Bumrungrad International Hospital

TEAM Pangaea Vanguard Hospital IT Infrastructure: Problems, and Implementations Prepared For Therapy Piccalilli Dry.

Scripps Planking's An Daddy Honorable English Instructors Prepared By Terrace Tiramisu Eukaryote Lackawanna Chauncey Returnable's Picaroon Running Natal Superpose Contents Introduction There is no doubt that technology has become a great part in our lives, and the importance of it is admittedly increasing as time passes by. The longer time passed, the more essential technology will be in our dally routines.

When It comes to Information Technology or IT, It Is hard to believe that there Is someone out there who did not actually know about IT. The definition of IT, according to Walked, Is simply the application of computers and telecommunications equipment to store, retrieve, transmit, and manipulate data, often in the context of a business or other computer or the network of computers, but it includes all the technologies that help distributing the information, for instance, televisions and telephones.

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Therefore, there are actually a bunch of industries related to information technology, no matter if they are computer hardware and software, internet, e-commerce and other computer-based services. As same as technology, IT has been developing continuously during the past years and the range of applications is getting wider and wider day by day. Nowadays, many companies adopted the IT system into their company as communication is the key in developing a successful organization. With the help of IT system, people inside the organization could communicate with each other faster, easier, and more reliable.

The loss of communication, or even a small glitch in the communication process, might slow down the decision-making process which, in some cases, could mean the termination of the company itself. In comparison, if any company has a good IT system in their possession, the company could accomplish so much beyond imagination; the company might be capable of working more systematically and have the upper hand in the competition. Thus, the IT system is considered one of many significant factors in bringing more revenue to a company and guaranteeing the well-being of a company as well.

From the vision of the executive manager of Vanguard Hospital, the economy of Thailand could be substantially developed which the results could be seen in the near future. As a consequence, they gathered all the people involved in the placement of the hospital and came up with a plan for the business in order to make sure that the hospital has the capability to handle the continuous growth in the number of patients in each year in an effective manner. For the current situation, it seems like it is the best opportunity for the IT to save the day.

Company Description Vanguard Hospital Public Company Limited (the "Company') runs a famous private hospital business in Bangkok, Vanguard Hospital. The hospital was established in 17th September 1980 in the form of a private hospital on Summit Road, which is considered as one of many business districts in Bangkok. In an average of 1. 1 million patients (both inpatients and outpatients) were accommodated by this hospital annually; about half of the figure is foreigners from over 190 countries globally. In the past 2013, the company earned around 14,651 million baht from the given services.

The hospital started in 1980 with the 200-bed facility with 90 million Thai baht investment. Currently, the hospital has approximately 580 authorized bed and support the total capacity of over 5,500 outpatients daily. On the 1st January 1997, the ewe main facility building named "Bandager International" was first utilized. The 12-story building is known to be the largest private hospital compound in Southeast Asia which is equipped with underground parking lot and the international standard rooftop helipad for helicopter landing. Later on, in 2008, the outpatient clinic facility was opened.

This outpatient clinic facility is a 21 -storey building with a parking lot that supports about 700 cars, spacious sky lobby on the 10th floor for business negotiation, international medical cooperation, and even visa extension services, and extensive range of sophisticated medical equipment. The cashier and the pharmacy customers. Moreover, other than Wi-If, LCD directories, and TV's, there is also an automated lab so provided faster and more liable results allowing the doctors to access the customers' files from inside their exam rooms.

With the utmost concern about the quality of the health care services given by the hospital, this company pays extra attention in the process of recruiting the physicians and staffs. Presently, there are more than 4,800 employees, 1,200 internationally certified doctors and dentists, and 900 nurses working inside the hospital. Since the company has been kicked off, the company has been continuously providing complete healthcare services for both inpatients and outpatients with extra precautions.

