Customer Solution Case Study
/ WockhardtHospital Enhances Patient Experience and Improves Management
Overview
Country or Region:India
Industry: Healthcare
Customer Profile
Wockhardt is a major healthcare operator in India and more than 90 countries across the globe. It is India’s fourth largest pharmaceuticals company, and also operates a chain of speciality hospitals in the country.
Business Situation
The hospital division of Wockhardt had embarked on an ambitious growth plan. It found that it needed a hospital management system that could be integrated across the chain and could also provide for better management, information, and control inside individual hospitals.
Solution
Wockhardt implemented a Wipro HIRePS HIS solution based on Microsoft® Windows Server SystemTM integrated server software at its multi-speciality hospital in Mumbai.
Benefits
Improved patient care and turnaround time
Automatic alerts to different departments
Better inventory management
Fewer personnel required for back-end activities / "Wipro’s HIS helps run the Wockhardt Hospitals in an efficient and cost-effective manner. The HIS system puts clinical and financial information at our fingertips, helping doctors and administrators in critical decision making.” The improved efficiency has obviously resulted in a better experience for the patients as well.
Dr. Lloyd Nazareth, General Manager, WockhardtHospitals, Mumbai
Wockhardt is the fourth largest pharmaceuticals company in India and the largest in the U.K. In addition to manufacturing drugs, it also operates a chain of speciality hospitals. As part of the company’s plan to accelerate growth, the hospital division was identified for special focus and new hospitals were being set up. Wockhardt realized that the existing legacy hospital management system could not deliver in the changed environment of multiple hospitals. Nor was the system geared to integrate all divisions within the hospital. Wipro, a global IT services provider, was given the mandate to implement a new hospital management system at the new super-speciality hospital in Mumbai, the commercial capital of the country. Wipro implemented its HIRePS (Hospital Information Resource Planning System) Hospital Information System (HIS) based on Microsoft® Windows Server SystemTM integrated server software. The solution has substantially improved the patient experience, reduced waiting time, and improved inventory management and billing.
Situation
Wockhardt is the fourth largest pharmaceutical company in India and the largest in the U.K. 80 percent of the international turnover comes from the developed markets of Europe and the United States. As a leading player in the pharmaceuticals market, the company is listed not only on the Bombay (Mumbai) and National Stock Exchanges in India, but also on the Luxembourg Stock Exchange. The company is currently following an aggressive growth plan across all its divisions. One of the divisions that has been particularly earmarked for fast track growth is the hospitals division.
Wockhardt Hospitals has a collaboration with Harvard Medical International (HMI), which gives it access to top of the line international expertise and an edge over the other hospitals in the country.
The Business Situation
The hospital division was created 14 years ago to set up and run specialty hospitals across the India. The first hospital was located in Calcutta. Subsequently, one more hospital was established in Bangalore, and a super-specialty hospital has recently been developed in Mumbai, the commercial capital of the country, as part of Wockhardt’s accelerated growth plan. Another hospital, specializing in coronary care, is being set up in Nagpur.
With the division gearing up for accelerated growth, a need was felt to integrate the information and management systems across the hospitals for better management, control, and patient experience.
The IT Situation
The existing hospitals in Calcutta and Bangalore ran legacy systems that did not handle all the required functions. Nor were they easily amenable to integration across the different hospitals or to a Web interface. Wockhardt decided it was time for a new hospital information and management system across all its hospitals. As a first step, the company decided to implement the new solution in its recently constructed super-specialty hospital in Mumbai.
Wockhardt identified a clear set of objectives and deliverables for the new system. Beyond integrating the hospital chain and providing a Web interface, the system also had to integrate all patient management functions so as to ensure that patients did not have to wait unnecessarily for processes to happen. The solution had to integrate both the inpatient and outpatient departments, and also ensure that all the required departments had access to requisite patient information. Finally, the system had to be able to identify and streamline all commercial processes that form the back end of hospital administration.
After a robust qualification process in which Harvard Medical International played a key role, Wipro HealthCare IT, a division of global IT services provider Wipro Technologies, was chosen as the solution provider for the project.
“It was indeed an honor to have passed the qualification parameters set up by Harvard Medical International,” says Ranjana Maitra, Chief Operating Officer, at Wipro HealthCare IT. “It is a vindication of the quality of our solution set and proves that it is second to none, globally.”
Solution
Wipro HealthCare IT had already developed a hospital management system, the Wipro HIRePS HIS system. The system was in use by 45 hospitals across the world; had interfaces to laboratory equipment, telephone exchange mobile phones and pagers, attendance recording system , and financial accounting systems; and included 36 modules, including various inpatient and outpatient management and patient record management modules.
The Wipro HIS was developed for Microsoft Windows® Server SystemTM integrated server software. The version that was implemented at the WockhardtHospital has been developed using the Microsoft Windows® Distributed interNet Architecture (DNA). Wipro is currently in the process of migrating the application to a Web-service-based solution and scaling it up from the current 300 concurrent users to accommodate 600 users.
The Wipro HIS takes a holistic view of hospital operations and addresses the core issues in the area, including the five problems that are endemic to hospital administration. These are:
Loss of revenue due to billable services not getting billed to patients;
Increased operating costs due to increasing inventory and staff required for back-end operations;
Patient dissatisfaction due to the time taken for various processes, including registration and final billing;
Reduced access to paper-based medical records, leading to both patient and employee dissatisfaction; and
Inefficiencies due to data in disparate systems not being exchangeable, thus leading to the lack of a single view of patient or hospital information.
