Fortis Healthcare Limited: Background

Fortis Healthcare Limited was incorporated in 1996. It is now the fastest growing and India’s second largest healthcare provider. The company was founded by the visionary business leader, Late Dr. Parvinder Singh, the architect of Ranbaxy Laboratories. Fortis is a manifestation of Dr. Singh’s ideology “to create a world-class integrated healthcare delivery system in India, entailing the finest medical skills combined with compassionate patient care”. The company’s vision is to be a globally respected healthcare organization known for clinical excellence and distinctive patient care.

The company’s mission to deliver quality healthcare focuses on drivers such as clinical excellence, technology, research and patient care. Starting with its first hospital which opened in 2001, Fortis Healthcare Ltd. now is a network of 45 hospitals with the capacity to increase inpatient beds to ~6600 beds. These hospitals include multi specialty hospitals as well as super-specialty centres providing comprehensive tertiary and quaternary healthcare to patients across specialties such as cardiac care, orthopedics, neurosciences, oncology, renal care, gastroenterology, mother and child care .

Fortis has been rapidly growing through a combination of acquisitions, greenfields, brownfields and management contracts. The company’s employee strength across is over 10000. Operating Model Fortis operates on a hub and spoke model to provide Super Specialty, Multi Specialty and Tertiary level medical care. Hubs are the super specialty hospitals and spokes are the multi specialty centres. Patients who have the need are referred to these hubs from the multi specialty facilities in the region. By embracing this system the patient benefits from the many available network facilities.

Quality Focus Fortis Healthcare has been at the forefront of providing quality healthcare services and has raised the bar of quality standards in the country. The hospitals employ renowned medical talent at par with the best in the world. Some of these doctors are American Board Certified. Due to their excellent quality care and safety for patients, three Fortis Hospitals have received the highly respected JCI accreditation (Joint Commission International). Patient Centricity with excellence in medical delivery, empathy, care and compassion are the guiding principles at Fortis.

This is reflected in every aspect of the company beginning from hospital architecture, processes, larger than average bed-to-floor space ratio, nurse to patient ratio to front office staff. Standardized Operating System To standardize non-clinical processes which impact patient experience during their stay at any of the hospitals, Fortis has a standardized operating system called FOS (Fortis Operating System). This ensures that patients experience similar service levels irrespective of the hospital they visit within the group.

FOS was conceived and implemented with the objective to increase efficiency in non clinical processes leading to enhanced patient satisfaction in various departments such as OPDs, PHCs, OTs, Emergency, Radiology etc. Healthcare Information Systems: Introduction Healthcare Information Systems are capable of meeting the following 2 objectives: * To provide an optimized support to the specific needs of the individual centres and units by enabling different vendors to offer specialized applications and by allowing the users to select the most effective solutions for their needs. To permit the different centres to cooperate on the basis of information consistency throughout the healthcare network for more effectiveness and reliability of the clinical, administrative, epistemological and managerial activities carried out. A Healthcare Information System could vary from a simple server based inventory cum billing modules catering for a clinic to web based comprehensive systems catering to a chain of super-speciality hospitals.

Hospital industry’s requirement from HIS could be as follows: * It should cater to the demands of all sections of the staff as well as external agencies. * It should be easy to understand and use, maintain and modify. * Apart from this with increasing accountability and reporting activities the generation of reports and statistics should be easily done along with an effective EMR (Electronic Medical Record). * There should be continual back end technical and maintenance / support. One of the objectives of HIS is streamlining the treatment flow of a patient n the hospital, while allowing doctors and other staff to perform to their peak ability, in an optimized and efficient manner. HIS uses a network of computers to gather, process, and retrieve patient care and administrative information for all hospital activities to satisfy the functional requirements of the users. It also helps as a decision support system for the hospital authorities for developing comprehensive health care policies. The HIS incorporates an integrated computerized clinical information system for improved hospital administration and patient health care.

It also provides an accurate, electronically stored medical record of the patient. A data warehouse of such records can be utilized for statistical requirements and for research. HIS is based on the standard of a centralized information system designed for quick delivery of operational and administrative information. The software is built around a highly optimized core library. Application modules are layered around this core and can be suitably customized for any user specific requirements. Healthcare Information System at Fortis Healthcare Limited

In 2000, Fortis Healthcare Ltd (FHL) was looking to establish a hospital setup that would provide world-class healthcare to its patients. The administration identified the criticality of IT in providing healthcare that would not only be integrated for convenience of the customer, but could also provide the required information for the hospital to evolve over time. FHL therefore had to put in place a Healthcare Information System (HIS). Initially the company was on the lookout for packaged software.

The lack of a suitable offering prompted, Sunil Kapoor, Head Information Technology of the company to develop a module in-house. The HIS was developed piece-by-piece aligned to the specific business and operational needs of the organization, and today it is deployed across four Fortis hospitals The Technology The HIS comprises a Picture Archival and Communication System (PACS), patient monitors, and Web access to MIS and data. The PACS captures, stores and transmits images. This results in efficient archival and retrieval and thus cost efficiency.

More importantly however, PACS makes diagnostic imaging, such as X-rays, almost film-less. Radiologists get enhanced images on any computer on the network, based on which they can diagnose a patient’s problem. The connected monitoring devices and Web access allow specialists to view certain live parameters of an admitted patient from remote locations. That means that more consultants and doctors can review a patient’s condition without actually visiting the patient on site. In addition to the basic functionality of the HIS, FHL has also implemented an MIS within the system.

With a front-end developed in Visual Basic, 80 percent of the MIS is browser-based. It provides business-critical data reports from the billing and usage information and addresses the day-to-day needs of the hospital’s various departments. Features For better customer support, the company has evolved a single window approach. Here the customer can gather required information, make an appointment and clear bills. The system provides the person at the counter all the technical support that may be required to address any query a patient may have.

Even the waiting times for the facilities are made known to the patient before signing up. For example if there is a two hour wait for an X-ray, the patient can be given the option to either wait or return on another day. The MIS stores critical resources, such as a doctor’s case history, status of high-end equipment, and procedures done on patients. These can help find out the costs that have been incurred and contribution that has been generated. The system generates the bill and breaks it into cost and contribution.

It keeps track of costs incurred at different points-of-care, such as OTs/ICU/Wards, which in turn forms a sub-set of budget comparisons. And since it is browser-based, it is a convenient tool for decision-makers to access critical information in time. Sub-modules In addition to the macro level functions of the system, various sub-modules have been developed to facilitate the daily workings of the hospital. One such module provides a list of the essential details necessary for any medical procedure. Advantages of HIS: * Cost benefit to the organization: The project has cost FHL over Rs 300 lakhs.

Most of the development done during the process will be reused as the company establishes more hospitals around India. * Decreased scope for human error: For example, before an Angiography, the system provides a list of pre-testing essentials such as, the patient must have an empty stomach, and the time of injection of the dye. Before an operation the system provides a list of consumables that must be stocked in the OT. Modules such as these eliminate the scope of human error that can sometimes have fatal consequences. * Increased workforce efficiency.

Customer satisfaction: The MIS has a patient satisfaction measurement system. It analyses patient feedback so that the business heads can take preventive and corrective action in a time. A mail about the patient or customer feedback is generated automatically and sent to the concerned departmental head and follow up communication between the Guest Relations Officer and the concerned department head is tracked. A satisfaction index is generated by the system based on the feedback. This helps the management keep a tab on customer satisfaction levels.

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