April 2008

N. M. VIRANI WOCKHARDT HOSPITAL , Rajkot

“Wockhardt Hospitals is exclusively associated with Harvard Medical International (HMI), giving it access to the latest clinical protocols, innovations and patient care practices from 17 prestigious Harvard-affiliated hospitals in the United States.”

As part of its foray into Saurashtra, Wockhardt took over the N.M. Virani charitable hospital situated in Rajkot in 2006, converting it into a super-speciality facility. The hospital was formerly run by the Ashok Gondhia Memorial Trust. The Brownfield project combined the infrastructure and some manpower of the existing hospital with the technical expertise and over 18 years’ experience of Wockhardt. The Rajkot facility is a boon for patients who previously travelled to Ahmedabad and Mumbai for advanced procedures in cardiology, cardiac surgery, neurosurgery and orthopaedics.

There are several remarkable aspects of the transformation story. One is that, the hospital continued to operate during the makeover which took approximately 8 months. Also, the high-end facilities are still available at a price which is less than that at Mumbai or Ahmedabad. This has been a policy decision on the part of the administration. Patients arrive here from Gandhigram, Bhuj and Jamnagar.

Wockhardt Hospitals is exclusively associated with Harvard Medical International (HMI), giving it access to the latest clinical protocols, innovations and patient care practices from 17 prestigious Harvard – affiliated hospitals in the US, including the Massachusetts General Hospital, the Brigham and Women’s Hospital and the Beth Israel Hospital. The administration leadership and senior employees were trained both at Rajkot and at Mumbai and Bangalore and best practices from the Bangalore and Mumbai facilities were incorporated into the training modules.

The super-specialists at the N.M Virani Wockhardt Hospital have been brought in from across the country. Their families had to be relocated to the city. Though a major challenge, this was made easier by the huge clinical potential which Rajkot presented. A peaceful, non-violent society, yet in proximity to Ahmedabad helped to sell the idea.

Wockhardt’s expansion in the region began with the Nagpur facility. The IT team took 6-8 months to get the hospital’s IT systems ready and rolling. Thereafter, through learning-by-doing, the subsequent facilities were completed much faster. The Mulund (Mumbai) hospital was completed in 3-4 months and today, the Wockhardt team is capable of setting up a hi-tech hospital within 1 month. There are plans to spread out in the region � a hospital has already been set up in Bhavnagar. Another has been commissioned in Surat and one is in the pipeline for later this year in Bhuj.

There were a number of challenges that the team faced when setting up the hospital and making the sweeping changes. An important one was moving from a ‘Charitable Trust culture’ to a corporate, professional environment. The professional, international flavour that Wockhardt has introduced will no doubt raise the expectation levels of the sleepy town and surrounding areas.

Changes
Although Rajkot does have secondary level health care facilities, N.M. Virani Wockhardt brings world-class tertiary level facilities for the first time to a population of about 1.5 crores.

INR 30 crores was spent on upgrading the equipment and technology. The previous EMR system was MS-DOS based and minimal. After the takeover, a Wipro Hospital Information System (HIS) was introduced. This was applied extensively to almost all areas of the hospital’s functioning.

“We have the advantage having run this software for five years, that when we go a new hospital, we can roll it out in 15-20 days flat. Every module is interconnected, every department is computerised.” “Our staff is trained at the nearest hospital, so they work on the same software. From day one, they are familiar with the screen.” Pradeep Vaidya,Head, IT

N. M. Virani Wockhardt Hospital is equipped with 166 beds and 6 operation theaters. It offers a wide range of specialised services including Endocrinology, Oncology, Gynaecology, Cardiac surgery, Cardiology, Paediatrics, Critical care, Nephrology, Urology and preventive health care. Previously only catering to secondary care, it now offers bypass surgeries, replacement surgeries and minimal access surgeries. The hospital layout plan was changed significantly to improve work flow. The pharmacy, which was earlier placed at the back, was brought forward and the laboratory placed at the back of the hospital. There are now separate entrances/exits for doctors, outpatients and equipment. An ‘ICU on wheels’ cardiac ambulance was introduced � the need of the hour today. There is a fingerprint ID system for all staff.

