Riverside
Health Care Facilities Inc.
Fort Frances, Ontario, Canada
IT
Background
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he Riverside Health
Care Facilities Inc. (RHCFI) is a corporate entity formed in 1993,
bringing together the three health care facilities located in the
cities of Emo, Rainy River, and Fort Frances in Northwestern Ontario.
At the time of formation, this new corporate entity represented
a combined total of 131 beds with an annual operating budget of
some $21 Million. They now have, in three locations, 100 beds and
a $15 Million budget.
The Fort Frances facility,
namely the La Verendrye Health Centre, had implemented the financial
and patient administration systems from Encom Information Systems
(EIS) in the late 1980's, on an IBM RISC 6000 CPU, supported by
the AIX operating system. The facilities in Emo and Rainy River
were not computerized extensively on-site and had their payrolls
processed at a remote service bureau.
As the La Verendrye
Hospital continued its computerization, certain stand-alone systems
were acquired from specialized software suppliers since EIS could
not provide the software products required by the hospital at the
time. This led to the common problem faced by most hospitals where
their main information system was not communicating with the various
ancillary systems acquired for specific departments, resulting in
the duplication of effort and untimely, or non-existent, corporate
reporting because of the fragmented systems in place.
Recognizing the need
for a fully integrated system, the Information Systems Advisory
Committee (ISAC) prepared a Request for Proposal (RFP) and issued
it to the supplier marketplace in the fall of 1993.
As a result of this
RFP the ISAC narrowed their selection to two potential single source-vendors,
namely Meditech and HealthVision. Each appeared to be able to offer
all of the required modules, although at a cost much higher than
was then being experienced and considered.
However, the higher
expenditure was approved by the Board in anticipation of proceeding
with the three-site new corporate facility which would require a
much higher degree of computerization than the single Fort Frances
site.
The final decision
between the two short-listed vendors was made in 1994, with HealthVision
being selected as the preferred vendor, following which contract
negotiations got underway.
This process was halted
in June of 1995 with the election of a new government in Ontario
and a reduced budget for the new CHIN (Community Hospital Information
Network). The Board instructed the ISAC to go back to the marketplace
to find a less expensive solution to reflect the overall reduced
operating budget.
This time the Hospital
Information Systems Advisory Committee (ISAC) selected a multi-vendor
[eight (8)] approach proposed by Heron Technology Corp (HTC) of
Markham, Ontario, which included an integration engine or 'middleware'
software product. The middleware software product was from Stratsys
Corporation, a Canadian software developer which has developed the
middleware product, FITS (Flexible Information Transport System).
The flexibility of
this approach was exemplified by the fact that the ISAC selected
two (2) software vendors directly who were not included in the HTC
submission. This flexibility is the foundation of the multi-vendor
solution, with each software module connected to the integration
engine, FITS, and all software modules are integrated and Year 2000
compliant.
The Hospital has now
implemented a system that costs approximately 50% of what the previously
selected single-vendor approach would have cost in hardware, software,
licensing and ongoing support costs. In addition, and a very important
aspect of the multi-vendor solution, the individual department managers
had total flexibility in selecting software modules for their departments
and their unique requirements did not have to fit into a single
vendor's solution for that department. In the end, the hospital
initially selected software modules from eight (8) different vendors,
and added three (3) more vendors after the initial selection in
1996. The hospital deals directly with each vendor. This is the
Best-of-Budget approach.
Another major consideration
of the ISAC was the future and the need for flexibility to deal
with changes in the corporate structure, shared services with other
healthcare organizations, vendors offering up-to-date solutions,
pricing of the vendors' solution, budgets and future software requirements
such as the Smart Card.
Since information systems
in healthcare facilities are becoming ever more complex to meet
the increasing demands of Governments, suppliers, and the population,
overall flexibility must be built into the system at the outset
to address these complex issues that will be arising in the next
decade.
What happens when one
of the software modules does not handle the requirments of the Department?
With the flexibility of the multi-vendor system, RHCFI had this
situation. Their solution - replace the software module that they
knew was not what they wanted in the first 30 days and replace it
with another vendor's solution. If the software module is not the
right fit, you are not required to live with it, you can replace
it. In the case of RHCFI, one of the initial eight selected vendors
was changed as the system was being installed.
An important benefit
for the Canadian economy occurs in a multi-vendor solution. Do you
realize that there is over 90% US content in most Canadian hospitals'
single-vendor installations. With the ability to select software
from specialized vendors, RHCFI's Canadian content is 83% of the
software/training revenue, and this money stays in Canada. These
vendors' head offices span the country from Nova Scotia to British
Columbia. Once the decision was made, the Hospital drew up an implementation
plan that would leave most hospital executives breathless. All systems
were to be replaced, all data converted to the new software modules,
and everything, including hardware and software, was to be up and
operational, and integrated within nine (9) months.
All the implementation
goals were achieved. The total hospital resources required to implement
this system consisted of the Director of Finance and Systems, Terrie
Tucker, and the MIS Department, which consisted of one person, George
Bruyere. The new system was installed on time, and under budget.
The Hospital is now in a position to implement additional software
modules from any vendor they care to deal with, and they can implement
these new software products without external assistance.
More
information on the RHCFI Implementation
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