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Advanced Operations Management in a Spanish Healthcare Public/Private Partnership Vicent Moncho Mas CIO Marina Salud S.A. San Francisco, 2014.

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Presentation on theme: "Advanced Operations Management in a Spanish Healthcare Public/Private Partnership Vicent Moncho Mas CIO Marina Salud S.A. San Francisco, 2014."— Presentation transcript:

1 Advanced Operations Management in a Spanish Healthcare Public/Private Partnership Vicent Moncho Mas CIO Marina Salud S.A. San Francisco, 2014

2 1.Introducing Denia’s Health Department 2.IT Strategy & Oracle Applications overview 3.Using Oracle Apps in Logistics 4.Healthcare activity management 5.Conclussions INDEX

3 1.Introducing Denia’s Health Department 2.IT Strategy & Oracle Applications overview 3.Using Oracle Apps in Logistics 4.Healthcare activity management 5.Conclussions INDEX

4 Population: More than 150,000 residents (Health department is financed mainly per capita) Tourism: From March to October Municipality: 34 towns [ Dènia: approximately 40,000 – Vall d’Alcalà: around 200 ] Total area : 297 square miles (759 km²) Population density: 635 people per square mile (245 hab/km²) Geography: Complex orography. Numerous mountains, valleys and hilly coast Denia’s Health Department (I)GEOGRAPHICAL SCOPE

5 RED ASISTENCIAL MARINA SALUD 1 Hospital 4 Integrated Health Centers (Specialized care) 32 Primary Care Centers (11 Basic areas) Department of Health. Dénia. OPERATIONAL SCOPE

6 Department of Health. Dénia. OPERATIONAL SCOPE (II) Public Service Private Managed Public Service Private Managed Administrative concession granted for 15 years Direct supervision via AVS commissioner Service improvement investment Marina Salud builds the new Hospital Marina Salud builds a new CSI in Calpe Marina Salud builds a new CSI in Denia Marina Salud builds the new Hospital Marina Salud builds a new CSI in Calpe Marina Salud builds a new CSI in Denia Integration of professionals Public Health Integrated Management Health Department’s integrated Management (both Primary Care an Specialized Care) There was a previous Hospital (100 % managed by regional government; all employees depends from AVS HR Resources policy as civil servants and locum) At the time Civil servants (28%) and private employees (72 %) There was a previous Hospital (100 % managed by regional government; all employees depends from AVS HR Resources policy as civil servants and locum) At the time Civil servants (28%) and private employees (72 %)

7 1.Introducing Denia’s Health Department 2.IT Strategy & Oracle Applications overview 3.Using Oracle Apps in Logistics 4.Healthcare activity management 5.Conclussions INDEX

8 Department of Health. Dénia. IT STRATEGY (I)

9 Department of Health. Dénia. IT STRATEGY (II)

10 Denia’s Health Department (VII) – CERNER MILLENNIUM’s implantation scopeORACLE APPLICATIONS OVERVIEW (I)

11 Denia’s Health Department (VII) – CERNER MILLENNIUM’s implantation scope Logistics Dept. Billing Dept. Maintenance Dept. Accounting and Finance Dept. Human Resources Dept. ORACLE APPLICATIONS OVERVIEW (II)

12 Denia’s Health Department (VII) – CERNER MILLENNIUM’s implantation scope 2,700 suppliers 14,000 receiving transactions 120 receiving transactions per day Daily Automated Purchase planning ORACLE APPLICATIONS OVERVIEW (III)

13 Denia’s Health Department (VII) – CERNER MILLENNIUM’s implantation scopeORACLE APPLICATIONS OVERVIEW (IV) 5,800 articles 120 receiving transactions per day Patient consumption assignment More than 1.5 million lines in trans.

