Speaker Presentation Bassem

GOING PAPERLESSEFFECTIVELY MANAGING CONTRACTS

FOR HEALTHCARE PROJECTS AND INTEGRATING PROCUREMENT

PLATFORMS WITH INFORMATIONMANAGEMENT SYSTEMS

Bassem Samir Hamade, Contracting and Purchasing Manager, Al-Mashfa Hospital, KSA

Subjects Going paperless:

Ensuring that the procurement division has the most appropriate tool and synchronizing information flow to improve efficiencies, reduce waste and manage long-term costs

Ensuring purchasing process integration with SAP through material management as well as setting corresponding policies and procedures

Evaluating crucial points to consider whilst negotiating contracts for major/capital medical equipment and services

Going paperlessWhen people hear the phrase “going paperless,” they often assume they’ll no longer be using paper in daily tasks or even have access to it in their office. This obviously isn’t true or practical. Going paperless means using paper wisely and sparingly and finding effective alternatives.

Going paperlessConsider these statistics:o Organizations spend in labor costs (on average): $20 to file a

document, $120 to find a misfiled document, and $220 to reproduce a lost document.

o Of all documents, 7.5 percent get lost; 3 percent of the remainder get misfiled.

o Professionals spend 5–15 percent of their time reading information, but up to 50 percent looking for it.

o The average cost to process a single invoice manually is $24.o Of 1,200 organizations surveyed, 40 percent indicated disaster

recovery planning is not a priority.o Two out of five companies that experience a disaster are out of

business in five years.

Sources: PricewaterhouseCoopers, IOMA, Gartner and Captaris.

Going paperless Advantages:

To overcome problems and delay when transferring paper medical records. To improve problems with loss or misplacement of physical paper records

and record envelopes. To save time spent on handling paper records. Information can be shared more easily. Email and intranet communication within the practice reduce internal paper

flows, telephone calls and faxes. Increase in security and confidentiality because it is easier to control and

audit access to records. Opportunity to improve the existing electronic patient records (EPR). More efficient and effective consultations (all information is available and

up-to-date( Mixing of paper and electronic records causes confusion. Patient access to records can be an advantage (more transparency,

equality within the doctor-patient relationship(

Going paperless Disadvantages:

Data security. Document managing and scanning have proved problematic. Lack of IT standards for GP staff. Problems with data backup (if data are lost or if a system goes down) Lack of national protocol. Lack of internal protocols within a practice. Staff training (time, costs, standards) Fear of change and the unknown. Health and safety issues regarding more time spent at a

screen/monitor. Less effective consultations, as dominated by technology (but patients

do not seem to complain) It takes more time for clinicians to read documents such as clinical

letters on screen.

Going paperlessTraditional telecommunication companies are heavily involved

in “Paperless” healthcare markets

Germany’s e-health smartcard project Austria’s the NÖMED WAN-project. connecting all public hospitals there via

a Master Patient Index that uses the Austrian E-Card for patient identification. In Spain, installed a regional health network that uses an SAP based

medication module, which enables a large number of primary care centers to do electronic prescriptions.

In Saudi Arabia, the new ongoing project for Electronic Medical Records (EMR) across its health system particularly the integration of diverse information systems. It effectively linking an EMR to existing and future systems, at hospital, regional and national levels.

Traditional telecommunication companies will not develop its own next generation HIS which is important, but it is certainly not indispensable to life. Their key expertise lies in system integration.

Going paperlessHIMSS Healthcare Information and Management Systems SocietyHIMSS is a cause-based, not-for-profit organization exclusively focused on providing global leadership for the optimal use of information technology (IT) and management systems for the betterment of healthcare.

Saudi hospital first in the Middle East to achieve global recognition for its healthcare IT. HIMSS Analytics Asia announced King Faisal Specialist Hospital & Research Center (KFSH&RC) in Riyadh and Jeddah, Saudi Arabia, has achieved Stage 6 on the Electronic Medical Record Adoption Model (EMRAM). And recently in UAE, Corniche Hospital and University Hospital Sharjah.

Going paperless

Going paperlessDefinitions: Clinical decision support system (CDSS) Computerized physician order entry (CPOE) Computerized assessment system (CDR

system) Continuity of Care Document (CCD)

It is a standard intended to specify the encoding, structure, and semantics of a patient summary clinical document for exchange

Closed Loop Medication ApplicationIt is a process to ensure automated validation of medications and patient identity matching.

Going paperless

Going PaperlessIt is not just a computer

upgrade, It's a change in the way we

operate.

purchasing process integration with SAP

Ensuring purchasing process integration with SAP through

material management as well as setting corresponding

policies and procedures


HISInternational Conference on Social Science and Humanity had Described:"Hospital Information Systems can be defined as massive, integrated systems that support the comprehensive information requirements of hospitals, including patient, clinical, ancillary and financial management." ……." Hospitals are becoming more reliant on the ability of hospital information system (HIS) to assist in the diagnosis, management and education for better and improved services and practices. In health organization such as hospitals, implementation of HIS inevitable due to many mediating and dominating factors such as organization, people and technology."


