Ever since I finished creating my first hospital ERP system designed along the lines of Aerospace industry requirements, I realized that it was important to directly link resource usage to patients.
Why is this?
This was due to the need to build over time (a few years) a patient allocated resource allocation table that was based on actual hospital resource usage as allocated to patients incoming to the system either as hospitalized or as outpatient.
Review of a Hospital
A hospital is split into three distinctive sectors: Medical, Technical & Administrative. The Medical sector includes all physicians and medical related services such as operating rooms, outpatient clinics, diagnostic labs and all the staff thereof. Technical includes all maintenance staff and services to supply gasses, power, heating, sanitation etc and nutrition services (Kitchen etc). communications and IT. Administrative includes all finance, billing, supply chain, legal, logistics, HR, PR and patient office services.
Hospital Flow chart (a quick look):
A hospital is a medical service provider that requires diagnostics and treatment space to enable the medical staff to provide the highest quality medical service possible. In order for the physicians to offer this service they require support services that are so varied that they make a hotel seem simple. In fact, imagine a hotel and now add medical treatment rooms, diagnostic laboratories and access to gasses and power at a very high level. This will give you the basic idea of how complex a hospital is.
So even before a patient arrives at the hospital, the hospital must be prepared to receive the patient and accompanying persons. So we need to add accessibility (for all types of vehicles and invalid transport units) as well as parking space.
A patient enters the hospital via two ways: Self admittance or an Ambulance, the self admittance can be either via ER or patient admittance office. The Ambulance will always go directly to the ER.
On order to accept a patient, the hospital must enter all the relevant personal data into a computer system, this will generate a medical file that will accompany the patient for the rest of their life.
Once the patient is entered into the system, it immediately generates requirements for diagnostics that can include (the main ones); blood, urine and stool, x-ray, CT, MRI, PET and Gene type. Each diagnostic lab employs staff, uses specific equipment and requires specific maintenance. These labs are similar to production lines where the tests are all similar in style. They are similar to a production lie in that they can be quantified irrelevant the source material or subject.
All the administrative and technical services are also fully quantifiable and can be given allocated actions.
Medical Device quality vs cost method; medical device maintenance requires the recording of device downtime, the exact repair details and costs thereof. Over time the devices break down more and their downtime costs more, since once they are not in use they are neither replaced nor in use, so the staff must either find a replacement or work extra hard using one device on more patients or if the device is not critical have one less device connected for data gathering of patient status. (ie. pulse oximeter, blood pressure, heart monitors etc.) No matter the device, downtime costs time and money and there is a moment on the QOS (quality of service) graph of the device that it becomes more expensive to use than to replace, that is the moment when a new device ought to be bought.
The medical services include operating theaters that use many resources, the sterile supply unit that prepares the tools for the OR and of course the ER and trauma unit.
Wards are the “hotel rooms” with all the services included.
Once a patient is introduced into the system for treatment and an ICD is assigned, the system will allocate the various resources expected to be used to treat and diagnose the patient. Any variances from the standard are the direct result of the variance in the patient’s physiology as well as any other ailments or genetic disorders the patient might have that can change standard treatment. Such as wild RAS in gastric cancer that will change the protocol, or a diabetic with penicillin intolerance receiving cardio-thoracic-surgery. All these variations create additional resource allocations on the standard line and over time the system will be able to see patterns emerge in these differences.
The end product is a ERP system that can predict the expected hospital costs to about 95% taking into account seasonal changes as well.
This ERP system is quite simple to produce, the unique innovation that has come in recent years is the blockchain, and by using blockchain enables multiple hospital staff to access the patient file and update it simultaneously whilst recording the information with a time-stamp so that any errors corrected or changes to treatment will be obvious in the system.
This system also offers one extra special service, it enables complete overview of resource allocation, so that no resource is ever overlooked either in time usage or stock levels. A resource in this system is everything; human, material, tool and time.
If you wish to receive a complete ERP package and wish to set this system up in your hospital or clinic, contact me directly at ianpkano@gmail.com