14 Denia’s Health Department (VII) – CERNER MILLENNIUM’s implantation scopeORACLE APPLICATIONS OVERVIEW (V) 20,800 invoices 65,800 inv lines

15 Denia’s Health Department (VII) – CERNER MILLENNIUM’s implantation scope 86% per capita financed 12% compensation financed 2% private financed ORACLE APPLICATIONS OVERVIEW (V)

16 Denia’s Health Department (VII) – CERNER MILLENNIUM’s implantation scopeORACLE APPLICATIONS OVERVIEW (V) Private financed invoices private clients insurance companies

17 Denia’s Health Department (VII) – CERNER MILLENNIUM’s implantation scope Work orders ORACLE APPLICATIONS OVERVIEW (VIII)

18 Denia’s Health Department (VII) – CERNER MILLENNIUM’s implantation scope 1,200 employees 34 contract types (5) Absence requests 7,811 Holidays 57% ORACLE APPLICATIONS OVERVIEW (IX)

19 Denia’s Health Department (VII) – CERNER MILLENNIUM’s implantation scopeORACLE APPLICATIONS OVERVIEW (X) 134 shift templates 80 Shift execution types

20 Denia’s Health Department (VII) – CERNER MILLENNIUM’s implantation scopeORACLE APPLICATIONS OVERVIEW (XI) 12 regular payroll 2 extra payroll 4 variable salary

21 Denia’s Health Department (VII) – CERNER MILLENNIUM’s implantation scopeORACLE APPLICATIONS OVERVIEW (XII) 450 positions 70 Departments 56 HealthCare 13 Administrative

22 Denia’s Health Department (VII) – CERNER MILLENNIUM’s implantation scopeORACLE APPLICATIONS OVERVIEW (XIII) 334 courses 1,294 attendees Evaluation

23 1.Introducing Denia’s Health Department 2.IT Strategy & Oracle Applications overview 3.Using Oracle Apps in Logistics 4.Healthcare activity management 5.Conclussions INDEX

24 Selección e integración de profesionales en modelo concesional preexistiendo estructura sanitaria LOGISTIC PROCESS PROCESS SCOPE (I) PURCHASINGWAREHOUSING PROCESS CONTROLLING DISTRIBUTION

25 Selección e integración de profesionales en modelo concesional preexistiendo estructura sanitaria PURCHASING Medical supplies & materials, medication, laboratory, Sterilization, blood bank, office-supplies, prosthesis and osteosynthesis Purchase orders and claims planned and executed every day using: Inventory planning report (min/max) Consumption in twenty days for each article Demand reports based in inpatient medication orders, preference cards, high economic impact activity schedulling (Outpatient special medication, Oncology) PROCESS SCOPE (II) PURCHASINGWAREHOUSING PROCESS CONTROLLING DISTRIBUTION

26 Selección e integración de profesionales en modelo concesional preexistiendo estructura sanitaria WAREHOUSING General warehouse (KARDEX) 2 Automated horizontal carousel systems 3 Automated vertical storage systems 1 Automated vertical cold storage system Distributed warehouses 42 Kanban (double box system) (fluids) in the Hospital 12 in Primary Care Automated Dispensing Systems (PYXIS) 32 for Medication 7 for Materials (*) Stock real time sinchronized from PYXIS, daily for General Warehouses & Kanban PROCESS SCOPE (III) PURCHASINGWAREHOUSING PROCESS CONTROLLING DISTRIBUTION

27 Selección e integración de profesionales en modelo concesional preexistiendo estructura sanitaria DISTRIBUTION Daily distribution from the General warehouse to Distributed warehouses in the Hospital 15 days based distribution for Primary Care Centers Monthly distribution for external elderly care centers PROCESS SCOPE (IV) PURCHASINGWAREHOUSING PROCESS CONTROLLING DISTRIBUTION

28 Selección e integración de profesionales en modelo concesional preexistiendo estructura sanitaria CONTROL Daily distribution and stock control Discrepancies and consumption Analysis per Cost Center and Department (monthly feedback) Centralized out of date medication & drugs control Patient imputation control (patient based dispensation control) Logistics Balanced Scorecard (average storage time, breaks of stock, not served orders, …) PROCESS SCOPE (V) PURCHASINGWAREHOUSING PROCESS CONTROLLING DISTRIBUTION