ERP ERP is short for enterprise resource planning.It is business management software that allows an organization to use a system of integrated applications to manage the business. ERP software integrates all facets of an operation, including product planning, development, manufacturing processes, sales and marketing.


ERP Software ModulesERP software typically consists of multiple enterprise software modules that are individually purchased, based on what best meets the specific needs and technical capabilities of the organization. Each ERP module is focused on one area of business processes, such as product development or marketing. Some of the more common ERP modules include those for product planning, material purchasing, inventory control, distribution, accounting, marketing, finance and HR.


The basic goal for ERP is to provide one central repository for all information that is shared by all the various ERP facets in order to smooth the flow of data across the organization.


ERP Vendors

The ERP market for large enterprises (ERP Tier I) is dominated by three companies: SAP, Oracle and Microsoft.

For the midmarket (ERP Tier II) vendors include Infor, QAD, Lawson, Epicor, Sage and IFS.

For small Business ERP (ERP Tier III), Exact Globe, Syspro,

NetSuite, Visibility, Consona, CDC Software and Activant Solutions round out the ERP vendors for small businesses.

(Source: EnterpriseAppsToday; ERP Buyer's Guide; Drew Robb)

http://www.enterpriseappstoday.com/erp


ERP One of the benefits; - Integrating between the

different modules in order to facilitate transforming the information between modules and saving the efforts & required time for recording the information again in more than one module.

Can be utilized as a requisitioning and procurement productivity suite that is flexible and scalable to meet your business needs, giving you the power to enhance, manage and control any step of the purchasing process


to interface directly to ERP, users can quickly select vendors and items, see what's left in real time and, quickly recreate requisitions for future orders using templates, or quickly assign budget distribution to designated companies as needed.

Routing through the approval hierarchy, based on flexible criteria such as order type, vendor category, approvers can approve, reject, ask for changes, or request additional information. Email notifications keep the process moving and increase process visibility. With some specific modules, approvers can easily review requisitions on the go.


Approved requisitions can be converted into purchase orders through the connected ERP. Need to make a change? The Change Order Module allows users to open a PO, make necessary changes, and reroute it for updated approval.

Saved in your transaction history, Requisitions and POs are easily accessed for quick reference. With the Search Module, you can search based on multiple criteria such as Requisition ID, PO, Receipt, Invoice, Voucher Number, Date, Status, Name, Vendor, Item, and General Ledger (GL Account # and easily exported to Excel, PDF, etc,. for reporting.


SAP SAPMM Module

PurchasingComponent

Procurement Process Create PR

Inbound to HIS

If STDCreate POSource List Save PORelease it

If NewRFQ

RFQ Process

Inventory Management

Material Requirement

s PlanningComponent Component

FinanceModule

HRModule Etc.

Policies and ProceduresPURCHASING DEPARTMENT

Policies and Procedures

Number: PD 01-004-0

Title: Purchase Process

Original Date: August 1, 2012

Effective Date: August 1, 2012

1. Policy Statement

All acquisition facilitated by the Purchasing Department should follow the Purchase Process.

2. Purpose

2.1 Establish a standardized flow in making purchase requests throughout the hospital. 2.2 Serve as a guide to all personnel with regards to the purchase process. 2.3 Protect the interest of Al Mashfa Hospital by assuring that purchase requests are of good faith

and beneficial to the cause of the hospital.

Policies and Procedures

3. Responsibility

In accordance to this policy, it is the responsibility of the;

3.1 Purchasing Manager to ensure that all departments are well informed with the process implemented by the Purchasing Department.

3.2 Department Heads to ensure the necessity of item requested; and to inform the Purchasing Department on the nature and urgency of each request.

3.3 Appointed personnel of each department that all purchase requests follow the approved process in Submitting requests.

3.4 Purchasing staff to ensure that all requests go through the standard flow and assure that these are processed in a timely manner.

Policies and Procedures4. Definition

4.1 Purchase Requests are written communication substance to the Purchasing Department describing item not available in the storeroom and the requested for purchase.

4.2 A Vendor/Supplier is an individual or company that provides supplies, equipment or services to the hospital.

4.3 A Request for Information (RFI) is a method of collating information from different supplies prior to formally sourcing products or services. It is normally used where there are many potential suppliers and not enough information is known about them.

4.4 A Request for Proposal (RFP) is a formal method of receiving detailed and comparable proposals from different supplies for a defined products or service. It is a comprehensive document that should provide all the required information needed to make an informed purchasing decision.

4.5 A Request for Quotation (RFQ) is a competitive bid document used when inviting vendors to submit a bid on project or products. An RFQ is suitable for sourcing products that are standardized or products in repetitive quantities. A technical specification must be provided as well as commercial requirements.

4.6 Cooperative Purchasing refers to the exchange of price information, vendor list, and other purchasing information between institutions so that maximum value can be obtained.