Wipro HIS is based on Microsoft Windows® 2000 Server and Microsoft SQL ServerTM 2000, and integrates with Microsoft Exchange Server to send automatic reports and alerts to the relevant people. The solution is an n-tier system.
The Architecture
Windows DNA defines a framework for delivering solutions that meet the demanding requirements of corporate computing, the Internet, intranets, and global electronic commerce, while reducing overall development and deployment costs.
Windows DNA architecture employs standard Windows-based services to address the requirements of each tier in the multi-tier solution: user interface and navigation, business logic, and data storage. The services used in Windows DNA are integrated through the Component Object Model (COM).
The presentation layer consists of Windows client applications developed using the Microsoft Visual Basic® 6.0 development system. All the client applications connect to the business logic components hosted on Microsoft Transaction Server (MTS) in the Business Service Layer. The Business Service Layer is a set of COM+ components hosted on a COM+ server. The business logic COM+ components are hosted in different packages as application-specific components, common components, and Microsoft Data Access Components (MDAC).
Application-specific components execute specific business logic for the application. The common components will contain the business logic that is common across HIS, while the Data Access Components contain the data access logic. Every module in the HIS will have application-specific business logic components, common components, and Data Access Components. These components are grouped in such a way so as to gain optimum performance, scalability, and manageability.
The Data Service layer consists of Microsoft SQL Server 2000. The HIS database is hosted on SQL Server.
Another feature of the Wipro HIS architecture is the implementation of a no-cost replacement for the clustering of the application server. All users connected to the primary application server can switch over to secondary application server, if the first one fails, by restarting the application once they get a message “Primary Application server not available. Restart the application to switch over to Secondary Application Server.”
The Implementation
The implementation took eight months to be completed. For implementation, Wipro follows a MileStone-based Litmus Test (MSLT) approach, wherein the implementation is divided into seven milestones. Upon achieving a milestone, implementation proceeds to the next module only after the milestone passes the litmus test as determined by Wipro. For example, the test for the front-office system could be a one-minute registration of a new patient. So, for the front-office system to be accepted as implemented, and for the team to move on to the next task, this level of performance has to be achieved.
The Exchange Server for all locations is centralized at the corporate office. At the hospital, there is a two-node Microsoft SQL Server cluster to manage the database, along with a single-node application server (production server) and a single-node staging server. In order to reduce the cost of implementation, the staging server also doubles as fallback for the production server.
The implementation was first done for the outpatient departments, and then the inpatient functions were also integrated.
Benefits
Improved Patient Care and Turnaround
After the implementation, Wockhardt was able to realize real and tangible benefits from the system without having to wait for long. In the words of Dr. Lloyd Nazareth, General Manager, WockhardtHospitals, Mumbai: "Wipro’s HIS helps run the Wockhardt Hospitals in an efficient and cost-effective manner. The HIS system puts clinical and financial information at our fingertips, helping doctors and administrators in critical decision making.” The improved efficiency has obviously resulted in a better experience for the patients as well.
Automatic Alerts to Different Departments
Immediate benefits were noticeable in the speed of all commercial processes. From patient registration to billing, all processes are happening much faster than before. Information flow is automatic and smooth. The dietician, for example, can be automatically alerted when a new patient registers, along with his or her specific requirements, rather than having to wait for someone to manually pass on that information. Doctors have immediate online access to patient histories and lab reports, even inside operation theatres.
Better Inventory Management with
Fewer Staff
The hospital administration can get a better fix on inventory and billing, even while reducing the number of staff deployed for the purpose. Says Dr. Nazareth, “The benefits of Wipro's HIS permeate all the crucial areas from patient care to back-office operations and play apivotal role in providing quality medical care at Wockhardt Hospital."
Future Plans
The solution is currently under implementation at the newer Wockhardt Coronary Care Centre at Nagpur, India.
In the future, the Wipro solution will be extended to all the 16 Wockhardt Hospitals across the country, linking patient information across all hospitals. Wockhardt hopes that this large repository will enable it to improve its research and clinical trials, as well as help to provide better care for its patients.
About Wipro Technologies
Wipro Technologies is the global, technology services division of Wipro Ltd., a company that posted U.S. $1.35 billion in revenues in 2003. With more than two decades of IT experience, Wipro has pioneered the offshore delivery model for software solutions. Combining extensive capabilities in technology with deep domain expertise, Wipro delivers seamless solutions that bring tangible business value to leading organizations around the world.
About Wipro HealthCare IT Ltd.
Wipro HealthCare IT Ltd. (Wipro HCIT) is a dedicated Health Informatics Company with a talent pool of more than 100 professionals with domain expertise, and technology and management skills. The company has more than 650 person-years of experience in providing healthcare IT solutions to hospitals, clinics, laboratories, diagnostic centers, and physicians.
Wipro HealthCare IT has satisfied 45+ global healthcare customers with successful implementations across large provider chains, community/government hospitals, clinics, pharmacies, and healthcare supply chains.
About Microsoft Windows Server System
Microsoft Windows Server System™ is the comprehensive, integrated, and interoperable server infrastructure that helps reduce the complexity and costs of building, deploying, connecting, and operating agile business solutions.Windows Server System helps customers create new value for their business through the strategic use of their IT assets.With the Windows Server platform as the foundation, Windows Server System delivers dependable infrastructure for data management and analysis; enterprise integration; customer, partner, and employee portals; business process automation; communications and collaboration; and core IT operations including security, deployment, and systems management.
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