Mapping the Implementation

My experience with implementation of effective clinical transformation comes from a medical institute specialising in diabetes. The institute is equipped with state of the art medical technology and it conducts advanced research and takes educational initiatives
By Rajmohan Nair, Head – Sales (Partner), 21st Century Informatics

There were various challenges faced by an institute in implementing IT solutions, as they were a new medical centre. The team there was not very IT savvy and this was basically a specialty centre, where research was also being conducted. Hence integration challenges of specialty Electronic Medical Records (EMRs) and revenue cycle management was also considered.

They were also aware of the difficulties they would be facing while evaluating options to implement an EMR especially in the start-up stage. The industry reports made them take a very cautious approach – the report indicated that many organisations discovered post-implementation problems in their EMR. The EMR does not integrate well with other existing or new IT systems, it is not tailor-made for the organisation’s unique business needs. It brings down clinical workflow and creates dissatisfaction.

The centre decided to implement a tightly integrated EMR that provides the benefits of realising the required cost reduction and achieving the desired efficiency improvements in patient care. The applications they were aiming for not only had to capture data at the point of care, but also had to support the doctors in decision making.

Approach taken

With the primary objective of optimising the clinical operations, 21CI’s highly trained consultants proposed business process consulting study, in other words an ICT roadmap creation and solutions deployment. 21CI’s business process consulting and business process blue print document provided an in-depth understanding of clinical and business processes that helped the medical centre build an ICT roadmap. Next, we mapped the organisation’s unique ICT needs and based on the business process blueprint, and we configured our 21CI apex health information system.

A range of solutions were deployed under 21CI Apex Health Information System and proper training was provided to the key users. Clinic Information System (CIS) with day-care facility and laboratory Information system and Electronic Medical Records (EMR) and Picture Archiving and Communication Systems (PACS) were deployed.


One year after the date of implementation, 21CI and the medical centre jointly evaluated the benefits achieved. The study found that the centre had attained ICT-enabled revenue cycle management with diabetes management as the core pillar. This had the potential of improving care processes, delay diabetes complications, and provide adequate healthcare. A major benefit was that the time needed to service clinical processes was transformed from a semi-automated to process-driven automation. There was a reduction in transaction cost, and this resulted in a saving of almost 30 percent. The overall quality of patient service was improved, leading to increased patient satisfaction. There was an improved and effective billing capability. This eased clinical reviews and accelerated disease prevention interventions


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