Enhancing Hospital Patient Experience Through IP Communication Enablement

Patient Engagement + Operational Efficiency

Communication Enabled Hospital

Functions

Emergency

OPD

OP diagnostics

IP Room Stay

IP Admission-Covered

IP Admission-Self pay

Billing

ICU

Discharge

Drug Administration

Asset Tracking

IP Diagnostic

Patient Care Pathways

Connecting Hospital Care Givers & Patients Through Technology

Emergency

Pain Point:– Waiting time – Getting the concern Doctors

at odd hours in hospital. – Payment issues from the hospital

perspective.– Getting through to ambulance service. Time

consuming process.– Emergency investigation and emergency

charges.

Features:– The system through a single touch from the first care giver

connects to all concerned doctors and put them in a conference to develop a collaborative treatment plan.

– The same staff can access any clinical reference material on the go.

– Ambulance booking module allows checking of availability of ambulances from desktops and phones. Single touch booking feature saves time and alerts all the related services.

– Ambulance booking along with asset tracking allows the emergency room staff to be always on the know of where people who may be required are present.

Benefits:– Instant response in an emergency situation by the hospital.– Precious time saved in the beginning is invaluable.– The difference is minimized between a doctor present to attend the

things and a nursing staff doing it in consultation with multiple specialists.

– First medical contact at the hospital are well equipped to take multiple approach towards medication by in touch with the doctors and associates.

Appointments/OPD

Pain Point: – In case of prior appointments patients have to

come over and wait for the doctors to show up. – Often, the doctor is running late or attending

emergency and gets delayed. – If this happens every body waiting for the

doctors ends up spending more time than they intent to or prepared for resulting in resentment, dropped appointments and a bad patient experience.

– Significant % of OP patients land up without appointment, making scheduling difficult.

Feature: – Communication enables OPD appointment procedure by keeping patient,

administrative staff as well as doctors in the loop. – Patient gets a notification about the expected check up time and queue position

when an previously defined threshold is crossed. (I.e.; actual check up time – scheduled check up time > ½ hr than intimation message is sent to the patient)

– Routine intimation are sent before a pre defined time of the actual appointment. (I.e.; 15 mins before the scheduled check up message to the patient to be present in the outdoor)

– Drop intimation are captured and forwarded to the intended recipients.– SMS based system allows patient to book an appointment by sending pre defined

text messages. In response they get a confirmation message and if an appointment is available than the queue number and also the expected time of appointment.

– Doctors get an intimation before the OPD time, he/she can use the same system to confirm the arrival time or expected time of arrival.

Benefit: – Less waiting time and responsive system allows enhanced patient experience. – Creates a positive impression among its clientele. – Registered patients preferred doctors availability captured.– SMS based booking module allows patients the option to book an appointment

against coming unannounced.– Everybody including the doctors are in an information loop which allows capture

of information and free flow of it.

TPA Desk

Pain Point: – For pre approved treatment patients do not

have to come to the TPA desk. But for non-scheduled or emergency treatment where it is not pre planned this is the desk which communicates for third party approvals.

– Patients has to generally fill up application forms and follow up on that for approval.

– This process is not optimized and requires multiple follow ups. This process is also very time consuming.

Features: – Patient get document check-list on their IP Phone. – Once they submit these to TPA desk, status is updated and

patient can track progress through their IP Phone. The approved and non approved parts of the treatment are conveyed to patients promptly.

– Once the application is stuck for what so ever reason the patient/attendant is notified immediately by the desk about the reason.

Benefits: – Patient/attendant is proactively intimated about problems

and requirements in the approval process, without wasting precious time.

– TPA desk function is automated and unnecessary crowding at the counter is avoided.

– The process is optimized with respect to customer service by the hospital, time in obtaining approval and most important of all ‘The Treatment’.

– Routine information is available online to minimize expectation mismatch.

OP Diagnostics

Pain Point:– Waiting time for investigation.– Report collection process. In case there is a

delay from lab there is no mechanism to inform patients.

– Urgent report collection process.– When there is a separate section of biopsy

to be studied extra payment is required.– Consent and extra payment is to be made by

patient for the same ( Process).

Features– The waiting time can be managed through a OPD type system, where the

queue is prepared for patients and they are intimated about their turn for testing.

– Patient or attendants get an intimation to collect reports already prepared. Once the report is checked through the system the message is automatically sent to the designated mobile numbers. For urgent reports the recipient of the report is intimated progress of each steps in the process. Delays are taken care of in this process.

– For extra biopsy study authentication can be obtained either through messaging or voice which is stored as record. In case of voice authentication the same can be transcribed to test and stored against the patient id.

– The authorized person can then be dialed and put through a payment authentication process which in the back end will be connected to a payment processor.

Benefits– Automated Diagnostics department and the communication enabled

collection process for both reports and payments. – Proactive report distribution.– Automation of payments.– Unclaimed reports and disputes alone helps in shortening the payback time.

In Patient

IP Admission – Self pay IP Admission – Covered Patient IP Room Stay IP Diagnostic

IP Admission – Self Pay

Pain Points:– Option of electronic transfer.– Option for using any credit card in the

hospital. – Availability of beds (clear, real time

information) – Information to consultants about bed status.– Bed clearing Process.

