Hospitals have evolved from being institutions that solely heal the sick, to big machines that operate like any other business. Today, advanced technologies are transforming the practice of medicine, while streamlining hospital systems, from clinical and administrative to IT. According to Deloitte, hospital groups and health systems around the world are looking to technology to boost collaboration, improve efficiencies, address workforce challenges, reduce costs, enhance the quality of care and better meet patients’ demands.
Historically, hospitals and technology have never really gone hand-in-hand, says Servesan Moodley, group IT manager at Busamed Hospital Group. He thinks this is because technology wasn’t traditionally something that hospitals do. While hospitals have different systems, like payroll and ERP, to handle hospital management, accounting and billing, they haven’t traditionally been bothered with much else. This is no longer the case. Technology now plays a role in every part of a modern hospital, from preadmission to discharge.
Patients being admitted to Busamed hospitals are asked to fill out pre-admission forms at home to speed up the admission process, says Moodley. “If you’ve gone through our fast-track pre-admissions process, on the day of your admission, your file is ready and you just need to sign a few documents before being taken to the ward. One patient even described it as a drive-through admission.”
Many of our nurses were inexperienced when it came to computers, so we started with the basics, using Candy Crush to familiarise them with this technology.
Travis Dewing, Netcare
Hospitals are complex and intricate ecosystems, relying on a number of integrated applications to improve patient, doctor and staff experiences, says Travis Dewing, Netcare’s CIO. He says the impetus behind its digital transformation efforts is to transform healthcare delivery by providing “patient-centred care” that is “digitally enabled” and “datadriven”. While this is the goal, he says there are some hurdles to getting it right. Its systems have to be accessible 24/7, which, like any other business, means that any upgrades have to be handled “quite carefully”.
A single view
Because hospitals have many moving parts and because there are so many different departments and service providers, it can be challenging to find consistency, says David Price, CIO at Life Healthcare. “In any hospital, you will find a huge diversity of systems and data and data sources. Often, it’s specialised and very rich clinical data. Aggregating this information and combining it with non-clinical data to get a single view of what’s going on is a challenge.” But when they do get it right, the results speak for themselves.
Life Healthcare is one the first hospitals in Africa to implement Salesforce Health Cloud, says Price. The platform provides a single view of each patient. They are currently using Health Cloud to improve the level of service delivered to their renal patients. This solution provides caregivers and clinicians with a more holistic view of patients and makes it easier to follow individual patients as they move through different stages on their healthcare journey. “This was the right fit for renal because a patient isn’t just coming in once and then you never see them again. Renal patients come in for dialysis regularly, which means you have a series of interactions with them and you can monitor these visits over a period of time so that you have a better idea of how they’re doing over time and of where you’re doing well and where you could improve.”
For Busamed, cloud is a major part of its digitalisation journey. Working in partnership with Datacentrix, the private hospital group recently consolidated multiple on-premise datacentres into one central hosted private cloud environment. Here, it hosts the core server environment and ERP systems. There were several reasons for the migration, says Moodley. “A lot of the infrastructure within our datacentres was reaching end of life, parts availability was becoming a risk, and finding the necessary support and managing maintenance on those environments was also a challenge. Maintaining multiple sites, especially when loadshedding was at its peak, and making sure that all the generators and UPSes were functioning as they should was another concern.”
Given how critical uptime is in hospitals, the migration and the vendor selection process was done very thoroughly “There are a lot of vendors that just want to make a quick sale, but that’s not what we were after.” Cost was a major factor in the decision. “We had discussions with a few vendors, but many bill in dollars and with the volatility of the rand, this could have a massive impact on the IT budget. Because you can’t predict what the rand/dollar rate is going to do, that means you have no way of forecasting what your hosting costs are going to be. As such, we opted for a private cloud approach.”
As far back as 2014, Netcare’s CEO Richard Friedland had a vision to make Netcare largely paper light by 2020. The CareOn programme was a big part of this drive. This electronic medical records platform provides clinicians with live access to their patients’ records, test results and vitals remotely and in real-time. They can check up on a patient even when even they are outside the hospital.
Digital scripting
According to Dewing, Netcare’s investigation into electronic medical records started in earnest in 2017, with a feasibility study and business case approved by the board in March 2018. The project team then spent 18 months planning and blueprinting, standardising processes and raising awareness about the project. In September 2019, the CareOn EMR pilot went live at Milpark hospital and CareOn was deployed across all Netcare hospitals earlier this year.
Discussing the details of the solution, he says that the core electronic medical record platform called iMedOne was provided by Deutsche Telekom Clinical Solutions. The refinement, customisation, and development of the iMedOne platform was implemented by DTCS teams in South Africa, Germany, and India. The development of the complete CareOn solution – including medical device integration, digital scripting, drug interaction, safety information and SAP developments and integrations – was conducted utilising a combination of Netcare internal technical teams and partners in the different domains. All CareOn data is stored in Netcare’s own datacentre, he says, and cybersecurity is a top priority for the hospital group. “We’ve made significant investments to ensure a robust environment that safeguards this information,” Dewing says.
One patient even described it as a drive-through admission.
Servesan Moodley, Busamed Hospital Group
As part of the rollout, Netcare spent time on change management to prioritise adoption among healthcare workers. It also partnered with a behavioural economics consultancy firm to ensure success across multiple hospitals. “Many of our nurses were inexperienced when it came to computers, so we started with the basics, using Candy Crush to familiarise them with this technology,” says Dewing. While he doesn’t provide any numbers, he does say the group measures metrics monthly to ensure that clinician adoption is at a certain level and, to date, the adoption metrics are above the targets and are trending upwards. Earlier this year, CareOn won the Digital Innovation Award at the seventh annual International Quality Awards held in London.
Dewing says that he and his team need to keep an eye on what comes next. This project has laid the right groundwork and opens the door for significant efficiency gains and technical transformation elsewhere.
Discussing Netcare’s broader digitalisation efforts, Friedland says: “Healthcare is not just about treating illnesses; it’s about crafting a future where every digital innovation becomes a tool for empowering patients to become equal and active participants in their health and well-being. In our healthcare ecosystem, digital technology and the rich, personalised data that it provides are the keys to continually elevating the most crucial deliverables for patients.”
* Article first published on brainstorm.itweb.co.za
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