Business Management, Business Management, Consulting and Consulting and
Information for Healthcare Information for Healthcare Systems and HospitalsSystems and Hospitals
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GOMLA (ISRAEL) ltd - Our Experience:
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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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
Hospital Operational
Information System – Medical, Financial and Logistical data
Hospital Data Uses
Defining and assimilating the accounting method
Analysis of managerial, operational and financial information; reporting to management and decision makers
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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.
The TMR Software4
TMR Serves Hospital Management:
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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2Positive incentives for department Who show improvement over last year
3Restricts areas of hospital operations Which lead to losses on a regular basis
4Expansion of clinics That are profitable
5Reduce clinics That are not profitable
6Release bottlenecks To increase profitability
Leading Examples of TMR’s Utilities in Organizations
1Positive incentives for departments Who meet budgetary goals
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1Of the need to increase ratesProvide evidence to regulators
2Amend agreements with insurance carriers
Which lead to losses
3 Profitable insurance carriersEncourage expansion of collaborations with
Leading Examples of Benefits Outside the Organization7
All data enter TMR
Financial accounting
logistics
Hosp` systemClinics
Payroll system
Diagnostic and therapeutic
services
laboratories
surgery
Data Import from all Hospital Information Systems 8
TMR is Unlimited in Data Import
TMR imports data from all existing information systems in the hospital
Both quantitative and financial data are imported
Data import is performed from all types of hardware and software, including excel spreadsheets
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Pricing-based budget
Pricing of effective performance
Quantitative D.W.H.
Oracle DatabaseData
import generator
Data from all systems
Budgeted quantitative
D.W.H.
Analysis of deviations
Excel report archiveE.I.S & Olap System
Structural Elements of the TMR Simulator
Economic
Simulator
General and specific report generator
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TMR uses the
Patient Medical FilePatient 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:
Imaging Surgery Laboratories
Revenue from insurance carrier
Hosp’
in ICU
2 days
Hosp’ in
surgical ward
6 days
Hosp’ in
rehabilitative
ward
4 days
Release
3 hours
Checks by ER staff
Admission
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qty Per unit cost in USD
Total cost
In USD
Profitability per Individual Patient Medical File
Hours in ER for examination and tests 3 40 $ 120 $
Days of hospitalization in ICU 2 750 $ 1,500 $
Days of hospitalization in surgical ward 6 250 $ 1,500 $
Days of hospitalization in rehabilitative ward 4 140 $ 560 $
Surgical procedures in OR 1 950 $ 950 $
X-rays 9 18 $ 162 $
Laboratory tests 17 5 $ 85 $
Total revenues 5,100 $
Total profit per individual medical file 223 $
Total cost 4,877 $
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How to Identify
Costs
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Calculating Costs
General
Computerization and security
Administrative costs
Operating costs
Misc.
Administration and Housekeeping
Para-medical
Nursing
Medical
HR
Laboratory tests
Diagnostic imaging
Angioplasty
Surgical procedures Ward
Ward
Ward
Ward
Ward
ER visits
Inpatient Medical and Surgical Services
Intermediate Products
Non medical equipment
Consumable medical equipment
Fixed medical equipment
Materials
Food, cleaning
and engineering systems
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Attribution of Costs – through Hospitalization WardsRehabilitativeWard
ICU Surgical Ward
Labs X-raySurgical procedures
Operating
Payroll
Materials
50 10 20 15 30 55 20
12 3 5 4 6 8 2
30 2 2 6 8 7 5Misc.
Total
Expense
200
40
60
300
92+ 5 3 15 19 30 20
40+ Surgical procedures 40
30+ X-rays 10 15 5
20+ Labs 7 10 3
5580 165Total:
= 300 + +Recovery ICU Surgery
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Complex Work of Physicians on Wards
S1-
S2-
Salary
Benefits
An orthopedic specialist work
Orthopedic Specialist
At the Orthopedic Clinic
W1-
No. of examinations x normative
duration per
examination
On ER Duty
W2-
Salary records
In Surgery
W3-
Hours of surgery
performed
On the Orthopedic
Ward
W4-
All other hours of
physician’s work
I.E, Orthopedic Specialist
W
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Anesthesiology unit
OR
Post-Surgery Recovery Room
physicians
operating
materials
nurses
operating
materials
nurses
Patient
Physicians of the ward
Cumulative Costs in Surgical Procedures
A
procedure
procedure
B
procedure
c
para
materials
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H1 Examination by specialistH3 Removal of cast
H3 Injection
Scope of Clinic Services
Standard Quantities
Physical Examination
Cast Removal Injections
Physicians
Materials
Para
Loading cost of physicians
Loading cost of nurses
Loading cost of paramedical staff
Loading cost of materials
Outpatient Clinics
Calculating Costs of Outpatient Clinics
Nurses
Q11
Q12
Q13
Q14
Q21
Q22
Q23
Q24
Hours of physician’slabor
Hours of nurses’ labor
Hours of paramedicalstaff labor
Cost of material
Q31
Q32
Q33
Q34
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Actual product process
Actual prices
Actual performance
Actual volume
Actual data
Total DeviationTotal Deviation
Simulation of performance
Projected prices
Actual volume
Projected product process
Projected scope
Projected prices
Projected product process
Original budget
Actual volume
Projected performance
Actual product process
Actual prices
Deviation in prices
Deviations of Performance from Budget
Deviation in effectiveness
Deviation in volume
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Set-up and Assimilation
Data entry Data calibration
Set up and assimilation
Users training
Activation by Gomla
3 weeks 12 weeks 4-12 weeks
Approval of model
Pilot\ Approval of
specification Completion
The system is fully operational in three months
Specifications meetings
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TMRTMR – – The Economic The Economic SimulatorSimulator
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