Taken all of dedication into account, there is no question that this company is one of the leading healthcare providers in Thailand and in Southeast Asia. According to Oversimplifications. Com, Vanguard Hospital is considered one of the world's popular medical tourism destinations. In the past 2012, the hospital serviced about 520,000 international patients who seek for high quality, International standard services, and lower cost healthcare. Vanguard Hospital is the first Thai candidate that received the US standard certification from Joint Commission International OIC Accreditation).

The hospital has also been given the Chic's Clinical Care Program Certification (CAP) for specialties programs including the Primary Stroke Program, Acute Myocardial Infarction, Diabetes Mellitus Type I and II and Chronic Kidney Disease Stage I to 'V. Other than that, the hospital also received many accreditations from many other famous institutions in both international and domestic levels, including the Thai Hospital Accreditation (HA). The company later Joined the public market and being enlisted on the Stock Exchange of Thailand in 1989.

The majority shareholders in the hospital can be classified into companies in Thailand and other countries such as Bangkok Dusts Medical Services Public Company Limited, Bangkok Insurance Public Company Limited, Bangkok Bank Public Company Limited and the Sycophantic family, which is one of Thailand's leading business families, Limited, and HASH (Singapore) Nominees Pete Ltd. Mission, Principle, and Policy The hospital was established with the main objective to make sure the world-class tankard healthcare service would be provided to the customers with care and compassion.

It has been operating with the following principles:

1. Strive to exceed our customer's expectations
2. Committed to our Medical and Hospital staff's welfare, education, training and development.
3. Continuously improve the safety and quality of the services.
4. Strive for professional excellence and innovation in the services.
5. Embrace cultural diversity with Thai hospitality.
6. Strive to make the services" World Class".
7. Being trustworthy, honest, and acting ethically in all dealings.
8. Work as a team ND share what is known.
9. Highly value the corporate social responsibilities (CARS) 10.

Operate in an environmentally responsible manner. After reading the points above, it might seem like all the company thinking is about itself, but actually, the company has also been operating with the global environment and conserving energy and natural resources. To make sure that the environment will be properly preserved, the hospital maintains a serious aim to follow the regulation enacted by the government and the world standards. Moreover, the hospital is also very careful about the water management system to prevent the eater streams nearby the hospital from getting polluted and affect the neighboring community.

Corporate Social Responsibility (CARS)

Corporate Social Responsibility (CARS), in a nutshell, is the responsibility towards the society and the environment of an organization. In other words, CARS is a systematic management under good morals, which leads to a sustainable development of an organization. For Vanguard Hospital, the Vanguard Hospital Foundation (UHF) was set up in May 1990 as the CARS of the company. The UHF is a registered non-profit foundation founded by the founders of Vanguard International Hospital.

The foundation is involved in many charitable activities for that unprivileged Thai citizens all around the country who did not receive a proper healthcare services with the intention to promote their well-being and to give them a proper knowledge of being healthy. Any donation made to this foundation can be used to reduce the tax (tax-deductible). Recent fund-raising programs and activities of this foundation are as follows:

1. 50 Pediatric Heart Surgeries: This is a follow-up campaign after the 72 Pediatric Heart Surgeries. In this campaign, 50 unprivileged people will be selected to get heart surgery without being charged a single baht.
2. Pediatric Heart Surgeries
3. "Mend-A-Broken Heart" Charity Heart Surgeries: This campaign was established in 2001. In cooperation between UHF and other business entities, 20 unprivileged people were selected to get free heart surgery.
4. Thompson Fund Mobile Free Clinic: The UHF and Thompson Fund cooperatively sent out mobile free clinics to give medical care to 100,000 people in an underprivileged area.
5. Charity Medical Relief: The UHF and the Bangkok Insurance Company work together to send out officers to help many people in Saxon angora and Musician province every single year. They also introduce them to more Job opportunities and offer them chances to improve their quality of life.
6. Patients in Need: The foundation offers financial aids to those who are in need of medical assistance but cannot afford the medical treatments. Other than offering decent healthcare to those who are unprivileged, the foundation also aids those people in the field of education by giving them proper education, training, and also scholarships for children with an insufficient budget. This foundation gets the money from the donations received from the patients of the hospital, other business entities, and even each individual person.