Features:– Electronics transfer is enabled through the payment

module and available at each IP Phone, PC as well as GSM end points. The patient or attendant will have to validate patient id and make payment using their credit cards. This system is capable of processing all the different types of credit cards.

– Once the patient bills are settled the bed/room will be marked with a ‘MUR’ sign, and the intimation sent to house keeping. The house keeping in turn can mark the bed/room as ‘Ready’ after cleaning and refurbishing the supplies.

Benefits:– Beds are ready for next patient without any delay after

cleaning. The entire process is automated. – Payment blues are taken care of by convenience.– Quick make time and automatic availability of room

afterwards helps squeeze the idle no use time of rooms by 2/3rd.

IP Admission – Covered Patient

Pain Points:– Printouts of all forms and policy– Payment at the time of admission– Authorization delay– Justification in paperwork, - due to confusion

from consultants end (doctors may not write accurate diagnosis in Pre-authorization form – and this may contradict with discharge summary version.

Features:– Print outs of documents can be configured in each phone end

points. This is in addition to the desktops form which stored documents can be printed.

– From hospitals side all the procedures related to insurance claims are automated and put into a flexibly defined workflow. This workflow will allow escalation depending on the severity level defined.

– Doctors can use the speech enabled transcription facility to dictate to their phone and all the summary related to a particular patient is transcribed to text and stored as part of the electronic medical records.

Benefits: – From the hospital end this entire system is automated. – It helps in saving time and pro actively obtain authorization from

the insurers.– Speech technology allows Doctors to note down every detail about

a particular case without picking up the pen.– Help first realization of payment from insurers and thereby save

cost incurred in unrealized amount.

IP Room Stay Pain Points:

– Directory information of various places and services provided by the hospital.

– Poor quality Room service (catering, housekeeping etc).– Lack of billing/payment update.– No update on progress of treatment/ surgery.– Basic Rules and regulations of the hospital. – Information of do’s and don’ts of the hospital – Accurate billing of all services provided – due to items not

updated by Doctors/nurses and other related staff– Ensure no errors in medication etc.– Attendants pass issues.– Fulfilling special requirements of patient (like barber/

beautician etc.)

Features:– All the directory information pertaining to the hospital are

configured in the form of menus accessible through the IP Phone as well as computers.

– Canteen menu application connects the patient rooms to the different cafeterias and allows order placing through the IP Phones.

– Billing, payment update, treatment and surgery update can be obtained through the bed side IP Phone, which has the option to drill down on each menu option.

– Basic rules and regulation as well as dos and don'ts are obtained through the same by patients or attendants.

– Visitor verification module manages the flow of visitors to the patient.

Benefits:– Free flow of information.– On demand information without any manual intervention.– Visitor validation and management.– Error minimization in medication.

IP Diagnostic

Pain Points:– Shifting of patient – wait to get attendant,

stretcher/wheel chair etc.– Reports which consume time – Process of

dispatching them to patients post discharge.

Features:– Asset tracking will be able to show all the related

hardware and human resource to do the job.– Report progress and collection alerts for time

consuming reports preparation. Benefits:

– Optimizes the operational aspects of the hospital. – Extra provisioning is not required for expensive

machines and resources.– Machines are tracked and obtained on a real time

basis when ever required. Quick response not only saves human lives but also cost of operations.

– Patients and attendants are always kept in loop about the report preparation part.

Surgery

Pain Points:– Time of starting surgery– Update information of surgery.– Due to scheduling issues, uncertainty on time

and place (OT) surgery – causes stress to patients/attendant.

– Form a mechanism by which patient Pre-Anesthetist Check is done on time / Patient is shifted to OT well in time / provision of patient attendant counseling about the procedure happens.

Features:– Regular updated information pertaining to surgery

on the patient bed side phones as well as attendants mobile phones as well.

– Patient specific surgery procedures and requirements are placed online and also pushed to the mobile phones of patients/attendants

– Pre OT procedure is completely communication enabled with multiple touch points.

Benefits:– Saves time and botheration to the patient and

attendants. – The entire pre OT and OT procedure is optimized.– Requirements are known before hand.– Progress is known real time.

ICU

Pain Points:– Time to time information about condition of

patient. – Visiting patient – ICU billing usually is very steep. –

counseling, timely bills updated.– Infection policy to be strictly monitored.– Accurate billing of all services provided.

Features:

– Messaging module allows all the near ones of the patient to be in know about his progress.

– Visitor verification module manages and optimizes visitor flow to the patient.

– ICU billing is reflected in detail as per the demand from the patient or the attendants.

Benefits:

– Attendants as well as near and dear ones are always aware of the condition of the patient.

– Easy in billing as ICU charges are detailed out to patients.

– Controlled visitor flow.

Billing Pain point:

– Patient billing is where a lot of heart burn happens.– In most hospitals billing is a continuous process and

the patients are asked to replenish their deposit amount from time to time.