29 Selección e integración de profesionales en modelo concesional preexistiendo estructura sanitaria Medication consumption control and cost assignment RESULTS (I) PYXIS TRANSACTIONS KANBAN TRANSACTIONS INTERNAL PURCHASE ORDERS PROSTHESIS AND OSTEOSYNTHESIS REGULARIZATIONS MANUAL ADJUST. BOTTOM-UP TOP-DOWN 85% 15%

30 Selección e integración de profesionales en modelo concesional preexistiendo estructura sanitaria Medication consumption control and cost assignment (special control medication) RESULTS (I) PYXIS TRANSACTIONS KANBAN TRANSACTIONS INTERNAL PURCHASE ORDERS PROSTHESIS AND OSTEOSYNTHESIS REGULARIZATIONS MANUAL ADJUST. BOTTOM-UP TOP-DOWN 90% 10%

31 Selección e integración de profesionales en modelo concesional preexistiendo estructura sanitaria Material consumption control and cost assignment RESULTS (I) PYXIS TRANSACTIONS KANBAN TRANSACTIONS INTERNAL PURCHASE ORDERS PROSTHESIS AND OSTEOSYNTHESIS REGULARIZATIONS MANUAL ADJUST. BOTTOM-UP TOP-DOWN 25% 75%

32 Selección e integración de profesionales en modelo concesional preexistiendo estructura sanitaria Material consumption control and cost assignment (Surgery Theaters Area) RESULTS (I) PYXIS TRANSACTIONS KANBAN TRANSACTIONS INTERNAL PURCHASE ORDERS PROSTHESIS AND OSTEOSYNTHESIS REGULARIZATIONS MANUAL ADJUST. BOTTOM-UP TOP-DOWN 70% 30%

33 Selección e integración de profesionales en modelo concesional preexistiendo estructura sanitaria Stock reduction by 30% in three years RESULTS (II) FROM %

34 Selección e integración de profesionales en modelo concesional preexistiendo estructura sanitaria Average storage time reduction in 54 % (35 days, 30 days for medication) RESULTS (III)

35 1.Introducing Denia’s Health Department 2.IT Strategy & Oracle Applications overview 3.Using Oracle Apps in Logistics 4.Healthcare activity management 5.Conclussions INDEX

36 Department of Health. Dénia. IT SYSTEMS INVOLVED

37 Selección e integración de profesionales en modelo concesional preexistiendo estructura sanitaria HEALTHCARE ACTIVITY MANAGEMENT PROCESS PROCESS SCOPE (I) DATA CAPTURE INTERFACING ECONOMIC PROCESS APPLYING PER CAPITA FIN. COMPENSATION FIN. PRIVATE FIN. PROCESS CONTROLLING

38 Selección e integración de profesionales en modelo concesional preexistiendo estructura sanitaria DATA CAPTURE INTERFACING Patient Information Encounter Information Charges Information Speciallized Care activity Primary Care activity for Private financed encounters PROCESS SCOPE (II) DATA CAPTURE INTERFACING ECONOMIC PROCESS APPLYING PER CAPITA FIN. COMPENSATION FIN. PRIVATE FIN. PROCESS CONTROLLING

39 Selección e integración de profesionales en modelo concesional preexistiendo estructura sanitaria ECONOMIC PROCESS APPLYING Aggregation/Division Per capita financed encounters processing Compensation financed encounters processing Private financed encounters processing Incident Management PROCESS SCOPE (III) DATA CAPTURE INTERFACING ECONOMIC PROCESS APPLYING PER CAPITA FIN. COMPENSATION FIN. PRIVATE FIN. PROCESS CONTROLLING