Anyhow, the foundation does not only rely on donations but also fund-raisin events and charitable art exhibitions. Additionally, the UHF also concern about those who are underprivileged in other countries as they have started charities such as, eyes operation for Laos kid who got a piece of the bomb embedded in the eyeball. Current Status, Direction, and Goals Judging from the information above, it can be clearly seen that the status of this company is on the rising trend with an increasing number of patients in each year.

It seems like the longer humans live in this cruel world, the more "natural selection" is Charles Darwin which simply implies that only the strongest will survive. More people are getting infected by some new diseases that no one has ever seen before. In fact, it is undeniable that no matter how strong a person is, everyone needs to be treated by doctors even once in a blue moon. Thus, the healthcare provider as Vanguard Hospital is becoming more and more profitable compared to other good or service providers.

This is the main reason why Vanguard Hospital is keeping on developing the hospital to provide better healthcare services to those who needed to be treated.

Position in the Strategic Impact Grid The Development of Vanguard Hospital's IT System In the year 1997

The hospital was facing trouble as Thailand faced the economic crisis as it affects the middle-class people which are considered the main customer base of the hospital. Thus, all the people chose the hospital that is operated by the government with a lower payment.

Under the circumstances, the hospital saw the opportunity to expand the customer base to an international level. At the end of this period, the hospital received ISO 9000 Certification. In the year 1999: The hospital started to use the internet as the mean for information distribution. At the time, the hospital's website had been visited for about 800 views per day. In the next revolution, the hospital brought in the US IT Consultant Service and started up the company called Global Care Solution (GAS) in Thailand for assembling the system for the hospital.

Later on, in December of the same year, the "Hospital 2000" was implemented as a substitute for the older platform. The software was regarded as the first hospital system that connects everything together from the front office, the system for doctors, pharmacists, nurses, and radiologists, patients' registration, time schedule of the operating room, exam room, and wards to the patients' profiles. The hospital invested on 450 clients to be set up around different sections of the hospital. In the year 2002-2004: The Hospital 2000 system was developed to support PASS (Picture Archive Communication System).

The hospital got rewarded by Intelligent Enterprise Asia magazine for being 1 in 20 top organizations that uses IT to maximize the ability to provide services to customers. The hospital also got an appraisal from CIO Asia for being top 100 organizations that implemented the hospital information system. In late 2003, the hospital invested on another 450 clients which causes less system breakdown as increase the uptime for 99. 99%.

As a result, Vanguard Hospital is now not only a user but also another invisible hand in the development of the system. In the year 2008: Microsoft started launching "Microsoft Amalgam" which is a combination of Xiii and Hospital 2000. The hospital also started using more sophisticated technologies inside the outpatient facility, for instance, Wife internet, LCD directories, automated lab for more precise and faster exults, online patient registry, and diagnostic image that the doctors can access. Later on, management for inpatients. The idea of using robot came up from the concern the safety of the patient.

From implementing the robot, the hospital can spend less time on the medicine of each patient. Other than that, the hospital also started up the laptop rental service for inpatients. The laptop was designed to use inside the hospital as it is attached to the table on the side of the patient's bed and it is equipped with a silicone keyboard, sterilized optical mouse, WebMD for video conference, and voice-over system. Hospital 2000 is a system specialized for hospital systems with the scope of almost every activity inside the hospital.

For usage inside the hospital, the system has the capability to handle the information of the patients or other employees, transaction processes, accounting, pharmacy, registrations, human resources, and even the patient transfer processes inside the clinic. All these sub functions are collected inside one big database in one system that supports almost every language available on this world. Microsoft Amalgam Hospital Information System (Amalgam HIS) Amalgam HIS is the developed version of Hospital 2000.

