While eHealth is a pretty common topic in the IT space today, few real examples of the massive performance and efficiency gains technology can deliver to medical disciplines exist locally. That is until now however. Ethekwini has a new hospital that epitomises everything a connected, technologically advanced facility should. Net.Work went to Durban for a closer look
The idea for Ethekwini Hospital and Heart Centre (EHHC) started with Dr Diliza Mji, a specialist surgeon who had a dream of creating a healthcare facility that would use technology to provide a service that was at the pinnacle of affordability and efficiency.
He approached Keith Bonsal, 25-year veteran of healthcare management and introduced the idea to him. A couple of years later, that dream is a reality
But as Bonsal, current CEO of EHHC admits, affordability and technology seem mutually exclusive concepts when it comes to healthcare – especially if one considers the capital costs generally involved.
“As it is, the cost of entry for a private healthcare group is high,” he says.
“So the question was, how could we as an independent operator with a completely greenfields environment, find the funding to build hospital that had credibility, used the best technology and had a cost level far lower than any of our peers.
“It was a landmark move in terms of challenging the status quo,” he says, “and we succeeded.”
After a tough time finding interested investors, the funding for the hospital eventually came from South Africa’s Industrial Development Corporation (IDC), who invested R350m in the 250-bed facility.
With the investment part of the equation dealt with, EEHC had to move onto other challenges.
Primarily Bonsal says the company had to get around the issue of the local skills shortage, a particularly taxing task since 85% of the market is dominated by three private healthcare players and as such, those players own the job market.
But, Bonsal says the EHHC managed to secure the staff it needed by being future-looking and promising healthcare professionals the ability to spend more time caring for patients and less time on administration.
More specifically, he says, nurses should nurse – but today, they spend most of their time dealing with administration and paperwork.
“By taking the administration headache away, our nurses have the ability to spend more time at the bedside. And because they have had to become familiar with technology and new processes, they have improved their skill level – something that has only added to their value in the market,” he says.
“We also realised that in giving doctors access to the information they needed immediately, they could make more timeous decisions about patients’ treatment and here is the clincher, cut down on the number of days they spent hospitalised.”
Instead of discounting their rates, Bonsal’s clinic is able to pass savings on to its patients by reducing the time taken for treatment and their stay in hospital.
So, besides technology allowing the clinic to reduce the patient’s stay by offering better care; the mere fact that it offers better care gives it a strong competitive advantage.
“The vast majority of the mistakes made in hospitals today stem either from the wrong information being written down on a chart or information being misinterpreted based on it being noted inaccurately.
“Limiting the interaction people have with the data contained in the care process means less inaccuracies,” he says.
“The future of healthcare is also the use of technology both at the back-end and on the clinical front to make sure data is accurate and clean,” he explains.
So what IT systems reside behind all of this efficiency?
Bonsal explains that a highly-customised version of SAP sits at the core of its IT system and handles the majority of the clinic’s back-office functions like financials, cost accounting, procurement, HR, payroll, patient administration and billing.
The partner that EHHC chose for this implementation, namely T-Systems also brought its own solution to the table, which it developed with Siemens Medical GSD.
Called Industry Solution Health-Medical system (i.s.h.med), T-Systems’ software package caters for the more specialised medical processes within the EHHC’s workflow.
These include clinical logistics processes like resource scheduling and clinical orders; a surgery component which streamlines the planning process for elective surgery including assigning surgical staff; and both a radiology and retail pharmacy solution, which helps routing radiology requests and results as well as improving the process of ordering and replenishing medication in realtime.
And since i.s.h.med is already the technology solution of choice for almost 300 hospitals worldwide, it had the track record EHHC needed.
All of these systems would be largely inconsequential if they were not accessible to the staff they were designed to be used by.
To improve the usability of the system, EHHC’s IT team and T-Systems built mobile computers called COWs (computer on wheels), which can be wheeled around wards, operating theatres and other areas of care so that the systems can be interacted with, easily.
Because nurses and doctors are working with the back-end systems directly, everything is realtime.
The chosen software solutions also give the EHHC granular resource management and billing capabilities, the since swipe-card access systems back-end directly into i.s.h.med.
“The technology has truly changed the way our staff works. We are very satisfied with the results,” Bonsal says.
Most of us outside of the healthcare market do not have a good grasp of just how much more efficient technology can make medicine.
Bonsal says that the EHHC cost R1,4m/bed to build and kit out – in the region of R350m for a 250-bed facility.
By contrast, the Medi-Clinic group estimates that one of its facilities without the technological advancements
Ekhuruleni includes, costs between R1,5m and R2m to build and kit out. And Old Mutual concurs with the latter of these figures, saying it is the more realistic estimate.
So not only is it more efficient at rendering healthcare, but it worked out more cost effective.
But Bonsal and his team are not done just yet.
The IDC is already primed to invest in Bonsal’s next project – after all, their investment in EHHC has created 500 jobs and substantially improved the quality of healthcare in the Durban area.
Over the next four years, Bonsal says his company will undoubtedly be expanding, building new facilities and branching out into new geographies.
“We aim to build another 10 or so facilities in the next four years, bringing our total patient capacity to 2000 beds.
“We cannot stop now that we have such a successful formula,” he says.
“And it is really something that would not be possible without us using technology the way we have,” he concludes.