A role oriented requirements analysis for ERP implementation in health care Organizations

Document Sample
A role oriented requirements analysis for ERP implementation in health care Organizations Powered By Docstoc
					                                                               (IJCSIS) International Journal of Computer Science and Information Security,
                                                               Vol. 8, No. 8, November 2010




           A role oriented requirements analysis for ERP
            implementation in health care Organizations
                                                Kirti Pancholi1, Durgesh Kumar Mishra2
                            1
                             Acropolis Institute of Pharmaceutical Education and Research, Indore, MP, India
                                  2
                                    Acropolis Institute of Technology and Research, Indore, MP, India
                                 kirtipancholi@acropolis.edu.in, mishra_research@rediffmail.com


 Abstract- Information is worthwhile only if it can be accessed at the            II. WHY ERP INTRODUCE IN HEALTH CARE INDUSTRY
 right time, by the right person & is useful for the purpose defined.       Healthcare is yet another booming industry that enjoys
 Health care providers have a strong tradition of safeguarding              unlimited growth opportunities through the globe. The obvious
 private health information. Today's world belongs to Information           reason is that science and technology leads to both vices and
 Technology. With information broadly held and transmitted
                                                                            virtues. The diseases are rapidly multiplying at a rate faster than
 electronically, the rule provides clear standards for all parties
 regarding protection of personal health information. Medical               the invention of medicines. No doubt it has become a very
 resources integration concerns has also been a long-standing               lucrative profession be it medical professional or paramedical
 problem, which need to work in collaboration with information              professional or corporate hospitals. Some of the reasons for the
 technology, aiming at a common goal. The complexity and                    increased usage and preference of ERP are as follows [9] [10]:
 extension of roles of the planning system demand extensive
 seamless integrations in the organization. Medical enterprise                A. Computerization
 resources planning (ERP) integrates each level of healthcare staff                   ERP function becomes very important in this context.
 by providing information and knowledge in timely manner,
                                                                            The attitude of personnel in hospital industry is quiet different
 making the ERP a synchronizing solution for all the roles required
 in the organization for various timely decision makings. From this         from that of the others. When people quickly respond to
 motivation, this paper proposes a role-oriented requirement                computerization and automation it is practically difficult for the
 definition analysis for ERP implementations in the organizations.          trend to follow suit in hospitals. The reason is doctors are
 Integrated hospitals need a central planning and control system to         keener to update about medical terminologies and surgical
 plan patients’ processes and the required capacity. Given the              trends than any about any other office equipment. This has also
 changes in healthcare one can ask the question what type of                increased the percentage of ERP use.
 information systems can best support these healthcare delivery                       This could not last for a long time. The situation
 organizations. We focus in this review on the potential of enterprise      changed slowly. In addition to the other departments medical
 resource planning (ERP) systems for healthcare delivery
                                                                            and paramedical professionals have taken the necessary steps to
 organizations.
                                                                            keep them abreast of the latest technology as it is directly or
 Keywords: Patient Logistics, Planning and control, clinical                indirectly connected with the profession. ERP function helps to
 management, ERP, AP.                                                       achieve this.
                                                                                      The concept of enterprise resource planning has made
                         I. INTRODUCTION                                    the process of segregating bills and patient records much easier.
         Information technologies in healthcare is more about               This industry also realized the need to adapt to ERP. Hence the
how it originally developed for manufacturing are fitted to                 industry was able to save more lives (but at the cost of an
support clinical and administrative work in hospitals. Common               individual's privacy) as it enabled to access the database of
denominators for these information technologies are Enterprise              patients and medical histories through the common database
resource planning systems or simply ERP. As the healthcare                  shared by hospitals and that too at a quicker rate.
sector faces increasing demands from political and public sides
to document increased cost- effectiveness, to make optimal use                  Avenues for earning
                                                                               B.
of still more scarce resources and to improve the quality of                    The scope of medicine gets enlarged at a devastating
patient care, a number of IT vendors Endeavour in a quest to          rate. ERP architecture is an important factor in this area. What
