CASE STUDY AT MANIPAL HOSPITAL, BANGALORE

Manipal Hospital is situated in Bangalore city, known as Garden city of India, with a
population of around 6 million. The hospital located on Airport Road, is in the centre of
eastern part of the city, opened its doors in 1990 for in and around Bangalore citizens to
usher in a new era in sophisticated and specialized medical care in the southern part of the
country. The hospital is housed in a magni- cent twin towered, centrally air-conditioned,
fourteen storied building with a bed strength of 450 at each of the towers, totaling 900. The
hospital has been set up to benet the local population mainly.
This hospital is an addition to the Manipal family of health care institutions which
included four medical, two dental, nursing and pharmacy colleges and 10 hospitals with a
total of around 5000 beds. All of this represents four decades of their total experience and
expertise in medical education and health services and it is this track record that ensures
the quality of Manipal hospital, Bangalore, known to each and every citizen of Bangalore.
This hospital has provided sophisticated medical and surgical facilities. It has gained
reputation in Bangalore as a centre for medical excellence and it is all due to the pre-
eminence of the specialists on its medical sta panel, its highly skilled nurses and support
sta and sophisticated medical equipment. A premier, multi specialty unique hospital with
multiunit situated at Bangalore, Mangalore, Manipal, Nepal, Sikkim and Goa, is committed to
providing personalized care of the highest order with the widest scope of advanced medical
facilities. The hospital oers its medical services on a break-even nancial basis, thus
bringing high quality healthcare on commercial terms. The individual health insurance plans,
company group insurance plans and some subsidized inpatient beds in line with
government directives are some of the highlights that bring so- phisticated treatment to the
middle class family. Besides these, they have standard screen programs at a very nominal
rate for the middle class families and executive screen programmes for the privileged class
at a higher rate covering complete blood count, urine-analysis, stool examination, blood
grouping, blood sugar, urea, cholesterol, electrolytes, lipid prole, X-ray chest, ECG,
creatinine, triglycerides and nally consultation with physicians, gynecologists etc. They
work towards a preventive approach, pinpointing all possible risk areas and oering
solutions to each and every problem areas with the cream of medical fraternity and state-of-
the-art equipment, and thus each of the Manipal hospitals is a cost centre.
The central oce is at Manipal, where the medical director and other directors
working there provide corporate guidance to their other hospitals. They decide important
matters connected with all their units. At Bangalore, CEO heads the three hospitals (two
situated in the Airport Road, one at each of the towers and the third hospital known as north
side hospital situated at Malleswaram, northern part of Bangalore with 62 beds). One
hospital at one of the towers deals with heart operations and is headed by the divisional
head and designated as director, operations. Similarly, in the 2nd tower for three dierent
operations, like Nephrology/Urology, Neurology, Diagnostics, there are three divisional
heads who control the operations in their respective areas. The fth divisional head of
Bangalore is at the north side hospital. Each of the divisional heads has dierent
departments under them and each accounts as a separate cost centre. The various
departments are personnel, engineering, maintenance, purchase, accounts, matron, nance
of- cer, pharmacy, laundry, security, kitchen, housekeeper etc. and their clients are all at
the same level. Each of these ocers has again assistants, senior assistants, and junior
assistants etc. to look after various sub-functions. Since, inception of Manipal Hospital in
1991, the hospital has computerized various recurring activities like inpatient, outpatient
admissions, transfers, discharges, and registration, certain corporate activities, payrolls,
billing etc. from the computers and software packages purchased at that time. They have
also developed softwares of their own at the head oce by their software engineers to suit
their operations. Though the computerization activities are in full swing at various
departments the intercon- nectivity is lacking and the system is also old, to cope up with the
increased work load. At present, they do not have any connection between computers of
dier- ent departments and also with dierent hospitals. As such, the hospital was very
serious in modernizing the old computer system at each of the departments and to expand
its activities to other departments and to have connectivity to various hospitals including
their hospitals at Nepal and Skkim, which are far o.
The hospital, considering its future expansions as well as anticipated in- creased
work load negotiated with some of the reputed consultants in the software eld, about six
months back and is likely to entrust to one of the leading software companies at Bangalore
(short listed) for the full computerization of the hospital.

They are likely to spend a huge amount for computerization activities and the pilot project
was likely to commence in April 1999. Manipal Hospital at present is hav- ing MIS activities,
at one nodal centre at each of the hospitals. MIS do not have a separate department, but all
MIS activities come under nance controller.

The pilot project commencing in April 99 included computerization of the following:

(a) Front oce (Administration, registration, discharge, transfer etc.)

(b) Billing
inpatient
outpatient

(c) Accounts
Billing
Purchase
Stores
Payroll
(d) Corporate activities
(e) CDR
(f) Medical records, ward management, OT scheduling, doctors appointments scheduling,
engineering and maintenance, laundry, kitchen, housekeeping, all wards etc
(g) Laboratory (Interfacing)
(h) Computerized library.... etc and
(i) Radiology


Many of the activities, though existing, need to be updated with new systems and wherever systems
do not cover departments, these are to be included.
According to Mr. Sairam, who is in charge of all these activities at present, conrms that the
entire work will be done in ten phases as under within a span of 2 years maximum?
(a) Pilot project at Manipal Hospital (Tower 1 - 450 beds).
(b) Extend the pilot project to (Tower 2 - 450 beds).
(c) Extend the same to North side hospital - 62 beds.
(d) Connect all the three through WAN.
(e) Simultaneously with activity 1, work starts at Manipal - 1600 beds.
(f) Simultaneously with activity 2, work starts at Mangalore - 1000 beds.
(g) Connect Bangalore, Mangalore, Manipal, across all the hospitals through ex-
tended WAN.
(h) Extend the similar activities to Nepal.
(i) Extend the similar activities to Goa and Sikkim and
(j) Connect all hospitals.
During this period, care will be taken to include all high tech systems like expert
systems (may be useful for hospital research work), executive information systems and
DSS for top management to take decisions on vital matters.

Application Questions

(a) Do you feel that DSS and EIS are required in hospital information system? Give explanations for
both yes and no answers.

(b) Analyze whether the DSS could be used electively in hospital R and D activities.

(c) In your opinion, the computerization plans of Manipal Hospital, a multiunit, multi product,
multi location organization are OK. Any other suggestions you could oer in making this still
eective, keeping the budget also as a constraint.

(d) Do you think that client/server technology is part of the business strategy for prot health
maintenance organization (HMOS) and hospitals. Why or why not?