– Once the patients are intimated about new deposits to be made all concerned with the process scramble to know how the previous money is adjusted for.

– The bill desk is where the patient/attendant has to walk down to clarify the doubts and this is not feasible always.

– Over phone the same can be done but that requires a hospital staff at the other end to explain the various expense heads.

Features: – Allows the patient or their attendants to know how and

on what rate they are charged for the treatment. – The details of the same can be obtained by choosing

one particular expense head and reviewing the details. – The patient can also pay online through their bed side

IP phones using their credit cards. Benefits:

– The billing operation and payment options are brought to the patient bedside table.

– The patient/attendant is not required to go to a cash counter to pay and can do that at convenience from his room.

– The discharge routine is shortened and made comfortable for the patient.

– Bill drill down option gives the patient the option to know on what all account he is charged.

See

Discharge

Pain Point:

– Patient discharges is initiated by the attending doctor and that is followed by a lengthy process.

– Lack of coordination between various hospital functions and the billing desk is a major bottle neck in timely discharging of patients.

– Usually the patients are the first to know about the discharge.

– Collection and reconciliation of dues and taking care of perceived abnormalities of charges which requires explanation by the billing clerks leaves the entire process far from being optimized.

Features: – When Patient is ready to be discharged, phone based work- flow

system sends messages to all department for sending their debits.– The messages are preconfigured for escalations till acknowledgement

is obtained. – Patient is kept in the loop about the progress of the process and

knows what time it is going to take for doing this. – He can view the final bill through the IP Phone and also obtain

clarification from designated persons before choosing for online payment.

– Once Patient leaves room is marked with a ‘MUR’ status which the hospital staff will change to ‘READY’ after cleaning and replenishing supplies.

Benefit: – Allows Patient to be in the comfort of his room while settlement and

bill compilation is in process. – Entire process is communication enabled and optimized leaving very

little room for complacency. – Payments and clarification is obtained not from a crowded counter

but from the confines of a hospital room which improves patient/attendant experience.

Drug Administration

Pain Points: – The drug administration to patients is

directly linked to the billing system. – The drug is administered by the nursing

staff and usually intimation about that is obtained while preparing the final discharge report.

– The process is entirely dependent on the staff deployed at any particular time.

Features: – Talks to the central database and shows on the patient IP

Phone the entire list of drugs to be administered to that particular patient.

– On the nurse desk it shows the drugs to be administered to all the patients in that bay for the next one hr/session.

– Once the nurse mark it done from either of the phones the database is updated and reflects in billing.

– On a need basis the nursing staff can take benefit of the single touch dialing option and consult the concerned physician.

Benefits: – The entire drug administration process goes through

multiple validations, eliminating errors and ensuring timely adherence.

– The system is communication enabled through a single devise; i.e. IP Phone for alert, updation and , consultation.

Asset & Individual Tracking Pain Point:

– At the time of need the individuals; i.e. Doctors, Nurses, Ward boys are difficult to locate and impossible to communicate.

– The doctor may not be picking up the phone for various reason and one of them might be he do not want to be disturbed while in the OT.

– If at all the doctor location is known to be in an operation Theatre than he must not be disturbed and in case of emergency can be reached in person.

– Word boys are required to ferry patients from one location to another and also to fetch different machines when required.

– This process depends on the availability of a word boy nearby and who is free to take up another assignment.

– Mobile assets like ECG machines or X-Ray machines are not always at a pre defined place in the hospital.

Features: – The RFID tagged assets are located throughout the

premises of the hospital for management of medical equipment assets.

– The assets can be tracked with location based service and the information can be obtained through multiple devices.

– Low end resources can be assigned task numbers on a round robin basis which can be confirmed through the nearest IP Phone by entering the id or calling up.

– Mobile assets like portable ECG machines or X-Ray machines are tagged and their exact location can be found out when the need arises.

Benefits: – Optimizes the operational functioning of the hospital. – Extra provisioning is not required for expensive machines

and resources.– Machines are tracked and obtained on a real time basis

when ever required. Quick response not only saves human lives but also cost of operations.

Emerging Trends in Health Care Secondary & Tertiary Care requires large investment,

viable bed size, technological obsolescence Increasing corporatization Venture capital funding Slow, but emerging private health insurance/TPA Global alliances Listing of companies Felt need for professional management “Sick” hospitals “Marketing” of services M&A, Brand buying, Brand extension, franchising

Business Benefits

A typical bad set up in a secondary care hospital can be to the tune of 35 lacks and above

Of this only a fraction is spent on IT (Apprx. 2.5%)

The hospital earns most of its revenue in the first 3 days of hospitalization of the patient

After that it needs to made up the room soon and make it available for other patients to occupy

With a marginal increase in the IT investment (.25%) towards converged applications the entire IT investment can be paid back quickly.

MARS Benefits

Connected patients for information, payments, insurance, drug administration etc.

Operational efficiency in addressing the patient needs, facility and room management, discharge and billing

Uses the existing IPT infrastructure Shortens the pay back time

CISCO Partners

Unified Communications

Applications

Certified Products

Multiple access points; i.e. Ph,

PC, Mobile

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