Medcurial

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A Playbook To Improve Clinical Effectiveness and Reduce Variability in Care

A Playbook To Improve Clinical Effectiveness and Reduce Variability in Care 768 487 Exist Software Labs

Rules and payment models keep changing, revenues falling while demand for care quality is at an unprecedented scrutiny. To thrive, hospitals need to address clinical variability.

For years, our team at Exist has made it a priority to build technology capabilities that tear down the barriers of siloed systems particularly in healthcare.

From our clinic system which connects both users and clinics to our hospital system that integrates every available important service within the institution around the patient data and the care that they received, we believed that achieving significant and quality care outcomes required connecting dots via promoting effective care coordination.  After all, a superhero doctor approach – which traditionally has been the case, is unsustainable, if not constrictive.

While ‘interoperability in healthcare’ presents a tremendous gain, it is still not the end goal. What connecting through data unlocks is access to information that could lead to evidence-based care protocols and if taken to heart, reduce care variabilities.  

It is apparent that hospitals globally are under tremendous challenge, not only from containing diseases but operationally with slow revenue growth that results in a sustainability challenge.

This sustainability gap for healthcare providers is a result of multiple factors, not limited to:

    • Rules keep changing midgame
    • Shifting payment models
    • Regulatory changes
    • Rise of non-traditional competitors with tech advantages such as Google, Apple, and Amazon.

It is quite a challenge!  

Many hospitals will try to tighten their revenue cycle management — contain costs by streamlining operations and reducing staff and adding technology — but it would only be a short-term measure because it won’t be able to close this gap unless variability – source of inefficiencies, adverse events, increased lengths of stay, and higher mortality rates is addressed until consistency of care becomes the norm.

At the root, two critical factors emerge that need to be addressed: the decisions clinicians are making every day and the engagement and preferences of your patients. 

For institutions, however, addressing variability is an itch better left unscratched since it involves challenging traditional approaches and behavioral change for an overburdened care workforce, it can get pretty tricky.

Unless doctors and clinicians come across a common care playbook that could make the transition easier and by which they could all align with.

Healthcare is under siege and new approaches are needed. Learn more about evidence-based playbook to reduce clinical variability and address the sustainability gap.  Download the eBook Reducing Variability in Care: Drive Behavioral Changes That Improve Clinical Effectiveness to take a deeper look into proven approaches for improving your organization’s clinical effectiveness.  (Registration required).

Check out our healthcare product, MEDCURIAL, and see how it helped some of the biggest hospitals in the country provide better patient outcomes.

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Our Share in This COVID Warfare

Our Share in This COVID Warfare 768 487 Exist Software Labs

The year shocked us with a change we have all not foreseen. For the first time in years, perhaps, decades, we had to turn our backs from the living condition that has grown on us. The world has taken a hiatus from almost all of its activities. The population succumbed to the walls of their homes in fear of acquiring the virus.

At the forefront of this global health crisis are fighters equipped with medical weapons and gowns, the first line of defense in this war. While we remain in the comfort of our homes, hospitals keep striving. It has served as heroes’ quarters even in retrospect, saving lives at the best of their guts. But a pandemic can take anyone by surprise.

Throughout history, viruses, bacterias, and parasites have been killing more than wars and natural calamities. We have heard of similar diseases like SARS and MERS before. But even with hundreds of health cases related to this, the COVID19 is a whole new deal. Medical experts are still seeking answers. The world is still yet to discover the cure for it.

As the crisis magnifies each day, humanity and empathy for those in the frontline also amplify. Assistance comes in many forms from different people and institutions.

As technology innovators, we hope that our technology is serving health workers from our partner hospitals well. Compared to the risks that they are taking, it might be little. But it draws us more to continuously work in advancing our healthcare technologies, knowing that it is serving a great purpose in these troubled times and might even be useful in the future.

Having a system that can effectively manage medical records digitally can save some of their time. It also contributes to reducing errors that could affect patient outcomes.

