Inderjith Davalur is an MBA and MS (University of Massachusetts, USA) in Healthcare Administration and has worked for over 20 years in the US. With an exclusive background of IT in healthcare, Mr. Davalur has served on patient privacy and electronic health record committees in the US. He is currently the CEO of Aosta Software Technologies, Coimbatore, India.

This article is an account of Mr. Davalur’s introduction to a hospital that has garnered a fair level of recognition and respect and its President, who is a well known figure in the healthcare sector in India. Through this article, Mr. Davalur shares his observations made over the past few months of the hospital and its tech savvy President.

It was the year 1990, when Dr. Nalla G Palaniswami and his wife Dr. Davamani returned to India from the US after working as physicians, and founded Kovai Medical Center and Hospital (www.kmchonline.com). It is a 500-bed multi-disciplinary super-specialty hospital on the NH 47 corridor, minutes from the airport in Coimbatore. The hospital has more than 50 medical disciplines managed by highly qualified and trained full time medical specialists providing round the clock service. Over 1000 inpatients and outpatients are treated every day at the hospital. There are three more centers within a 100 km radius.

Mr. UK Ananthapadmanabhan, President, KMCH (ukananthsvp@gmail.com) is a familiar face, and quite well known as a good orator in the healthcare sector. He is one of those people who takes things forward very easily, even in a situation critical, though. He has lived with and breathed in administering hospitals in India most of his life. An engineer by profession, Mr. Ananthapadmanabhan is a tenacious technocrat, who could be an asset to any technological company and the proof of that is live at KMCH, which houses some of the latest in clinical diagnostic and treatment technologies and gadgets. My primary interest, however, lies in the hospital’s information system and the extent to which they have managed to utilise the technology.

It has been my theory and pet peeve that most of the companies (I include the manufacturing and distribution sectors in this) all over the world spend money on software for the wrong reasons. While there are several reasons to go around for this malady, one reason that stands out in my opinion is that there is not enough education from the software industry. I belong to the software industry myself and I feel that in a general sense, we (here, I am referring to the software applications in the healthcare sector) have only recently come to recognise and promote software purchases as an investment and not as an expense. I also feel that we have not done enough to understand the healthcare industry, its practices, and its needs well enough to be able to proclaim ourselves as suppliers of “software solutions” to hospitals. However, my discoveries at KMCH should demonstrate that it is not all of bad news; if the vendor and the hospital work together (as they always should) a lot can be accomplished and gained on both sides.

In the interest of sustaining readability, I am keeping the mundane features of most hospital information systems (HIS) in the market out of this article. What interested me were some very specific uses of technology and clever customisation that have been done at KMCH. While a good part of the credit goes to the software vendor a sizeable portion of credit goes to the President and teams within the hospital that worked tirelessly to make it all come together and work right.

1. Insurance Claims Processing:
   With the rapid increase in the number of patients with insurance the number of claims to be processed has increased multi-fold. The process of filling out claim the forms claiming and submitting them manually is fast becoming a major challenge for most mid-size and large hospitals. Manual process introduces errors and delays making automating the process a major requirement. Unlike some hospitals that use a third party software, KMCH chose the HIS – BackBone’s insurance claims module to accomplish this task. Since all the data on the patient and his/her visit is already in the system, only a minor portion of data needs to be entered and the claim submitted electronically. In cases where the insurance company or a TPA is unprepared to receive the claim electronically, BackBone can fax the claim electronically which will appear as a regular hard copy on the fax machine of the TPA. This versatility has increased the efficiency and reduced the errors and turnaround time for KMCH in insurance claims processing.

2. Paperless Patient Ordering System:
   KMCH has a specified list of default suppliers for certain items and also their information for Reorder Quantity to be supplied. Suppliers can logon to BackBone and monitor the stock position of the items they supply. A text message will be sent to the suppliers when the stock goes below Reorder Level. The pharmacy, lab requests, supplies, surgical issues etc., are all done within BackBone thereby completely eliminating paperwork. This also improves accuracy and reduces errors. Several built-in safety nets block most of the common errors in the ordering process and reduces waste and losses. It also improves patients’ experiences and reduces administrative work.

3. Text Messaging:
   while SMS usage in business is nothing unique, its use at KMCH is purely aimed at improving patient time utilisation. Text messages are used in communicating vital information such as lab results, insurance pre-authorisation, Job Order Status, Collections, and Patient Statistics etc. For the management, text messages carry information on census, collections, and other alerts that would otherwise take longer times.

4. Information Kiosk:
   A very simple to use touch screen kiosk in the hospital’s lobby has reduced the number of patient visits to the information desk. The kiosk provides information on patients’ details, bill details, and certain test results and for general information and non-patients, it also provides information on ATM locations, call taxi phone numbers, airline and train schedules. A very interesting feature offered by the kiosk is a patient self-registration service that speeds up the process for the patient and the hospital staff.

5. Supplier Portal:
   Based on the success of the paperless concept, there is also a mechanism to generate purchase orders directly through the system for wholesalers and retailers. This allows the system to bring those transactions directly into the financial system and generate GRNs.

6. Personnel:
   With BackBone in all KMCH satellite centers, employee attendance, leave, permission can be monitored by the personnel department from anywhere. With all information available centrally, personnel department can generate salaries on the fly.

7. PRI:
   BackBone is interfaced with Ericsson PRI Exchange. When a patient gets admitted in the Private Room, the telephone facility with the required services (ISD, STD, Local) is are allotted which in turn will be integrated with the PRI Exchange.Any calls made during the patient stay are posted in the patient bill.

8. Patient Movement Tracker:
   Request for wheel chairs, stretcher, etc are raised in BackBone to the Central Transport System (CTS) eliminating the normal procedure of using telephones.

9. Equipment Integration:
   Two-way integration of Lab equipment such as Cobas 6000 helps reduce manual intervention and automate the entire process.

10. CSSD:
    BackBone helps KMCH manage the CSSD with reports for instance, that analyse the cycle time. The system captures each of the stages of processing, preparation, sterilization etc.

11. Report Builder:
    With BackBone report Builder, KMCH generates reports with the Backbone Implementation Coordinators. Report Builder can generate data and graphical reports on the fly. The uniqueness of this feature is that someone that cannot even spell SQL or know what it means can build a report in minutes.

Why should any of these features matter to the average or large hospital? Given the competition in the marketplace, every hospital has to find ways to reduce costs, increase efficiency and most important of all, enhance the experience for the patient. It is an accepted fact that an electronic system (HIS/HMS) for managing the hospital operations is a must and considered an investment rather than an expense. How well a hospital chooses an HIS and how well it gets implemented play a key role in its success and in my opinion, KMCH is a textbook of cases of success. In fact, it is in pursuit of perfection. As for the Chairman, Dr. NG Palaniswami and Mr. UK Ananthapadmanabhan, they continue to push the envelope on all fronts of healthcare technology.

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