This sophisticated system was designed to systematically take care of the IT system inside the hospital by collecting all the necessary data inside the database. Amalgam HIS was created based on the Electronic Medical Record (EMMER) which is composed to patient management, bed management, operating room management, pharmaceutical management, and even a management system for radiologists. In addition, the system is also capable of storing and transferring image data (IRIS/PASS), doing some complex accounting calculation, and managing both inventories and human resources.

PASS (Picture Archive Communication System) is the system produced to digitally store the medical images and x-rays results without using any film. By using this system, the doctors could access the images by using the Internet from remote distance. In addition, the system also allows long-term storage. In a normal situation, where physical films are used to store the images, the images could be changed or damaged as time passed by and not to mention that it took so long to find the record in the form physical films whenever it is needed.

Thus, using PASS will elf ease out all the processes for easy retrieval and increase reliability. Current IT Infrastructures At the moment, Vanguard Hospital is using the Amalgam Hospital Information System (Amalgam HIS). This system has been implemented in the hospital since 1997. Thus, the information system for Vanguard Hospital is considered an essential component in the management processes that occur inside the hospital. It is clearly seen that if it is not because of the marvelous IT system, the hospital might not be able to come this far as one of the best hospitals in the Southeast Asian region.

The actors who are involved in the system are as follows:

• 1.Doctors: The Amalgam System takes a great part in helping the doctors to look at the overview of the profile of each patient. The doctor can glance at the profile of the patient and suddenly have an idea of who they are treating which will prevent any mistakes from happening. Another good point is that the doctor can write medicinal prescriptions and schedule the next appointment via the online system.

The appointment and the prescription will then be sent to the cashier and the pharmacy so that the patient will the safety of the patient, the system also provides options for the doctors available for operating the patient as each doctor has a different specialty and different schedule. The system will filter out the doctors who are the best for operating on each specific patient. However, it does not mean that every doctor knows how to use the system. The elder doctors might not be accustomed to using the IT system and the part-time doctors might think that it is unnecessary to learn how to use the system as they come from time to time.

To handle this problem, the hospital decided not to banish the old IS system which is manually writing the prescriptions and recording the patients' records. The information recorded manually will be transferred to the QUA department in where the information will be recorded into the system to make sure that the information of the patient will be available by the next time the customer uses the hospital service again Just as same as another patient that information recorded by the doctors.

By implementing this IT system, it ensures that the hospital is using its resources of 1,200 doctors efficiently and the customers can be assured that the appropriate healthcare will be given to them as the total amount of patients will be distributed equally among doctors to ensure the maximum ability n providing the services.

• 2. Hospital Officers: Every hospital employee is obligated to know how the system works no matter if they are receptionists, accountants, nurses, radiologists, pharmacists, or even human resources.

All the officers will have to work in harmony to be able to maintain the fast-paced work and provide the information needed in a short period of time. Although all the systems are connected together, it does not mean that everyone will be seeing the same information. As an example, this is what happens in steps when Mr. A visited Dry. B. Mr. A visited Dry. B in the year 2012 with the symptoms of Acute Tuberculosis. Later on, in 2014, Mr. A came back to the hospital again with an intestinal infection which he was assigned to Dry. C. Dry. C will be able to see the whole medical report of Mr.

Including the medicines that he is allergic to, who was his former doctors, what were his symptoms, and all the medical implications. When Dry. C wrote the medical prescription, and the lists of medicine will be sent to the cashier and the pharmacy. The pharmacy will only see the lists of the medicine that Mr. A will get so that they could pack everything he deed while the cashier will only see the list of the medicines and the price so that Mr. A will be charged correctly. These two departments would not be able to see the medical report related to Mr.. A. When the pharmacy packed all the medicine for Mr.

The total amount of each medicine inside the inventories will be updated which will be easier to keep track of all the drugs inside the stocks to prevent those drugs from running out. In case the report is needed, the system also provides the function to generate the report of the patients who were treated by Dry. C in each day. With the help of the system, all the information from the doctors to other departments and employees will be synchronized which will increase the speed, reliability, precision, and accuracy of the service that will be provided in daily routines.

