"A role oriented requirements analysis for ERP implementation in health care Organizations"
(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 firstname.lastname@example.org, email@example.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  : 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  . 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?  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 : 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 . 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  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  Open Source ERP by Redhuan D. Oon conferences in India as well as other countries also. He is also the programme  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  What is ERP? http://www.tech-faq.com/erp.shtml Computation of Information Security. He is an author of one book also. He is  www.acsonnet.com also the reviewer of tree International Journal of Information Security. He is a  http://searchsap.techtarget.com/definition/ERP Chief Editor of Journal of Technology and Engineering Sciences. He has been a  http://www.mariosalexandrou.com/definition/erp.asp consultant to industries and Government organization like Sale tax and Labor  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  A White Paper on Healthcare ERP implementation services by Infosis 2009.  A White Paper on ERP Popularity and Need in Heath Care Industry By: Nick Mutt 2010  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.  Asian Journal of Management Research Vol., 1, No. 1, 2010 titled “A Study of Patients’ Expectation and Satisfaction in Dindigul Hospitals”.  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: firstname.lastname@example.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