There might still be millions of unknown diseases comparable to COVID19 that the world may encounter again. Thus, an effective documenting system to gather information about the patients can help in medical research, developing vaccines, and improving medical practices.

This phenomenon hit us with the reality that a multitude of possibilities is still unknown in the field of medicine. Takeaways from this event will likely propel a much intensive organizational development and the adoption of modern solutions for modern problems. 

We hope that once the brighter days are upon us once again, we will have more chances to work hand in hand with those in the health sector, improving their operations while enhancing our healthcare products. So that when another biological threat comes in our way, our medical practitioners are better geared, having better access to medical knowledge. We can be more ready than afraid.

Check out our healthcare product, MEDCURIAL, and see how it helped some of the biggest hospitals in the country provide better patient outcomes.

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Healthcare Crisis Demands Use Of The Cloud

Healthcare Crisis Demands Use Of The Cloud 768 487 Exist Software Labs

The pandemic has placed institutions around the world under a heavy burden.  Except for national governments, no other institution or workforce has taken the full force of the effect of the COVID virus than hospitals. The immensity of the response needed, saving lives in addition to those that are infected while protecting their own care teams is unprecedented possibly since the post World War.

But we are, by no means still in the industrial age.

Technology has advanced to the point that people can stay in touch with families and workmates while physically apart across continents.  What this also means is that systems can be serviced and operated remotely while interfacing with other systems in order to provide valuable data and/or service that workers need to perform their jobs.  At its core, most if not all businesses, institutions including hospitals, require software systems in order to run their operations and coordinate the disparate but dependent functional parts.

We have at our disposal the use of magnificent machines that we’d never thought would be smart enough to turn on and off and operate by themselves. Inside the modern hospital, we’re used to seeing nurses carry tablets instead of paper charts, programmable infusion pumps instead of IV drips, and patients viewing lab results from the mobile phone instead of reading them on paper.

Yet all this may not be enough and the situation right now and post-crisis demand that healthcare upgrade and become more digital.

It has been said that the web is the future and along with it, is the use of cloud computing.  But this isn’t true at all because the future is upon us already!

The window for getting by with anything manual or use of outdated software applications that require complicated installations and effort-intensive management has just about closed.  The current crisis just illustrated how fragile are the systems that are highly dependent on onsite physical support. Unless, you’re a care provider – a doctor or nurse or medical team member, any function that can be performed remotely can mean lives being saved and less burden on medical services.

To believe that this is temporary and that things will return to normal soon is to remain in denial.  The world has changed and expectedly, so will the tools.  

One can bet that this crisis will spur innovation that will bring about better technology for hospitals, businesses and other industries than what we have right now.  The kind that allows people to focus and invest on work that is truly valuable like bedside care and directly saving lives.

But until that time comes, it is best to perform an honest audit of what keeps your business up and running. Heaven forbid that IT systems experience downtime and can’t help hospitals stay afloat.  Because every medical personnel’s fervent wish is for people to stay home, expecting the hospital systems and processes running efficiently (from admissions, discharge, orders, billing and cashiering among others) while they do their jobs is probably high on their wish list, too.

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Exist Software Labs’ Medcurial Becomes First DOH NCR-Certified EMR Software

Exist Software Labs’ Medcurial Becomes First DOH NCR-Certified EMR Software 768 487 Exist Software Labs

Metro Manila, March 2020 — Exist Software Labs, Inc, a global IT consulting and solutions leader  achieves another feather in its innovation cap as it successfully completes the required EHR/EMR certification thus becoming the first EMR software certified by the Center for Health Development in Metro Manila under the guidelines contained in the Joint Administrative Order No: 2017-001 also known as the implementation of the National eHealth Electronic Medical Record System Validation (NeHEMRSV).

Guided by the Philippine eHealth Strategic Plan (PeHSP) for Universal Health Care (UHC), one of the jointly-identified major strategies by the Department of Health (DOH), Philippine Health Insurance  (PhilHealth) and Department of Science and Technology (DOST) is through the implementation of the NeHEMRSV. 

