(TIỂU LUẬN) GROUP ASSIGNMENT 2 business IT and supply chain

Hence, it is necessary that private hospitals like Than Chan to cooperate with public hospitals to increase its patients as well as reduce the occupancy rate of public hospitals.. The co

Lecturer: Bill Au

GROUP ASSIGNMENT 2

Business IT and Supply Chain

Nguyen Tuan Thanh – s3695708 Nguyen Hoanh Dat – s3697277 Nguyen Dang Khoa – s3678800 Phan Quang Huy – s3678653

Le Khoi Nguyen – s3682366

I Introduction

Figure 1:

A core issue of Vietnam healthcare industry is the high occupancy rates in national hospitals while there are available capacities in private ones It can be seen from Figure 1 that there is an inconsistency when private and public hospitals Moreover, according to Exson.com, Vietnam currently has 170 privates clinics, hospitals, takes 14,2% of the number of hospitals in the whole country; however, private hospitals only take up 4.2% of the occupancy rate in Vietnam The reason is the quality of medical equipment or medical staff in private hospitals is still lower than in public hospitals, at least in the mind of a majority of Vietnamese patients (Pwc, 2019) According to the interview with Another reason for this mismatch is that not all of the private clinics, hospitals have health insurance for patients while 100% of public hospitals have health insurance

Hence, it is necessary that private hospitals like Than Chan to cooperate with public hospitals to increase its patients as well as reduce the occupancy rate of public hospitals The cooperation of public and private hospitals will also bring the visibility, transparency and ability to respond as well as the collection and analysis of data within the whole supply chain Additionally, with the Industrial Revolution 4.0 and the birth of 5G, it is crucial for Vietnam healthcare supply chain to apply technology to overcome its challenges such as manual work process, little collaboration between departments, lack of organization’s visibility as well as maximize the capacity and utilization

In order to tackle the problem of the extremely high occupancy rate in public

hospitals while there are available capacities in privates ones, the government should impose the new regulation on the maximum occupancy rate for each type of hospitals This will encourage the collaboration between public and private hospitals within an area to share the occupants and reduce the overcrowded situation in the country

This paper aims to analyze the case of Thanh Chan private hospital, investigate and evaluate its current supply chain and then suggest new technologies to migrate its manual supply chain to eSupply chain Later on, we will discuss about some

potential problems that may occur during the implementation of technologies and our action plan to tackle

II Current situation of Thanh Chan hospital

Background

Thanh Chan clinic is an international polyclinic with modern medical infrastructure including 55 patients rooms that have 550 patients capacity Furthermore, the

equipped machines in the clinic have the technology functions which are qualified for the international standard The workforce of the clinic is the experienced doctors and nurses who have worked for the top-tier hospital In terms of price concern, the clinic

is having reasonable medical examination and treatment costs which comply with the regulations of the Ministry of Health (Phong Kham Thanh Chan, n.d)

The current aim of the clinic is to reduce the reliance on manual methods in

collecting data, communication and prescription In addition, the clinic also wants to leverage the implementation of technologies to improve productivity, efficiency and collaboration within its supply chain

The current process, technology + evaluation

Despite having high-tech facilities of Thanh Chan clinic, some software-systems still needs renovation One of those systems is the data collecting systems which

is mostly manual meaning that the data about the patients is on personal health record or offline-storing in the clinic computers However, in case of system

collapse, without the backup file, these difficulties will significantly affect the service of the clinic Moreover, this offline health records is incompatible with other hospitals’ systems, therefore, Thanh Chan may struggle when transferring patient data outside the clinic

Another category needs improving is the pen-and-paper prescription Despite the fact that doctors and nurses in Vietnam are more familiar with hand-writing, this traditional prescription is claimed to affect the quality of the service One of the drawbacks is the cost As stated in a report by S.T McMullin (2005), the hand-writing prescription takes approximately $4.12 more for each prescription,

compared with prescription provided by software In addition, hand-writing

prescription may also be vulnerable to error meaning users have to spend more time verifying compared to e-prescription

Lastly, the communication among departments are currently is face to face method, meaning a nurse will be in charge of delivering the message

Nevertheless, this traditional type of reporting information is prone to error as it relies mainly on human faction without any record of the conversation This has lead to a long lead time and reduced productivity

III Application of advanced technology

EHR

Definition

As a complementing technology that can compatible with the cloud computing system, The Electronic health records, in short term EHRs, is a technology software that has the functions to store , analyze the health information of patients for the purpose of ensuring continuous improvement in healthcare service, quality of treatment and most important ensuring confidentiality at all times (Iakovidis, I., 1998)

In terms of EHRs system, the EHRs software is saved on electronic devices like computers or laptops, making its usage can be from anywhere that has an internet connection Due to this attribute of technology, cloud computing is the essential

infrastructure for the implementation of EHRs (Lian et al, 2014) Therefore, Remote EHRs system is defined as “cloud-based” or “internet-based” (Health IT, n.d) In another way, EHRs can be described as one of the crucial components of delivering healthcare services to patients since it provides the availability of both clinical and administrative patient data that are accessible and secured by hospitals based on a common standard (Iakovidis, I., 1998)

