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IT Empire in Escort Hospital
Harish Revanna
Tuesday, March 1, 2005
A grueling period of trial and error with implementation of different management systems for 17-years is no-doubt a testimony in itself. M.P.Singh the age-old IT-father of the company has stood along EHIRC’s testing times deploying the best and the latest of technology. Singh recounts through his early days of deploying FoxPro from today’s Mettrak—a system that EHIRC implemented in July 2004.

Mettrak software, a product of Trak System, currently controls the entire hospital information system (HIS) by updating the administrative, patient care and financial details religiously. Although this system was implemented in 2002, the hospital had to configure and customize the system to suit its needs before taking it live.

After successfully deploying the new system, EHIRC today believes to have reached the ultimatum: customer delight. However Singh knows well that technology expands day and night.

For the first time in its history the hospital outsourced its HIS to Trak System. Before implementing Trak’s Mettrak, Singh dealt with Oracle system for a decade. During this time, the hospital witnessed a major change in its IT environment with a slew of swarming technologies.

One interesting aspect was the transition of the hospital application database from client server basis to web browser. “We had most of our services based on the client server hosted on a FoxPro/FoxBASE system. Subsequently our HIS was replaced by Oracle database but the client server still continued,” he says. With Internet’s initialization the hospital upgraded to web technology and browser-based systems revamping the entire IT set up over an IP.

To maintain EHRIC’s large system, across three buildings, it deployed a 100 mbps switched Ethernet, with 400 plus nodes and twenty servers. To bring in interconnectivity among all the buildings Singh also positioned a 1000 mbps fibre channel across the hospital.

Managing Infrastructure
Implementation of such technology is not the key to success, rather than monitoring and maintenance, asserts Singh. As EHIRC initialized a technology upgrade in 1999, it soon required a unified central system able to monitor the processes, and Unicenter TNG was appropriate. “Unicenter today is helping us in multiple ways,” explains Singh. “First, it helps in giving a back up on the database and also alerting on those databases which needs attention from the medical staff.”

Interestingly, one of the main challenges was educating the medical staff, especially nurses—biggest user community in any hospital—on computer utilization. Realizing the huge effort and time computer education required, Singh opted for a remote control option. This remote option did not aid EHRIC as expected, but it did help with managing the infrastructure. Take the example, he says, if any computer in the entire system gets choked, someone from the department would call the IT staff and Singh’s 15 personnel would immediately identify the system and rectify it remotely in minutes—an option of Unicenter.

Another service pact with Unicenter was network management module, through which the hospital network could be traced sitting on a central console. It helped in determining collusion within the network and slippage of packets.

As the network usage increased in the 325-bedded heart hospital, customers began demanding higher performance efficiency. EHIRC hosted a website (ehirc.com) in collaboration with GE in 1996 to deliver and service its customers. But once the website was hosted and the server was initialized, security became a major concern. To address this, the hospital implemented CA’s eTrust solution in place.

eTrust brought in the firewall, content inspection and IDS into the HIS. Incidentally, the firewall also helped the hospital control discrepancies that happened over the high-speed 512 kbps Internet connection—which was until then a browsers’ haven, he says. “Now the hospital internet users can only visit the productive sites.”

EHIRC also allows online consultation, OPD appointments, e-greeting services, access to lab reports, online billing, airlift or ambulance payment and many other online services.

Flavours of technology
Although IT initiatives in EHIRC escalated, some of the non-IT technologies required implementation. SMS services, for instance, leveraged most efficiently with the company’s database. All a doctor did was to register himself and send and receive SMS to all the concerned people in the hospital. This method was hugely successful due to the custom-designed approach to database—which received information from the HIS regularly on a patient’s condition. This helped in sending the doctor an alert message if the patient’s condition became serious. Now SMS is also used to locate a patient in the hospital which keeps transferring patients frequently from one ward to another.

To maintain a check on patient’s intake and to avoid confusion over their ward numbers the hospital implemented Barcode sampling—an innovative approach the company took up with its new HIS system (Mettrak). Today there are no samples in EHIRC without a barcode, this monitors everything a patient experiences in an orderly format and automatically controls the next action like—drug intake, health checks and blood transfusion. “Through this, every material that goes into the patient also goes into the system and the patient gets billed for that,” says Singh. Interestingly, this also maintains the inventory of the hospital in terms of medicines and other rechargeable equipments. Once there is a shortage of any of these then a message is sent to the concerned people and the inventory is refurbished. “All this happens automatically,” emphasizes Singh.

One of EHIRC’s recent field invasions is Electronic Patient Record (EPR). Accordingly, everything administered to the patient is automatically updated on the system through a laptop near the patient—creating a paperless environment. EHIRC is virtually a paperless hospital, chuckles Singh, due to the extent of IT initiatives. Singh is also occupied implementing wireless technology in some of the hospital’s core areas for further connectivity simplicity. Two of hospital’s prime areas today have WLAN connectivity.

“Wireless can bring the records wherever and whenever the doctors want to use them, eventually cutting time on all the paper examination one ought to carry on before consulting a patient,” says Singh. EPR helps to prevent errors, enforce standards, make staff more efficient, simplify record keeping and improve patient care. In an effort to strengthen partnership with associate hospitals, he deployed videoconference and an ISDN based network connection.


Here, the Business comes next
“The moral is about how to improve hospital’s efficiency and not cut cost,” says Singh. As a corporate hospital, EHIRC’s approach leads with computerization as a first priority. Daily, there are approximately 35 angiographies and 20 surgeries, and EHIRC sees no margin for error with its technology system in place.

Today, 100 OPD patients a day can be handled with only three staff members—who were ten until new-HIS implementation. After just a few hours of lab testing they can have the report online and can access a patient’s details by the press of a button. EHIRC’s barcode has also reduced diagnosis error due to frequent database monitoring and automatically avoiding any drug-intake mishaps. Drug interaction and blood transfusion have been effectively undertaken with no confusion among the nursing staff leading to bigger problems.

Implementation of wireless has made productivity sense in the workflow system and also relieved staff constraints.

However, a human-touch can never equate that of a machine-touch. Through IT you can perhaps delay the onset of ones illness or even extend ones lifespan, but isn’t physical contact and moral support the soothers of these delicate hearts? Singh concurs and explains: IT takes care of all the back end delivery while ultimately making way for doctors to spend more time with their patients.
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