5. Equipment

5.1 Purchase Request From 5.2 Request for Information (RFI)/ Proposal (RFP)/ Quotation (RFQ)

Policies and Procedures6. Procedure

The following process ensures that all purchases are beneficial to the institution. Process is depicted in a diagram. (Refer to PD 02- 001-0)

6.1 The Store Keeping submit requests for regularly consumed supplies only. 6.2 Purchase Requests for new items must be made by concerned units/ department and may be Accompanied by products/ item descriptions. 6.3 All requests must have been signed by the respective department heads. 6.4 Requested items classified as Prohibited Item are not accepted. There include; 6.4.1 Personal items such as pencils and other personal care items. 6.4.2 Luxurious items; wherein more expensive new products have no proven advantage or Benefits over the current and more economical products in the hospital supplies. 6.5 Single Transactions which include items needed in few amounts or used infrequently and Costs SR 2000 are bought directly by Purchase Agents, upon approval from the Purchasing Manager. 6.5.1 Purchase Agent scout and present the best price to the Purchasing Manager. 6.5.2 Funds are requested directly from the Finance Department. 6.5.3 Relevant expenses may be reimbursed as Petty Cash, as per Finance Department Policy. 6.5.4 Official receipt Department.

Policies and Procedures6. Procedure (continued)

6.6 Items worth more than SR 2000 and considered non-urgently needed may have to go through a bidding process to identify the most suitable supplier/vendor. 6.6.1 RFI/RFP/RFQ are sent to qualified companies listed in the supplies database. 6.6.2 Bidding determines the most suitable Vendor/Supplier. 6.6.3 Products are tested for trial use, or sent for evaluation prior to awarding a contract to a Supplier. 6.7 Items bought in large quantities and used regularly are usually included in Blanket Orders. 6.8 Purchasing Orders are prepared are must be approved by the Purchasing and Finance Department before being sent to Vendor/Supplier. 6.9 The Finance department is notified upon delivery of products. It is only then that the transactions can be entered in the Accounts Payable List. 6.10 The Purchasing Department may participate in Cooperative Purchasing Agreements with other healthcare institutions or organizations to gain better prices and choices, in the provision that, participate does not affect the quality and service requirements maintained by the hospital. 6.11 Inter- institutional purchasing arrangements can be implemented if it is in the best interest of AL Mashfa.

Policies and Procedures7. Documentation

* Refer to the following policies for more information; 7.1 Policy on Product Evaluation and Standardization 7.2 Policy on Selection of a Qualified Vendor 7.3 Policy on Preparing Purchase Orders

8. References

Negotiating Contracts

Evaluating crucial points to consider whilst negotiating contracts for major/capital

medical equipment and services

Negotiating Contracts

Total Cost of ownership (TCO) Service Coverage uptime Guarantee Update/Upgrade Policy

Negotiating ContractsTotal Cost of ownership (TCO):

The core principles of the concept of utility and efficiency. is a method to describe all costs of a certain infracstructure.TCO, when incorporated in any financial benefit analysis, provides a cost basis for determining the total economic value of an investment. Examples include: return on investment, internal rate of return, economic value added, return on information technology, and rapid economic justification.TCO tries to quantify the financial impact of deploying an information technology product over its life cycle . These technologies include software and hardware, and training.

Negotiating ContractsTechnology deployment as part of TCO includes the following : Computer hardware and programs

Network hardware and software Server hardware and software Workstation hardware and software Installation and integration of hardware and software Purchasing research Warranties and licenses License tracking - compliance Migration expenses Risks: susceptibility to vulnerabilities, availability of

upgrades, patches and future licensing policies, etc.

Negotiating ContractsTechnology deployment as part of TCO includes the following :

Operation expenses Infrastructure (floor space) Electricity (for related equipment, cooling, backup power) Testing costs Downtime, outage and failure expenses Diminished performance (i.e. users having to wait, diminished

money-making ability) Security (including breaches, loss of reputation, recovery and

prevention) Backup and recovery process Technology training Audit (internal and external) Insurance Information technology personnel Corporate management time

Negotiating ContractsTechnology deployment as part of TCO includes the following : Long term expenses

Replacement Future upgrade or scalability expenses Decommissioning

Negotiating ContractsService Coverage uptime Guarantee

All major systems Included to a contract shall be subject to service coverage uptime Guarantee of 95% to 98% depending on the system. Let's take some equipment at Al-Mashfa hospital as an example: 97% for Diagnostic Imaging, Ultrasound and

BMD 98% for Anesthesia and Ventilator systems 95% for all other clinical systems and devices

Negotiating ContractsUpdate/Upgrade Policy

The update/upgrade policy for Major equipment should be mentioned clearly either under a separate clause or within the warranty clause. Needless to mention, major equipment shall be warranted for 5 years from earlier of final commissioning date or first patient.

Negotiating ContractsUpdate/Upgrade Policy

Updates shall be provided free of charge of the lifetime of the capital equipment.Contracts must be made to ensure the receipt of the major equipment with the latest upgrade version regardless of the version mentioned in the PO at that time.

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Thank you

Speaker Presentation Bassem

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