Specific implementation plan (SMART method)

We will establish the electronic health record (EHR) for recording patient historical data and electrical prescription for all Thanh Chan’s patients within a period of 6 months

The first phase when implementing EHR is installing EHR on every PC on different departments of Thanh Chan hospital such as treatment rooms, reception, et cetera Next, using PCs, employees will migrate offline data to the new online system During this process, any irrelevant document that couldn’t be electronically

incorporated into the EHR will be excluded In this stage, a supervisor is required to manage the accuracy of the data migration as this process is done manually by employees

The following phase is training, this includes 2 parts: training session and system trail The former focuses on educating employees on how to input as well as access the EHR of patients in the system Next, the EHR system will be put into motion alongside the traditional method while the supervisor will check the matching

percentage between the 2 This will help him in deciding whether or not have

employees known how to use the system thoroughly Finally, the system will be customized for suitable perposes which are calculating the occupancy rate as well as being user friendly for both internal employees and public hospitals For example, when a patient arrives at the hospital, this information will be forwarded to and recorded in the main system and then being displayed to its users Specially, the EHR of Thanh Chan hospital needs to be compatible with other hospitals’ system for the convenience when transferring patients from one hospital to the other

Benefit of implemented technology

The first benefit of EHR is reducing human error from pen and paper prescription results in lowering the cost of storing data, duplication of testing while improving safety Further, EHR provides accurate, complete, and up-to-date information about patients It also enables quick access to patient records with more coordinated and efficient care Moreover, data are collected and categorized making it easier for users to observe while also avoiding leaking unwanted information Overall, it

improves patient and provider interaction and communication with the system

Cloud computing

Definition

Cloud computing is defined as a system that users only have to pay for the computing resources and services used to get access to data, files, programs and the desired third party services from an online browser which is hosted by a third party provider ( Kim 2009) There are 3 broad categories of cloud computing that are worth-mentioned including Infrastructure as a Service (IaaS), Platform as a Service (PaaS) and Software as a Service (SaaS) (Iacob 2015) (figure … ) The cloud computing services provide extraordinary assists to the workers in the company that applied the system The main advantage of the implementation of the services is believed to be the ability that helps employees to telecommute from home or from any other place without physically presenting at the company’s headquarters (Iacob 2015) This means that workers can work anywhere as long as there is a laptop and

an internet connection Furthermore, Baciu’s research (2015) illustrated that the system also help employees to improve their productivity due to the increase in storage space which helps users to attach files with large data with a reasonable price, the fluent usage of the email service avoiding interruptions, email loss and difficulties when recovering vanished documents In addition, the centralisation and standardisation of cloud computing improve the communication between staff by providing features to access on the cloud servers which are constantly updated in real time

Figure:

Specific implementation plan (SMART method)

The suggestion for Thanh chan hospital is that they would establish a cloud network for storing as well as managing medical information and occupancy rate with the operation of 3-month period This includes saving prescription and medical data in the cloud precisely, build a platform in which worker can input and check the information and create visibility for the whole organization

Beginning at the first step, the company will have to subscribe to a cloud server, specifically we will use Google cloud system Google provides a system with a reasonable price for a certain number of users while the capacity of the cloud is customizable Furthermore, the Google platform is familiar to most of the employees,

therefore, they can work with the platform effectively and efficiently without much training

Figure : produced by the authors

In the next step, we will create an account to access the server for every employee

as well as supplier of Thanh Chan hospital For example, nurse id will include : N (short for nurse) and their ID number for each specific one (figure…… ), the same will be applied to other position (D for Doctor, S for supplier) In addition, each account will have different authorities For instance, for the external side, the supplier can only access to the file that is relevant to the goods that they provide for the hospital For the internal management, each department can access and input information related to their positions and responsibilities For example, nurses can add their time attendance or overtime hours on the system and check how many days off remaining The finance department can view these data on the server and based on that to calculate the salary/bonus which can be checked by nurses

Figure : produced by the authors Finally, we will provide an online instruction videos for our supplier as their task is relatively simple For Thanh Chan employee, we will host a training session to guide

them how to use the platform appropriately For instance, the medical record in EHR needed to be uploaded to the cloud computing to ensure the safety of information as well as real-time visibility and collaboration

