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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