The NeHEMRSV is envisioned to serve as the policy arm to implement national systems conformity assessment protocol for national health data reporting requirements of DOH and/or PhilHealth. Specifically, the NeHEMRSV shall confirm if an EMRS or HIS measures up and conforms to defined reporting requirements and 2 submission protocols. Further, its implementation will improve data capture, processing, aggregation, exchange and reporting on national health data requirements and standardize submission protocols among implementing health facilities.

“As an experienced enterprise IT solutions provider across a variety of industries, Exist has always planned and prepared for the dynamics of change that govern technology to be able to respond to the needs of the times”, reveals Mike Lim, CEO of Exist.  “Once again, our team has proven that the systems we create and in this case, Medcurial, can readily support hospitals and care institutions in compliance with government eHealth initiatives.”

Starting with the PhilHealth eClaims submission in 2018 as compliance to the electronic medical record (EMR) implementation, the renewal of hospitals’ license to operate (LTO) for 2020 now requires that EMR system and providers be duly validated by the Centers for Health Development (CHD) within their respective regions for which Medcurial has this distinction.

“As the Philippines’ preeminent region, Metro Manila is where the majority of the country’s leading and advanced hospital institutions are located which is why being their first validated EMR is such a great honor for us, adds Willex Perez, Exist’s Director for Healthcare Solutions.  “We take great pride in the systems we build that not only automate manual processes and produce reports because we go beyond and unlock other system advantages which in this case, means supporting internal validation of data that minimize and capture errors before any official transmission.” 

“Being awarded this certificate doesn’t mean that it’s time to sit back and rest easy.  On the contrary, it only lends more credence to our company slogan which pushes for continuous improvement be it in healthcare or any other systems in our portfolio”, adds Willex.

“As we say, with us, there’s always a better way!

Check out our healthcare product, MEDCURIAL, and see how it helped some of the biggest hospitals in the country provide better patient outcomes.

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Push for Philippine Healthcare Transformation Continues

Push for Philippine Healthcare Transformation Continues 768 487 Exist Software Labs

The Hospital Modernization Summit series has just concluded its latest stop in Manila last February 20, 2020, at the Sofitel Philippine Plaza Manila. 

Aptly titled Digital Hospital Transformation Conference, Philippines, the event united local healthcare leaders, executives, care providers, and stakeholders to address the pressure of improving healthcare amidst the increasing challenge brought about by the need to incorporate universal healthcare, rising population, costs, and the threat of new diseases.

Exist and Medcurial have once again teamed up with Zebra, a global leader in providing handheld and mobile devices, printers, and computers that are vital towards elevating the patient experience and promoting efficient hospital and clinic operations.

With Zebra products and our MERX hospital information system, visitors and attendees were able to glimpse how the right device and hospital system integration are simple ways for hospitals to make the technology leap into innovations that make practical sense. From simple printing of labels and patient tags on virtually indestructible, tear-proof stickers that capture the admission, lab order, and results, to the patient and item tracking via advanced RFID scanners, we have demonstrated that technology tools are already available which will greatly prevent significant medical errors and replace labor-intensive manual activities.

Below are some photos that were taken during the event:

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Check out our healthcare product, MEDCURIAL, and see how it helped some of the biggest hospitals in the country provide better patient outcomes.

CGHMC

CGHMC and Exist Software Labs Team Up to Successfully Run New MERX™ Hospital Information System in the Cloud

CGHMC and Exist Software Labs Team Up to Successfully Run New MERX™ Hospital Information System in the Cloud 768 487 Exist Software Labs

Manila, November 13, 2018 — Top Philippine tertiary healthcare institution Chinese General Hospital and Medical Center (CGHMC), owned and operated by the Philippine Chinese Charitable Association Inc. (PCCAI) achieves another milestone as it successfully completes implementation of their new hospital information system that helps bring them closer towards a more technologically-equipped and operationally-efficient facility.

Using Exist Software Labs’ next-generation hospital information system MERX™, Chinese General Hospital has set its sights on navigating the highly-dynamic healthcare landscape equipped with innovative technology to help its clinicians deliver superior patient care.

