IT ROLE IN EXPANDING SELF-GOVERNMENT OF THE HOSPITALS

Sergiy D'yachenko

Fundamental change of organizational structure of enterprise management is a required factor of successful expanding of self-government of the hospitals. Possibility of the heads of different levels to have access to operative and reliable information about the enterprise and its departments that deal with different aspects of activity is an essential part of such reorganization. Above all, it concerns information on financial and material security of the hospital, budget planning and control over its execution, continuous analysis of fulfillment of the contract obligations, calculation of the cost of provided medical services, etc.

Successful implementation of these tasks is impossible with traditional paper storage of information and reporting. Therefore the substitution of the paper technology of workflow with the electronic one using computers is urgent.

EU Project "Health Financing and Management in Ukraine" gives special attention to development and introduction of computer IT for the pilot regions. The system consists of the following modules:

1. Registration of medical services on the primary and secondary level
2. Management of statistical iformation
3. Personnel administration
4. Management of the contracts and agreements
5. Material and tax accounting, salary.
6. Budget module and management accounts
7. Calculation of the medical services cost
8. Analysis of effectiveness and quality of medical services.

Program modules are being implemented at the district level - primary care doctors (family doctors - general practitioners), in the hospital and polyclinics, stations of emergency care, in the district departments of health care, as well as on the oblast level - in the central district hospital, oblast information analytical center, diagnostic center and other health care institutions.

Spade-work of EU Project with supposed users promoted success in implementation of the program modules. The Project organized ten seminars that covered the whole scope of the questions that related to the change of the status of the hospitals from state to communal enterprises in the pilot sites.

From managerial point of view the following characteristics of computer IT are of high importance:

• Information support the business processes in hospitals and administrative authorities of the Ministry of Health of Ukraine
• Operative transmission of medical information to the family doctor and emergency care station
• Operative information exchange between hospitals and institutions of the Ministry of Health of Ukraine
• Information support of the heads of hospitals and administrative departments while adopting operative and strategic decisions

Information support of the heads while adopting decisions includes possibility of their first-hand access to the main activities of financial performance of the enterprise, analysis of the volume of provided medical services, analysis of the quality of performance of the departments and doctors, comparison of activities of their hospital with average oblast and national indices.

Cost Accounting (calculation of the cost of the provided medical services) module is an important analytical part of the information system. It enables the head to receive information on average economic and statistical indices of provided services in of in-patient departments, polyclinics, family and village ambulatories, etc.

Average cost of the single reception of the patient by the family doctor or polyclinics specialist, call of emergency care, single bed-day in in-patient department, treatment of the single disease in the hospital, etc. are among these indices. The cost accounting module is based on the data of medical statistic information, accounting and budgetary data.

Complete implementation of IT promotes reduction of working hours of the hospital employees. In particular, this will enable the doctors to spend more time for treatment than for clerical work. If traditionally the doctor has to spend about 65-70% of his time for filling in different documents and only 30 - 35% of his time for treating patients. Implementation of IT will enable the doctor to devote 50 -60% of his time to treatment and this will improve quality of medical services.

Active usage of analytical and modeling facilities of information systems will enable modeling of the structure of the hospital, consist of right budgeting and control over its execution. Reduction of expenditures may constitute up to 20%.

Thus, implementation of IT systems is substantial informational and financial basis for heads of the hospital in expending self-government and functioning in new economic conditions.