help healthcare organizations to gain control over their business     was considered as service in the yesteryears has become a
processes. My research is concerned with the issues that arise        service industry in commercial jargon. As hospitals multiply at
when an IT-solution, based on rationalistic models of                 a fast pace there is a constant urge to induce professionalism
Healthcare best practices meets clinical practice and the work        and best practices in the industry.
that needs to be done in order to align the solution to praxis or               In this context patients demand more than the previous
sometimes vice versa. Enterprise resource planning (ERP)              days. They naturally want the best return for the money. When
is a company-wide computer software system used to                    the industry is developing at a great speed with the two
manage and coordinate all the resources, information, and             elements namely business and service gets stirred in
functions of a business from shared data stores. An ERP               proportions. And in this situation no hospital can continue with
system has a service-oriented architecture with modular hardware      the old age practices and technologies and still charges heavily.
and software units or "services" that communicate on a local area     Therefore it becomes imperative for hospitals to adopt the latest
network. The modular design allows a business to add or               trends in terms of technology and acumen in order to retain
reconfigure modules while preserving data integrity in one shared     customer loyalty. There is no need to advocate hospitals to get
database that may be centralized or distributed [6] [7].              the latest medical equipments or follow the medical practices. It
                                                                  120
                                                                      happens naturally otherwise their survival will become a
                                                         (IJCSIS) International Journal of Computer Science and Information Security,
                                                         Vol. 8, No. 8, November 2010
question mark. However after repeated experiences and acid                    Enable the Growth of the Hospital ERP Administrator
tests hospitals have become prune to investing in latest                      Administrator Plus streamlines and integrate the
technology like ERP and at the same time justify their cost.                   operation processes and information flow in the hospital
                                                                               to synergize the resources namely men, material, money
C. Pressure from patients                                                      and equipments through information.
          Hospitals were not few and far between in the olden                 This ERP facilitates hospital-wide Integrated
days. Hence the patients yielded to the demands of hospitals                   Information System covering all functional areas like
every time even if it meant lesser quality of treatment for the                out & in Patients Billing & Management, Patient Beds,
charges because they had no other choice. This is evident from                 Visiting Consultants, Medical Stores, Pathology
ERP systems definition.                                                        Laboratories, Radiology Laboratories, Imaging,
          The rate of hospital expansion is alarming. They have                Pharmacy, Manpower Management, Kitchen and
mushroomed every where. Patients are no more at the mercy of                   Laundry Services etc.
doctors but it is vice versa. When a patient is not satisfied he              It performs core hospital activities and increases
will not visit the hospital anymore. ERP systems definition will               customer service thereby augmenting the overall
prove this better.                                                             Hospital Image. ERP bridges the information gap across
          When it comes to treatment there should not be more                  the hospital.
than minor discrepancies among hospitals that are off at the                  Administrator Plus eliminates the most of the business
same standards. One parameter for measuring the quality of                     problems like Material shortages, Productivity
treatment is the technology involved in offering it. This                      enhancements, Customer service, Cash Management,
technology not only creates a level of comfort but also helps the              Inventory problems, Quality problems, Prompt delivery,
patient to be confident that he is receiving the best treatment.               Pilferage, TPA Billing etc.
          Consumers themselves demand tools like ERP and
strongly rate it when it comes to the question of embarking with            Key Features
the hospital environment. There can be no wonder in saying                   Administrator plus (AP) is a fully-integrated, Hospital
that they have proved to be an important factor for influencing                 Information System Solution.
the hospitals to go for ERP. ERP review software helps them to               AP gives a total integration of order entry systems,
decide the appropriate software.                                                administrative system, and departmental subsystems
                                                                                within a hospital.
 D. Reduces operational costs
                                                                             AP allows for scalability, reliability, efficient data
         Enterprise resource planning helps to bring down the
                                                                                processing, quick decision making, reduced maintenance
cost of operations. Based on the requirements the hospitals can
                                                                                and overheads.