“Advancements in the healthcare industry are intertwined with improvements in technology”, reveals Mr. Jamie Dy, Director for Information Communications & Technology and Data Privacy Officer of CGHMC.  “We patiently searched for the type of hospital system that will best address our current requirements to better fulfill our vow of providing quality care while keeping track of the kind of hospital modernization including data privacy and security compliance that we wanted to achieve.”

One of Manila’s oldest running hospital can now also lay claim to be among the most innovative as it becomes the first to comprehensively adopt web-based technology and cloud infrastructure to run a large hospital.

“Implementing robust and advanced IT systems is a major investment, not only about license costs but investing in tech people as well. We knew our strength lies in our healthcare core but working with Exist Software Labs, we are proud converts to the power of tech innovation to help carry our hospital services further”, adds Mr. Dy.

According to Michael Lim, CEO of Exist, “We’ve always believed that the web and the internet have the ability to transform not just personal and social lives but even enterprises which include hospitals as well. The best technology, done right, can really empower the users to do better work.”

Mike further adds, “With MERX™, we help steer hospitals away from the complexities of maintaining traditional legacy systems so they can instead focus on their core delivery which for CGHMC is about healthcare.”

Designed to address both operational and clinical requirements of hospitals, MERX™ supports hospitals preparing for a near-paperless setup using integrated electronic medical records (EMR) while utilizing an entirely web-framework that has become the defacto standard for enterprise systems worldwide.

“Being a web-based system, MERX™ gave us the option of using the cloud which helps us save and reduce our capital expenses and at the same time mitigate the risk of running our own IT infrastructure that has often plagued non-IT core organizations ”, declares Mr. Dy.  “Even more fascinating is the fact that cloud platforms now rival traditional on-premise hardware performance and at the same time comply with global privacy and security protocols”.

While a number of healthcare apps especially electronic medical records (EMR) run on the cloud, there are very few precedents for operating a large tertiary hospital almost entirely on it. By proving that a cloud setup works, smaller to mid-size hospitals on a budget have better chances to benefit from modern hospital systems at manageable costs by cutting the expenses associated with forming an IT team and purchasing hardware.

“Part of the job of running a hospital is doing continuous research beyond the field of medicine – by observing other industries as well,” says Mr. Dy.  “From manufacturing to banks, you can see how widespread the use of technology has become integral to business success.”

Further, the youthful CIO concludes, “With our current technology partner Exist, we are confident that our doctors, nurses and, other employees are now among best-equipped to achieve the best possible outcomes to the Filipinos who entrust CGHMC for their health and care.”

Check out our healthcare product, MEDCURIAL, and see how it helped some of the biggest hospitals in the country provide better patient outcomes.

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The Decision to Support Clinical

The Decision to Support Clinical 768 487 Exist Software Labs

There exists a  healthcare blueprint for achieving better patient outcomes and as it has been, it involves putting the right type of processed data in the hands of the helper.

Personal, Communal and Personalised

Like a broken record, I keep telling everyone that next to actively maintaining a healthy lifestyle, having a doctor as a close friend, is an investment that will reap dividends.  A personal medical referral affords the patient with personalised care which comes in the form of ‘special’ care and medical treatment generally reserved for those with plenty of cash to spare.  And even better, this favor usually extends to family and friends as well.

Why?  Because complementing the medical meritocracy, the healthcare journey still traditionally goes through familial and social networks for a patient seeking medical services and treatment.  

To put it simply, healthcare success has and will always be personal, at the start.

Take for example the story of Kathy Halamka who was diagnosed with cancer and how having a doctor for a husband enabled her journey towards the best care services possible.

Personal to Informational
But before you jump into a ‘familial’ conclusion, the story doesn’t focus on the benefits of having a medically-trained family member but on how the decisions that guided Kathy’s therapy — using evidence-based protocols from available clinical data, is creating a strong case for its adoption in a healthcare industry still undecided about making technology investments.

