An Empirical Investigation of Transition Management

in Public Healthcare to e-Medicare: A Case Study of Thailand

Montri Wiboonrat, Ph.D.

Agendas1. Introduction to healthcare management2. Existing healthcare problems 3. Objectives and constraints4. Transition management5. Transition model6. Transition Impact measurement7. Integration of e-Medicare and HIS8. Discussions9. Conclusions

2

Healthcare in PresentDifference of healthcare services between

public and private hospital and lack of standardize of medical processes;Treatment proceduresTreatment qualityPatient’s information recordTraceability SpeedAccuracySecurityAvailabilityReliability

3

Existing in Healthcare Problems

Patient’s information is in different platform80% are in paper worksNo standard on healthcare recordNo linkage of patient’s informationWaste time for waiting healthcare treatmentNo standard for patient’s treatment recordAvailability and reliability of patient’s info.No security of patient’s information

Patient’s information lossPatient’s information errorRights of Patient info. access

4

Objectives and ConstraintsVision and Policy LevelFeasibility and Decision for Project

Approval (Consultant)Conceptual and Details Design for

Transition Project (Consultant) Implementation or Project

Management (Contractor)Testing, Deploy, and UATOperations Risks: Human, Machine,

Environment Conditions.

5

Transition ManagementTransition management can be classified

into the following characteristics:long-term thinking for framing short-term

policy;multi-domain, multi-actor, multi-tier; focusing on learning;aligning system innovation and system

improvement;keeping a large number of options open.

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Transition Management

7

Stages and Indicators in Transition Procedure

Indi

cato

r (s)

Time

Time period

Size

Stage [1] [2] [3] [4]

Equilibrium I

Equilibrium II

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Transition Design Process

DevelopGoals

DevelopGoals

DetermineObjectivesDetermineObjectives

DetermineConstraintsDetermineConstraints

Develop Design Space

DevelopTest

ExecuteTest

Select

Solutions

AnalysisKM

Y

Y

Y

Set of Possible

Designs in n-dimensions

Develop ModelDevelop ModelY

N

N

N

9

Healthcare Transition Management Model (HTMM)

Change in actor behaviorand existing ecosystem

Change in performance

Change in technologicalcomponents and

procedures

New policies, standards and regulation for design

and implementation

Need for inprovement

System Transition

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Transition ImpactDenotes:• TI: Transition Impact of hospital operations;• R: Resistance of organization [0.1,….1];• C: Capital requires for transition [1,…,∞]• T: Technological maturity and complexity

[0.1,…,1];• S: Standards and regulations that need to

comply [0.1,…,1]• Whereby; 0.1 is minimum and 1 is maximum

value of each actor. TI = R.C.T.S

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Integration of e-Medicare and HIS

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Discussions• Need more time for e-Medicare maturity• Require more expertise on the same person

(IT and healthcare service)• New laws against misuse of healthcare

information• Need “National Information Record

Exchange” organization (middle man)• Healthcare information security need to

fulfill: ISO 27001• Patient’s privatization need to fulfill: ISO

2779913

Conclusions• Standardize for healthcare system• IT as a tool for healthcare system

development and improvement• Transition need cooperation from every

parties that involve in healthcare services

• System integration needs and waits to be happen after policy is settle and clear in direction

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THANK YOUQ&A

montwi@kku.ac.thmwiboonrat@gmail.com