go for best of breed or enterprise applications. This is an
                                                                             The data is stored in a single database providing real
important step that helps hospitals to decide the appropriate
                                                                                time data across applications throughout the hospital.
software.
                                                                                Since all the data is stored centrally, it can be viewed
         Hospitals can reduce their overheads through ERP as it
                                                                                simultaneously from multiple terminals giving all
helps to integrate all functions namely accounts , finance ,
                                                                                departments' access to
human resources and bring them systems under one common
                                                                                timely, up-to-date patient information.
database on the basis of ERP architecture.
                                                                             Administrator Plus offers a foolproof data security
                  III. ERP IN THE HEALTHCARE                                    without user intervention to archive data.
         ERP present an organization with operational and                    AP is a comprehensive information system dealing with
technical advantages, as well as a set of tangible and intangible               all aspects of information processing in a hospital. This
financial benefits. In addition, ERP can provide number of                      encompasses human (and paper-based) information
benefits to health care organization. Human recourse can                        processing as well as data processing machines.
benefit from an ERP implementation due to centralized                        As an area of Medical Informatics the aim of Admin
scheduling. In addition, for billing, laboratory, pharmacy and                  Plus is to achieve the best possible support of patient
patient records can help in the anticipation of internal                        care and administration by electronic data processing.
workflow.                                                               Modules
The planning process of ERP in hospital environments:                   As fig 1 ERP AP devised the following modules according to
         ERP Administrator Plus integrated new generation               the requirements of a Multi Specialty Hospital and they
hospital management software which converges latest                     integrate the various departments into a comprehensive system.
technology and your administrative process to manage work
process within the hospital. This is designed for multi-specialty
hospitals, to cover a wide range of Hospital administration and
management processes. It is an integrated client server
application which uses Microsoft technologies as Front End and                                      Figure 1
Flexible back end (like Oracle, SQL, etc).
Objective:
   To provide an integrated Solution for the Hospital, which
helps in Efficient Management of the Hospital? [11]
     Enhance Patient Care
     Improve work efficiency
     Improve Fiscal Control                                                                   Figure 1: ERP Modules
                                                                  121
     Eliminate the chances of any Pilferage
                                                            (IJCSIS) International Journal of Computer Science and Information Security,
                                                            Vol. 8, No. 8, November 2010
The various modules of ERP Administrator Plus are [8]:                     defined for various categories/ penal/ time etc to the patient
      a. Reception Management                                              with his Patient ID. The Payment is collected for the service
           Reception is the first point of interaction for anybody         provided and a receipt is generated.
coming to the Hospital. It has all the information of the                            This module works as an interface with the diagnostic
patients, doctors, departments and activities of the Hospital. All         modules. All services will be automatically entered into the
enquiries and appointments are scheduled through this module.              respective modules wherever required like lab & Imaging
All information available here are in real time and any enquiry            reporting.
about the patient status, Room Status, Doctors availability or                  e. Investigation Reporting
tariff's for various services is on actual status since the data is                  In the routine functioning of a hospital, various types
constantly updated.                                                        of investigations are carried out. Carrying out number of tests
This module comprises of the following components                          and making the results available promptly is very crucial for
     Patient Enquiry: This will provide information of any                assessing the patient's medical status and deciding on the further
          patient like: Patient status, Name, Address or any other         course of action.
          demographic detail.                                                         Investigation requisition can be auto-generated
     Consultants Enquiry: Any Information regarding a                     (through OPD billing or IPD) or can also be generated here,
          visiting Consultant can be obtained like consultant's            depending on the system followed in the hospital. The tests
          availability, days & time of availability, Department,           parameters are pre defined with the interpretations & formulae