Benefit of implemented technology

The application of cloud computing on the supply chain in healthcare industry has plenty of impacts It’s stated by many researchers that the 8.9% compound annual growth rate in 5-year period (from 2017) is the consequence of the growing concern

on software solutions as well as cloud-based healthcare supply chain management engines (LaPointe J., 2017) Firstly, the cloud platform will bring visibility and collaboration in real time within the organization as well as other entities in the supply chain of Thanh Chan hospital Hence, the face-to-face communication will be eliminated which will lead to a significant reduction the human errors created by face-to-face communication In addition, the cloud platform will make the information easier to check if there is any error caused during the data input process With the help of the cloud server, Thanh Chan can reduce the lead time resulted from the inefficient communication in the past Moreover, the cloud technology will help Thanh Chan develop a better management of its internal operation as well as the cooperation with external parties The cloud will also serve as a store for various types of data collected by Thanh Chan which will play a crucial role for the data analysis process In addition, the scalability of cloud technology bring a huge benefit

to Thanh Chan as from an economic perspective, the implementation provides cost flexibility and high potential to reduce costs (Cloud Standards Customer Council 2017) Another worth-mentioned benefit of the cloud platform is its ability to restore data even in the case of server malfunction as the data is constantly being uploaded online

Predictive analysis

Definition

Predictive analytics is defined as a diversity of statistical and analytical skills used to establish models that forecast future possible events and behaviors (Nyce 2017)

Specific implementation plan (SMART method)

We will establish a SPSS in order to further assist the analysing and predicting data process such as the expected occupancy rate in the next 3 months, the amount of required medicine in the next year, et cetera with the inaccuracy rate of 5% within 3 months

In the first step, the company will have to subscribe to a predictive analytic

technology, specifically in this case is SPSS After that, we will hire a professional data analyst His/her main tasks including processing the data in the system and upload those data to cloud system which is divided into specific document for each

specific related stakeholder (doctor, nurse, supplier, et cetera) We will supervise the performance by examining the cause of the mismatch between actual and predicted data in order to take further action such as change the predictive system or hiring new analyst

Benefit of implemented technology

Firstly, the implementation of predictive analytic technology will help maximizing the capacity of the hospital by reducing spent time in the hospital, leading to a decrease

in cost According to the case of Mercy Virtual, by using predictive analysis, the hospital manages to reduce 35% of the time patients staying in the hospital which increase the hospital’s ability to maximize its own capacities Moreover, with the help

of predictive, Thanh Chan hospital can improve its decision making process or planning strategy due to the information processed For example, Thanh Chan can use predictive analytics to expect the amount of inventory on next month based on the trend of current occupancy rate, which types of medicine is highly used, et cetera This can create a great responsiveness to Thanh Chan hospital as well as a demand- pull mechanism for its supply chain

IV Potential problem while implementing

technologies

EHR

EHR requires extra and specialized training for physicians who are already reluctant

to the new system as its interferes with their existing routines On the other hand, patients also show resistance to the new changes due to their concerns about privacy For example, physicians aren't allowed to share their patient health record with other health care providers without the patient's consent According to Mathai, Shiratudin, and Sohel (2017), patient negative attitudes toward the EHR system will contribute to physicians' decision of rejecting the system in clinical practice

Furthermore, EHR is an online system which can only be accessed via electronic devices, therefore, in the case of server crash down, system malfunction, the whole hospital system would be ceased For example, Universal Health Services Inc recorded electronic health devices at 26 facilities were heavily affected due to 2 hours outage

Predictive analysis

The biggest challenge for Thanh Chan hospital to apply predictive analysis is the process of data preparation Specifically, at this step, data needs to be cleansed, transformed and reorganized into a suitable format for predictive analytic This involves profiling the data,

looking for anomalies, determining what types of data quality standards to apply and what corrections to make, devising a data model suitable for analysis, and performing the

transformations needed to make data sets consistent (Loshin, 2018)

V Action Plan to tackle potential problems

EHR

First of all, Thanh Chan hospital can persuades both physicians and patients by demonstrating the benefits of EHR systems For patients, they will be notified about the application of EHR in nearby area and its benefits as well as the agreement of sharing patient's health record between hospitals Therefore, patients can only be transferred from one hospital to another only if they agree to the terms above Meanwhile, for physicians, they are introduced to the benefits of EHR which

includes better health care by improving all aspects of patient care such as safety, communication, effectiveness, and efficiency

Next, the technological issue requires quarterly system maintenance Furthermore, in case

of malfunction, the hospital should develop an action plan such as manual method to provide

physicians and staff with temporary guidance about workflows

Predictive analytic

In order to tackle the problem of data preparation for predictive analysis, we suggest that the data analyst of Thanh Chan should work closely with other department on producing a default platform to input their data on the cloud According to the default platform, the

process of cleansing the data as well as reorganized can be solved a part This is because the data noise can be eliminated easily with an organized data from every department while uploading to the cloud

VI Conclusion

In conclusion, after evaluating the current process as well as pointing out its

drawbacks, the paper suggests several solutions including EHR, cloud computing and predictive analysis The combination of all 3 technologies creates an ecosystem with the aim of storing, managing and analyzing the data in order to speed up the overall process and increase productivity while minimizing the human interaction involved Moreover, we propose suitable action plans for the mentioned potential issues when implementing these advanced technologies We acknowledge the limitation in our action plans as it couldn't be better without creating new cost for the hospital