well you integrate it with your business processes. Technology, then, just becomes a business enabler. We recently saw an IT implementation that follows this rule very well. This was the IT setup of Fortis Heart Institute and Super Specialty Hospital in Mohali, Chandigarh. The institute has implemented its own homegrown hospital-information system, which fits in very well with the way the hospital functions.
The system is built using MS SQL server at the backend and VB at the frontend. Plus, there's an IIS Web server running in between, that provides a Web frontend to the whole system. This system is also connected over WAN links to the Fortis head office in Delhi, and can provide all sorts of useful MIS information there. Needless to say, that the entire hospital is completely networked, from the doctors' cabins, labs, administration cell and even the kitchen have Ethernet ports. The information system, and even the physical infrastructure of the hospital are built in a way to help improve the workflow in the hospital.
How it works
The whole system has a customer-centric focus. Here, the customers include, not only the patients, but also doctors, suppliers and other staff such as nurses and administration people. Since all have their roles to play in the hospital's functioning. The system has automated all the processes in both the OPD (Out Patients Department) and IPD (In Patients Department). In case of OPD, patients come in for consultation, to get tests done, and then go back. They're not admitted, which is the role of IPD. In OPD, every patient that comes in is registered at the reception with a unique patient ID. The reception staff, which is trained, refers patients to appropriate doctors. The patient pays up at the counter, gets a slip, which mentions the details of his appointment with the doctor. On the other hand, all the doctors have networked computers, on which they get a list of all the patients they're supposed to see during the day. For repeat patients, they can even see all the previous appointments and the history of treatment that had been given to them in the hospital. After consultation, the doctor can prescribe medicines or refer the patient for some further tests. The patient can then go back to the reception, which would already have details of the tests prescribed. The patient would then pay for the tests and proceed to the lab to get tests done.
Similarly, the pharmacy is also hooked to the same network. They will also get a list of all the patients visiting the hospital, and will have a record of the medicines being issued to them. This also allows them to keep a track of their inventory.
Similarly, most processes in the IPD have also been automated, right from the time a patient is admitted till his discharge. Everything about a patient's treatment is recorded, right from the consulting doctors, medicines and equipment used, to the food consumed. At any point of time, the registration counter can check how many beds are free in the hospital. The nurses also have access to information about which patient being located on which bed, and the kind of treatment that needs to be given. There's a system at every nurse station, which shows this information. Even the kitchen has a computer that's connected to the network. Here, an attendant takes all orders via phone and later enters them into the system. Interestingly, the computer was initially kept in the main kitchen, but later it was shifted in a sealed cabin. Reason was simple. The motherboard gradually kept accumulating oil from the cooking. A central audit department keeps track of all patient records, and the bills being raised against their names. The reports are very well structured and can be drilled into for extra detail. So, an auditor might first see the total amount for medicine taken by a patient, and can later drill down to see the exact medicines prescribed.
The radiology labs at Fortis are well equipped with the latest medical equipment, including a PACS (Picture Archiving and Communication System). This has been integrated with the hospital- information system. So, a doctor in the radiology department can see all patient records and the doctors they've consulted. There's a DVD Jukebox deployed, which is used for storing all the images. All records, therefore, are stored digitally, and can be accessed at any point of time. There's no real need for taking results on a film, other than for legal requirements, imposed by the government, wherein every patient must be given all diagnostic results on film.
Anil Chopra and Anindya Roy with Sunil Kapoor, Head IT, Fortis Healthcare