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1 Business Management, Consulting and Information for Healthcare Systems and Hospitals
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GOMLA (ISRAEL) ltd - Our Experience:
2 IEC (Israel Electric Company) Cellcom (Israel’s largest cell-phone company) Tnuva (Israel’s largest dairy manufacturer) El-Al (Israel’s national airline) Sheba - Israel’s largest (1350 bed) hospital Implementation of profitability in Israel’s leading business corporations: Wards Illness category Insurance carrier Other cross- sections defined by hospital management. Enhanced hospital profitability by:
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Hospital Data Uses 3 Analysis of managerial, operational and financial information; reporting to management and decision makers Hospital Operational Information System – Medical, Financial and Logistical data TMR DATA WARE HOUSE Accessibility to operational data by managers at all levels Processing of managerial, financial and operational data: budget, pricing, control, management and organization Defining and assimilating the accounting method
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The TMR Software 4 The TMR allows users to define business scenarios and detailed budgets, easily update budget data and separately analyze the performance and profitability of each organizational subunit. Users can select a pricing method of their choice, including ABC pricing, and combine several pricing methods in a single system. TMR meets the complex and multi-dimensional needs of hospitals by providing an “X-ray” image of the organization which allows management to improve organizational profitability.
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TMR Serves Hospital Management :
5 Informed profitability management Knowing the cost and profitability of each illness category Knowing the profitability of each population segment Knowing the per patient profitability (insurer) Decentralization of Organizational Subunits into Profit Centers Knowing the costs and profitability of each profit center; Supervising profit center budget compliance Allows benchmarking for profit center improvements (corresponding period in previous year) Definition of future scenarios for simulation Constructing and updating current budget Constructing and updating multi-annual budget Defining “What if” scenarios under uncertainty
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Leading Examples of TMR’s Utilities in Organizations
6 1 Positive incentives for departments Who meet budgetary goals 2 Positive incentives for department Who show improvement over last year 3 Restricts areas of hospital operations Which lead to losses on a regular basis 4 Expansion of clinics That are profitable 5 Reduce clinics That are not profitable 6 Release bottlenecks To increase profitability
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Leading Examples of Benefits Outside the Organization
7 1 Of the need to increase rates Provide evidence to regulators 2 Amend agreements with insurance carriers Which lead to losses 3 Profitable insurance carriers Encourage expansion of collaborations with
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Data Import from all Hospital Information Systems
8 Data Import from all Hospital Information Systems Hosp` system Clinics Financial accounting Diagnostic and therapeutic services All data enter TMR surgery logistics laboratories Payroll system
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TMR is Unlimited in Data Import
9 TMR imports data from all existing information systems in the hospital Data import is performed from all types of hardware and software, including excel spreadsheets Both quantitative and financial data are imported
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Structural Elements of the TMR Simulator
10 E.I.S & Olap System Excel report archive General and specific report generator Analysis of deviations Budgeted quantitativeD.W.H. Pricing-based budget Pricing of effective performance Economic Simulator Quantitative D.W.H. Data import generator Data from all systems Oracle Database
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TMR uses the Patient Medical File
11 TMR uses the Patient Medical File as the starting point in identifying a hospital’s centers of profitability or loss
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A Patient’s Medical File Contains:
12 A Patient’s Medical File Contains: Revenue from insurance carrier Imaging Laboratories Surgery 3 hours Checks by ER staff Admission Hosp’ in ICU 2 days Hosp’ in surgical ward 6 days Hosp’ in rehabilitative ward 4 days Release
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Profitability per Individual Patient Medical File
13 qty Per unit cost in USD Total cost In USD Hours in ER for examination and tests $ $ Days of hospitalization in ICU $ ,500 $ Days of hospitalization in surgical ward $ ,500 $ Days of hospitalization in rehabilitative ward $ $ Surgical procedures in OR $ $ X-rays $ 162 $ Laboratory tests $ 85 $ Total cost 4,877 $ Total revenues ,100 $ Total profit per individual medical file $
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14 ? How to Identify Costs
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Calculating Costs 15 HR Materials Misc. Ward Intermediate Products
Laboratory tests Diagnostic imaging Angioplasty Surgical procedures Ward ER visits Inpatient Medical and Surgical Services Intermediate Products HR Materials Misc. Medical Fixed medical equipment Operating costs Administration and Housekeeping Consumable medical equipment Administrative costs Non medical equipment Nursing Computerization and security Para-medical Food, cleaning and engineering systems General
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Attribution of Costs – through Hospitalization Wards
16 Attribution of Costs – through Hospitalization Wards Surgical procedures Surgical Ward Rehabilitative Ward Operating Labs X-ray ICU Expense 200 Payroll 50 10 20 15 30 55 12 3 5 4 6 8 2 7 40 Materials Misc. 60 300 Total 92+ 5 3 15 19 30 20 40 + Surgical procedures 40 30 + X-rays 10 15 5 20 + Labs 7 10 3 55 80 165 Total: = + Recovery ICU Surgery
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Complex Work of Physicians on Wards
17 I.E, Orthopedic Specialist On the Orthopedic Ward Orthopedic Specialist At the Orthopedic Clinic On ER Duty In Surgery W An orthopedic specialist work W1- No. of examinations x normative duration per examination W2- Salary records W3- Hours of surgery performed W4- All other hours of physician’s work S1- S2- Salary Benefits
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Cumulative Costs in Surgical Procedures Post-Surgery Recovery Room
18 Patient physicians Anesthesiology unit materials operating nurses procedure procedure Physicians of the ward para OR procedure materials c A operating B materials Post-Surgery Recovery Room nurses
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Calculating Costs of Outpatient Clinics
19 Physical Examination Cast Removal Injections Outpatient Clinics H1 Examination by specialist Scope of Clinic Services H3 Removal of cast H3 Injection Standard Quantities Q11 Q21 Q31 Hours of physician’s labor Physicians Loading cost of physicians Q12 Q22 Q32 Hours of nurses’ labor Nurses Loading cost of nurses Q13 Q23 Q33 Hours of paramedical staff labor Para Loading cost of paramedical staff Q14 Q24 Q34 Loading cost of materials Cost of material Materials
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Deviations of Performance from Budget
20 Actual volume Projected performance product process prices Simulation of performance Projected prices Actual volume product process Actual data Actual performance Original budget Actual volume Projected scope Deviation in volume Actual prices Projected prices Deviation in prices Actual product process Projected product process Deviation in effectiveness Total Deviation
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Set-up and Assimilation
21 Approval of model Pilot\ Approval of specification Completion Specifications meetings Activation by Gomla Set up and assimilation Data entry Data calibration Users training 3 weeks 12 weeks 4-12 weeks The system is fully operational in three months
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TMR – The Economic Simulator
22 TMR – The Economic Simulator
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