The hospital is equiped with the Philips Cath Lab Allura Xper FD 10, one of the latest, state-of-the-art digital imaging systems for Cardiovascular Diagnostic and Interventional procedures, also one of the very few in the country. It can be ceiling rotated and allows a 3-sided patient approach at maximum free floor space with full body coverage, based on high frequency converter technique. It accepts minimal dosage and delivers high image quality, thus helping the cardiologist to perform quality invasive procedures.

The Operation Theatres have Class 100 Laminar air flow systems, meeting international standards.

IT Infrastructure

The IT software was initially developed by GE who in turn had acquired it from Citadel. Later Wipro took over the package. Wockhardt was the first customer of this software. At the time, it was a ground-breaking, highly integrated model. However, Wockhardt is now looking to further upgrade and integrate its existing IT systems. There are plans to build a super-architecture on the existing, underlying model and create a model which will integrate Wockhardt hospitals across the country.

With the experience of nearly 5 years that Wockhardt has with its software, Mr. Pradeep Vaidya, IT Head and his team can now roll out the model in a new facility within 20-odd days! This he attributes to “duplication and a lot of learning along the way”. There are however a few issues which are tackled on-site, like faulty wiring, different LAN, different number of departments.

“I have been working here for approximately 1 year. I handle the health check-ups from beginning to end, right from registration to the reports. Registration and billing is centralised, so it can be done at any counter.”Charmy Bharvada, Customer Care Trainee

Many of the staff at the new facility are trained at the nearest Wockhardt hospital, making it very easy for them to hit the ground running. There is a patient feedback system in English and Gujarati and also an internal monthly review mechanism. An HR portal is being developed, which will be an intranet solution. A central purchasing portal is also in the pipeline. Through this, key items will be procured through the headquarters in order to enable cost-effective bulk purchases.

Challenges

  • Doctors’ reluctance to adapt to advancements in technology. The introduction of voice recognition systems and handwriting recognition systems should change this.
  • Rajkot is a small town where most offices and businesses are shut between 2 and 4 in the afternoon in keeping with the work culture of the place. This had to be overcome for the effective functioning of the modern-facility.
  • Switch from MS DOS to a new Wipro HIS and EMR system. At the pharmacy, the product codes changed, necessitating that the staff learn the new system.
  • Keeping up with the latest technology through constant software upgradation is difficult and costly. Wockhardt Hospital’s is on the lookout for an IT vendor to cater to their need for technologically advanced and highly integrated IT solutions.
  • Getting the small towns ready for a corporate hospital. Small town populations are usually heavily dependent on alternate forms of medicine.
  • Different methods of compiling discharge summary in different departments need to be streamlined to save more time.
  • System failures and loopholes necessitate paper records and backups.

Conclusion

The N.M.Virani Wockhardt facility comes to the right place at the right time. Rajkot is one of the fastest growing cities in the world with a population of over 1 million. Before the N.M. Virani Wockhardt facility was set up, patients in the region had to visit Ahmedabad for high-end treatment � situated 216 km away. With a literacy rate of over 80%, the scope for IT interfacing between hospitals and the public is high.

The Ashok Gondhia Memorial Trust continues to provide financial assistance to Below Poverty Line (BPL) patients. One surgery and one plasty is sponsored every month. A charity OPD operates between 1500 and 1700 everyday. In an attempt to welcome the patients from the lower economic strata, the general wards have maintained their old look and feel.

The state-run 108 ambulance service effectively augments the 3 ambulances which the hospital owns. One of them is well-equipped with emergency care facilities. As far as expansion goes, there is potential to build another floor on the same premises to serve the increasing needs of the region and city.

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