• 3. Patients: Other than hospital employees, another actor that cannot be neglected is the patients. Patients are considered an important part of the development of the hospital system as the system was designed for the convenience of the customers and to reduce the waiting time. Moreover, in case the patient is ready to be transferred perhaps in the form of hard copies or CDC. While those data are being transferred, the copy of the data will still be inside the hospital system in case the patients wanted to be transferred back for further medical treatments.
• 4. Executives: When it comes to the executive officers of the hospital, it is important that they can get the overall status report of the hospital whenever it is needed. The report that is provided by Amalgam HIS is in the form of an interactive report in which the executive can sit back and relax as the report generated will make the analysis process a whole lot easier. For simplicity, the interpretation will be made from the data collected from each patient.

As soon as the report reaches the executives, for example, the CEO, the CEO will be able to notice the trend of the symptoms at the moment so that the hospital can be prepared for the situation that might happen in the future.

• 5. The competitors: The competitors of Vanguard Hospital are not only private hospitals but also those hospitals that operate by the government. It is easy to say that Vanguard hospital is one of the first hospitals that implemented the hospital information system. But as time passes by, the IT system becomes more affordable for every organization.

The competition becomes more and more intense s more hospitals also implemented the IT system which will introduce newer dimensions of giving services to the customers luring in more customers. Though the system that the others used might not be as good as what Vanguard implemented but it is surely enough to become a more frightful business competitor. Workflow inside the Hospital

1. Make an appointment: The patients can choose whether they want to make an appointment using telephone or using online services. For foreigners, they can make schedule an appointment on www. Vanguard. Mom where they can select the doctors that they wanted to get treated.
2. The patient reached the hospital: When the patients arrived at the hospital, they need to hand in the patient card or tell them the patient id in which id will be keyed into the system to report that this patient has already arrived at the hospital and is ready to be called into the examination room.
3. Preparation of the patient's profile: As soon as the patients have confirmed an appointment with the hospital, the hospital needs to prepare the profile of that patient before they even reached the hospital. With the information, the nurse in each counter will be able to make a schedule for the doctor and get the attain ready whenever they arrived at the hospital.
4. Seeing the doctor: The doctors inside the examination room will be able to see how many patients are waiting for the examination. Moreover, the doctors also can access the profile of each patient to see the former medical diagnosis, drug allergic history, all the taken lab results which can be changed into the form of graphs for analysis.
5. Lab & X-Ray results: Whenever the doctors see that the extra labs need to be tested on the patient, the direct order from the doctor will be sent directly to the lab and X-ray room. Nowadays, there are many technologies and one many interesting breakthroughs is the digital x-rays which allows doctors to get the x-rays results digitally without using any film.
6. Payment: When the patients got the medical care that they need, the payment information and the information about the patients' insurance will be sent to the accounting and financial departments. In this step, the patients queuing sit still and wait for the system to manage their queues and call out their names.
7. Get the medicines: Practically, when the doctors ordered the medicine, the prescriptions will be automatically sent to the pharmacy. Thus, the patients can get their medicine as soon as the patients made the payment.
8. Executive operations: The executive officers can access the system to get the overall analysis of the current situation for management and make plans for the future.

In the data analysis, the system will use the system called OLAP (Online Analytical Processing) which is already pre-equipped in the Microsoft SQL Server. OLAP helps the executives in gathering information from the data warehouse for analysis, for instance, the proportions between domestic and international patients, and the nation where the international patient are from so that the hospital will be able to get the translators ready for assist the international patients who are incapable of communicating directly with the doctors.

Hardware Development For optimum efficiency, the hospital chose the computer system from Dell which is believed to be more stable compared to other brands. Since the computer system from Dell has been implemented, the hospital admitted that the expenses of the hospital were enormously reduced the left hospital with enough budget to invest in another secondary storage station, which will manage the data in a real-time manner, to prevent any system failure. The hospital system, there consisted of 4 servers from Dell, 1 main memory, and 6 desktop computers connected in the form of a cluster.