Hospitals focused on patient care cannot ignore the fact that “the complexity of medicine now exceeds the capacity of the human mind”, according to  Ziad Obermeyer, MD, and Thomas H. Lee, MD in the New England Journal of Medicine  and further adds, ‘because physicians and nurses, despite their years of education and clinical experience, have cognitive limitations”.

Their article further states that, “No single clinician can retain the petabytes of medical research and patient records now available in many clinical decision support systems. Nor can they be expected to see all the correlations and patterns required to make a fully informed diagnosis. No doubt these shortcomings are partially responsible for the disturbing number of misdiagnoses reported in the scientific literature.”

The standard of care for cases like Kathy’s is typically chemotherapy followed by mastectomy.  But having access to digital resources presented them with new options and an opportunity to test a personalised medicine approach.

Smarter Care Transformation
To achieve personalised medicine requires a more technology-enabled healthcare system. However, this is proving to be a hard sell to hospitals struggling to secure budgets and zeroed in on cash returns on investment.  

At the granular level, the transformation needs to start with the culture — on how medicine is being practiced. As the author Paul Cerrato states,  “[the] new resources can transform the practice of medicine, but only if clinicians are willing to recognize the need for such tools.”

As former Cleveland Clinic CIO, Martin Harris proclaims, “We must reimagine a healthcare system that will be built upon capabilities and connections that simply did not exist just a few years ago. To envision a new kind of HIT-enabled system of care, we will need people who see the role of technology in a more integrated way.”

What is required of technology as a start is the kind that will give healthcare providers access  to available clinical information that can lead to actionable insights and its management which should effect and transform the practice of medicine.  

Evidence-based & Clinical Decisions
Clinics and hospitals who use systems that are capable of collecting and storing clinical data provides patients with a huge advantage compared to facilities that are still stuck with technology that is focused on operational and billing efficiency.

As illustrated in Kathy’s case, availability of patient clinical data (with privacy and security features in place) is a treasure trove of insights waiting to be discovered and applied to a populace seeking not just personalized medicine but therapies and medical regimen that are evidence-based.

As defined by Dr.  David Sackett (1996), evidence-based medicine is the conscientious, explicit and judicious use of current best evidence in making decisions about the care of the individual patient.  It requires the integration of the best research evidence, clinical expertise and the patient’s unique values and circumstances.

Clinical expertise comes from knowing how vital ‘clinical’ data is and putting them to good use.  It comes with good history taking, physical examination and years of experience and the patient’s values include social and cultural factors besides the individual’s ideas concerns and expectations.

The need and demand for evidence-based health care is expanding rapidly driven by a combination of these factors: information overload, rising patient expectations, the introduction of new technologies and ageing populations.

The use of clinical decision support (CDS) systems to facilitate the practice of evidence-based medicine (EBM) promises to substantially improve health care quality by its potential to reduce medical errors thus lift care quality.  By matching patient characteristics with established knowledge base, updated evidence from medical research literature and practice sources, clinical decision support challenges clinicians to carefully consider and reconsider before jumping to conclusions (and biases) by presenting them with other diagnostic possibilities that don’t readily come to mind.

Currently, the numbers for different types of clinical decision support technology are steadily increasing.  These include knowledge-based tools like UpToDate, which gives users access online to a massive repository of medical textbooks and journals and guides users through interactive algorithms that recommend tailored recommendations.

We are in an era where medical advances continue to provide proof for healthcare providers to consider reasons to integrate technology innovation to their respective medical practices.  Amidst the promise, the goal to improve patient outcomes has never been under this type of pressure and scrutiny.  From the push to use electronic medical records to other core hospital clinical systems and decision support tools, the realisation that medicine needs to move past the limits and biases of human decisions is a provoking thought for it means that patient care is still currently subject to hits and misses.  If we need to raise the bar, healthcare providers and institutions will need help, too, in order to help guide their patients towards the best possible health care and outcomes.

Check out our healthcare product, MEDCURIAL, and see how it helped some of the biggest hospitals in the country provide better patient outcomes.