          specialization or any other.                                     wherever applicable. The test results are entered into the
     Tariff Enquiry: This option can be used to enquire about             software manually or with equipment integration and a
          the tariffs of the hospital. The tariffs are classified into     descriptive smart report is printed after verification and
          departments. Enquiry about any service provided in the           validation.
          Hospital can be made.                                                 f. Indoor Patients Management
     Appointments Scheduling: This option allocates the                             The Indoor patient module commences when the
          slots for various consultants. Any appointment can be            patient is being registered and allotted a bed in the ward. It
          booked either by phone or visit, enquired and cancelled.         deals with the complete treatment and services provided to the
     In-patient Enquiry: Any enquiry can be made for any                  patient during his stay in the hospital.
          indoor patient in the Hospital. The enquiry can be made          This module works at the nursing station. During his stay in the
          as per the Name, Address, Department, Bed, Ward,                 hospital, every patient is provided various services in terms of
          Patient Registration Number, etc.                                consultant’s visits, investigations, procedures, medicines &
      b. Patient Registration                                              consumable, room services, diet, etc. All these services are
           Every patient who visits the hospital has to get                entered online to the patient record through nursing station. It
registered prior to getting any consultation, treatment or                 also interacts with the Investigation module, Store, Pharmacy
investigations done. Registration of patients involves accepting           and sends the requisitions to these departments. This data serves
certain general and demographic information about the patient.             as major input for the IPD billing.
The patient is allocated a unique Registration number and a                IPD Billing
Patient Identification number. The Patient ID will remain same             Indoor billing module has a supervisory role. The entries for
for his all subsequent visits to the hospital whereas he will be           billing are automatically transferred to the patient bill by the
allocated a new registration number on every visit. The                    respective departments, which provide the service. The services
consultation charges (if applicable) can also be collected for the         are charged as per the category/panel/package applicable.
OPD patients during registration and a receipt will be                     Here the bill is compiled and the payment collected from time
generated.                                                                 to time. Provisional and Final bills are generated which
      c. Out Patient Management                                            provides complete information about the Services availed, its
           After registration an OPD Card is printed for the OPD           Charges, Advance collected, appropriate Receipts, Refunds,
patients, which list all his registration information. This card is        Credit notes, Concession allowed, etc.
used for the prescription writing by the consultant. An
Admission form is printed with all the registration details for            Optional Modules
Indoor patients, which serves as the cover page of the patient                  Hospital Store
file.                                                                                This module deals with the inventory of all Hospital
           After the registration the patient comes to the                     Equipments, Materials, Consumables, and Medicines,
consultation chamber, where the consultant records his history,                Implants & Asset items in different departments of the
diagnose and prescribe medicines & investigation.                              hospital along with their purchase and supplier details.
The Consultant note down the following details on Patients                     Requisitions for different items/equipment are sent to this
OPD Card like Complaints, History, Diagnosis, Investigation,                   store from different departments and accordingly the Central
Medicines, Advice and Next Visit                                               Store issues items/equipment to various departments and
           This information is then entered into the patient data              generate purchase orders for purchases. This also maintains
by the consultant or the operator at the OPD Counter. It serves                records of purchases, stock, and supplier list,
the purpose of tracing patient's visits history and also as a                  item/equipment/material master tables.
feedback for research & analysis. The prescription can also be                       The Store module ensures that there is a round the
scanned and saved. The scanned data can be entered later into                  clock availability of a sufficient quantity of drugs and
various fields by the operator.                                                consumable material for the patients in a mode that neither
      d. OPD Billing                                                           hinders efficient clinical work, nor it becomes a threat to the
           For billing of any OPD service like Pathology Tests,                survival of the Store.
or any imaging investigation, the patient moves to OPD billing
                                                                       122
counter. Here the services are charged as per the rates already
                                                           (IJCSIS) International Journal of Computer Science and Information Security,
                                                           Vol. 8, No. 8, November 2010