Moreover, the hospital also set up extra 450 computers around the hospital to support the increasing amount of patients. For maximum functionality and for ease of access, the hospital also spent some amount of money on 100 laser printers and 120 scanners to keep the data of the patients. In terms of system functionality, if in case of an emergency, the power supply of the system was cut off, the system will be automatically shut down and rely on will cause devastating damage to the system. Thus, the hospital made the decision to use the Infrastructure system offered by the APPC.

The Infrastructure is the architectural design for the data center IT room, which is scalable and adaptable, which dramatically reduces time and complexity from concept and design through installation. This Infrastructure system is composed of 2 40 KAVA N+l Redundancy UPS systems. The two systems are working in harmony in a load sharing manner. Each UPS system will be powered by different sources from different sides of the building to ensure maximum security from the electrical problems that might occur.

If something happened to the first UPS, the other UPS will be able to step up and take all the workload. From doing so, there is less probability of system failure and all the systems that are essential for providing the services to the customer will work continuously. Another good point of this APPC system is that there is built-in self-test software called "Powerhouse" which will automatically do the self-test to find if there is any hardware in the system that needs replacement.

If the software found out that there is actually hardware that needed to be replaced, the software will notify the arson who is in charge of taking care of the data center to replace the hardware without turning off the whole system. For the linkage of the system, Vanguard Hospital entrusted Motorola, Inc. Together, the hospital used more than 300 wireless switches and access points. For the switch, the Motorola REFORMS Wireless Next Generation, which is capable of layer-3 roaming, was utilized.

The layer-3 mobility allows the users to roam without losing its IP address and sessions which is great for large areas with many stories as the users can use the network while they are walking with the maximum bandwidth ND noise-free. This is considered as something that can benefit the hospital in the long run. This wireless system can be used not only by the users but also by the doctors and other staffs as well to ensure the availability of data in real-time in the range of 90,000 square meters of the hospital's area.

For security issue which is the main key in the designing process of the hospital system, the security system invented by Motorola, the Wireless Intrusion Protection System (WIPES), is taking care of everything Software Development As has been mentioned above, the hospital has implemented the Amalgam HIS to ease up the work processes of the doctors and other employees by making everything faster, more convenient, more effective, more precise, and easier for maintenance. Not to mention that using the system will also make communication with the users more understandable and more cost-effective.

The system works dependently with the Microsoft Windows Server 2003 and Microsoft SQL Server 2000, which is the software for managing the database. All information will be kept inside one big database inside the IT department which causes the hospital system to be in the form of a computerized system in which every department ND every computer can communicate with each other via a computer system. No matter in what direction the patients were led to, the computer system can help the hospital to prepare what is needed in a short period of time.

Nowadays, many people are getting treated by the hospital in each day which means a high amount of the transactions between each department each day. Thus, the system needs to be scalable; the hospital can add in more machines or take out some machines to be appropriate with the number of patients at a specific period of time. From the software perspective, the system needs to be adaptable, reliable, and e ready for any further system expansion in the future. The Amalgam HIS can be divided into 3 tiers.

1. Presentation Tier: This tier includes all the 1,000 work stations across the hospital which are used to get the data by accessing the central database of the Amalgam HIS that is set up on the machine that runs on Microsoft Windows 2000.
2. Middle Tier: The middle tier is in between the presentation tier and the database. Here, the Windows Server will be regarded as the Transaction server which is the main medium for managing the flow of the transactions that are being sent to the database.

When the transactions were generated, they will be sent to different servers to prevent one specific server from overloading. An extra services can be added whenever it is needed to handle the customers' needs without having to shut down the whole system. All in all, the hospital got a lot of assistance from the software from Microsoft as the software allows the hospital system to work faster, more consistent, and more precise, and also helps the hospital to control the number of employees needed inside the hospital.

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