40 Selección e integración de profesionales en modelo concesional preexistiendo estructura sanitaria PROCESS CONTROLLING Encounter status summary (per type, per accreditation) Incident analysis for operation improvement Activity based provisioning for receivables PROCESS SCOPE (IV) DATA CAPTURE INTERFACING ECONOMIC PROCESS APPLYING PER CAPITA FIN. COMPENSATION FIN. PRIVATE FIN. PROCESS CONTROLLING

41 Selección e integración de profesionales en modelo concesional preexistiendo estructura sanitaria HEALTHCARE MEDICAL SERVICES BUDGETING AND CONTROL Healthcare activity and consumption based For each Medical Service, Nursing Unit and Medical Center Specialized care and PC RESULTS (I)

42 Selección e integración de profesionales en modelo concesional preexistiendo estructura sanitaria HEALTHCARE MEDICAL SERVICES BUDGETING AND CONTROL Healthcare activity and consumption based For each Medical Service, Nursing Unit and Medical Center Specialized care and PC RESULTS (I)

43 Selección e integración de profesionales en modelo concesional preexistiendo estructura sanitaria HEALTHCARE MEDICAL SERVICES BUDGETING AND CONTROL Healthcare activity and consumption based For each Medical Service, Nursing Unit and Medical Center Specialized care and PC RESULTS (I)

44 Selección e integración de profesionales en modelo concesional preexistiendo estructura sanitaria COST PER PROCESS ANALYSIS Bottom-up cost assignment based From activity, consumptions and structural costs Specialized care and PC RESULTS (II)

45 Selección e integración de profesionales en modelo concesional preexistiendo estructura sanitaria COST PER PROCESS ANALYSIS Bottom-up cost assignment based From activity, consumptions and structural costs Specialized care and PC RESULTS (II)

46 Selección e integración de profesionales en modelo concesional preexistiendo estructura sanitaria COST PER PROCESS ANALYSIS Bottom-up cost assignment based From activity, consumptions and structural costs Specialized care and PC RESULTS (II)

47 Selección e integración de profesionales en modelo concesional preexistiendo estructura sanitaria COST PER PROCESS ANALYSIS Bottom-up cost assignment based From activity, consumptions and structural costs Specialized care and PC RESULTS (II)

48 1.Introducing Denia’s Health Department 2.IT Strategy & Oracle Applications overview 3.Using Oracle Apps in Logistics 4.Healthcare activity management 5.Conclussions INDEX

49 Selección e integración de profesionales en modelo concesional preexistiendo estructura sanitaria Daily supply planning & distribution based in reliable and integrated information Receiving, Storage and Distribution Process Efficiency Health care and management systems integration Health care professionals focussed in patient Health care profeesionals engaged and commited in process improvement Process eficiency from the patient point of view New projects: Inter-departmental Workflow improvement Cash and treasury module implantation Budget module implantation Preventive Asset management maintenance routes implantation CONCLUSSIONS (I)

50 Selección e integración de profesionales en modelo concesional preexistiendo estructura sanitaria We are using Oracle Applications since 2009 In 2009, 2010 and 2011, we were focused in vertical process improvement, working in the specific operative workflows for each department From 2011 to 2012 our company makes a hard job trying to involve representative users in driving both the healthcare systems and the management systems, prioritizing coordination and cross vision in process inprovement, with this change we achieve an inflection point and this implied processes to improve In 2012 we get HIMSS level 7 certification as a consequence of this change in our way of work and using IT Currently we are focused in transversal processes improvement and how to get valuable results from development, IT it is only a tool in this target We can work this way bacause we can measure We can measure because we have the tools to do that Today we are very proud about our culture, our tools and our partners, like oracle, because this is the key to generate together valuable results CONCLUSSIONS (II)

51 Selección e integración de profesionales en modelo concesional preexistiendo estructura sanitaria Thank you! VICENT MONCHO MAS CIO Marina Salud S.A. Office.: Mobile.: Hospital de Denia - Partida Beniadlà, s/n La Xara - Denia (Alicante)


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