       Pharmacy                                                        print quality from digital medical modalities with both color
         The Pharmacy Module deals with the Retail Sale of              and grayscale outputs with normal DeskJet or Laser printers.
   medicines to OPD patients and issue of medicines to the In-          With our software's outstanding, High Quality Images, Superb
   patients in the hospital. Its function includes, online drug         Color Reproduction, Live Recording & Web Based utility to
   prescription, inventory management and billing of drugs,             take 2nd opinion. Thus it can be used for any medical /
   consumables and sutures. This module is closely linked to            scientific application or radiology solutions with digital
   the Billing Module and In-patient Module. All the drugs              interface and for archiving or educational purposes.
   required by the patient can be indented from the various sub
   stores.
    Financial Accounting                                                       Main Features
         A Financial accounting module is linked with hospital                   • Can capture images indifferent formats.
   billing module. You get online accounting of all revenue                      • Recording facility, to record procedures or undergoing
   generated along with expenses incurred. There is no need to                   operations.
   enter the revenue entries as they are already fetched from the                • Procedure/Operations done Live can be given on CD.
   billing module. All relevant information for the staff                        • Workstation can be created, at one point, for different
   salary/wages, consultant share, etc is available.                             modalities.
    Payroll                                                                     • Data base to re-analyze and to keep patient records
         This module Keeps track of all staff member's                           updated.
   attendance; there leave record and deductions. Generate                       • Can create Editing, filtering of colors(R, G, B) on the
   salary slip and other related reports.                                        images.
    Canteen and Diet                                                            • Deferent report formats / Default formats for each
         This module deals with the billing of all canteen items                 modality.
   and issue to Inpatients or staff. This will work as OPD                       • Comparison mode is available.
   billing. The rates of all items will be defined as per the                    • Exclusive help menu, with brief knowledge about the
   category (general/Inpatient/staff) and the items issued to                    equipment & S/W.
   them are billed respectively. Inpatients bill can be reflected                • with voice recording.
   in their hospital Bill.                                                       • Clipping, Splitting and Merging of different clips
                                                                                 (Video).
    MRD Management
                                                                                 • Test overlay on a recorded video to mark abnormalities
         Patient's Medical record data is critical for the analysis
                                                                                 to built presentations when you need it most.
   and research purposes. This data includes patient history,
   observation, diagnosis and therapeutic conclusions along
   with the tests details and serves as a source of information
   for any analysis and research. The purpose for this module is
   to utilize the patient's medical information and use it for
   analysis thereby improving patient care [8].
    Online Reporting
         This module transfers all the diagnostic reports
   performed in the day to the hospital website where the
   patient can view or download the report using the password.                                  Figure 3: Image Record 2
   This has special significance for telemedicine.
    TPA Management                                                             Special Features
         Keep track of all patients from a particular penal, their               • Software can be operated by Remote Key.
   authorization amount and payment status with full bill                        • Software can be operated by Foot Switch.
   details. Special rates for any particular penal will be                       • Can E-mail, Report with images to take 2nd opinion.
   automatically calculated.                                                 OT Management
    Imaging Records                                                              Detailed breakup of operation charges, OT
         Image capture and analysis are vital to the use of                 consumables, anesthetist charges, etc from a separate
Nuclear, CT scan, Laparoscope's, Endoscopes, Colposcopes, C-                module. OT scheduling for the patients is also done.
Arm & Ultrasound Systems in medicine as shown in fig 2 & 3.                  Online MIS
                                                                                  This is a unique tool in the hands of top management.
                                                                            This module shows a screen where all current activities in
                                                                            terms of revenue are displayed and this screen is refreshed
                                                                            automatically after every 10 seconds. Simply saying, by
                                                                            looking at this screen, top management can find out the
                                                                            collection of various departments in OPD & Indoor,
                                                                            Outstanding of General and panel patients, No. Of
                                                                            admissions, Discharge of the day and so on.

                                                                                       IV. CONCLUSION
                                                                  ERP systems have become vital strategic tools in today’s
                     Figure 2: Image Record 1                 competitive business environment. The paper helps to
                                                              demonstrate how ERP is useful in healthcare system, what are
Digital Imaging Software dedicated for each Modality with 123 the benefits of this system, how ERP works when implemented
Auto report generation utility is designed to achieve optimum
                                                                      (IJCSIS) International Journal of Computer Science and Information Security,
                                                                      Vol. 8, No. 8, November 2010
in hospitals so that more hospitals can adopt this technology for                  (R&D) in Acropolis Institute of Technology and Research, Indore, MP, India.
                                                                                   He is having around 21 Yrs of teaching experience and more than 7 Yrs of
there betterment and advancement and also work with it.
                                                                                   research experience. He has completed his research work with Dr. M.
Ultimate Aim – Better Patient Care with Efficiency through                         Chandwani, Director, IET-DAVV Indore, MP, India in Secure Multi- Party
ERP implementation.                                                                Computation. He has published more than 60 papers in refereed
                          REFERENCES                                               International/National Journal and Conference including IEEE, ACM etc. He is
[1]    Why ERP? A prime on SAP Implimentation by F. Robert Jacobs, David           a Senior Member of IEEE, Chairman of IEEE Computer Society, Bombay
       Clay Why bark, and D. Clay Why bark                                         Chapter, India. Dr. Mishra has delivered his tutorials in IEEE International
[2]    Open Source ERP by Redhuan D. Oon                                           conferences in India as well as other countries also. He is also the programme
[3]    ERP: Making It Happen : The Implimentation Guide to Success with            committee member of several International conferences. He visited and
       Enterprise resource planning by Thomas F. wallace and Michael H.            delivered his invited talk in Taiwan, Bangladesh, Nepal, Malaysia, Bali-
       Karemzar (Hardcover - Jul 27, 2001)                                         Indonesia, Singapore, Sri Lanka, USA and UK etc in Secure Multi-Party
[4]    What is ERP? http://www.tech-faq.com/erp.shtml                              Computation of Information Security. He is an author of one book also. He is
[5]    www.acsonnet.com                                                            also the reviewer of tree International Journal of Information Security. He is a
[6]    http://searchsap.techtarget.com/definition/ERP                              Chief Editor of Journal of Technology and Engineering Sciences. He has been a
[7]    http://www.mariosalexandrou.com/definition/erp.asp                          consultant to industries and Government organization like Sale tax and Labor
[8]    ERP Solutions for Hospital Management Administrator Plus(An                 Department of Government of Madhya Pradesh, India.
       Integrated Hospital Management Software)
       http://www.acsonnet.com/index.htm
[9]     A White Paper on Healthcare ERP implementation services by Infosis
       2009.
[10]    A White Paper on ERP Popularity and Need in Heath Care Industry
        By: Nick Mutt 2010
[11]    Critical Success Factors in Enterprise Resource Planning Implementation:
            A Case Study in Saudi Arabia Hospital page no.3.
           www.brunel.ac.uk/329/.../KhaledAlfawazpaper32.pdf.
[12]    Asian Journal of Management Research Vol., 1, No. 1, 2010 titled “A
        Study of Patients’ Expectation and Satisfaction in Dindigul Hospitals”.
[13]    Profile - Soft Imaging & Medical Solutions India Pvt. Ltd.


            AUTHORS PROFILE

Ms. Kirti Pancholi
Lecturer Computer Application,
Acropolis Institute of Pharmacutical Education and Research
Indore, MP, India




Kirti Pancholi received her MCM. Degree in Computer Management from
DAVV University Indore in 2005. She is LecturerComputer Applications at
Acropolis Institute of Technology. Her research areas are ERP technologies,
E-governance, E- Commerce, Cloud computing.



Dr. Durgesh Kumar Mishra
Professor (CSE) and Dean (R&D),
Acropolis Institute of Technology and Research,
Indore, MP, India,
Ph - +91 9826047547, +91-731-4730038
Email: durgeshmishra@ieee.org

Chairman IEEE Computer Society, Bombay Chapter
Vice Chairman IEEE MP Subsection




Biography: Dr. Durgesh Kumar Mishra has received M.Tech. degree in
Computer Science from DAVV, Indore in 1994 and PhD degree in Computer 124
Engineering in 2008. Presently he is working as Professor (CSE) and Dean