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ITEC is a provider of comprehensive healthcare consulting services specializing in all aspects of hospital management. |
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| Consultation Services for Construction and Renovation of Medical Facilities |
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Building a new hospital costs 30 to 40 million JPY per bed including the construction cost, medical equipment, information systems, and related facilities.
For example, construction of a 300-bed hospital costs about 10 billion JPY.
Because a major refurbishment of a hospital is very difficult once it was opened, it is very important to carefully design the hospital in accordance with its true purposes and required functions. Bad design can result in inefficient operation, which leads to a great financial loss. Even in such cases, the hospital building is supposed to be used for at least 30 years in order to collect the invested cost.
It is also necessary to design a hospital from a long-term aspect, considering future demands for medical practices, and possibilities of introducing new medical equipment or information systems in the future.
ITEC supports a smooth implementation of a project by providing accurate information at an appropriate stage, and by proposing a detailed plan for the construction of the new hospital, from designing and construction management to assistance of operation and maintenance. |
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| Development of Basic Concept / Basic Design |
| (1) |
In the basic concept stage, we research and forecast supply and demand of medical services in the region as the external environmental factors, and analyze hospital operation, management, and facilities as the internal environmental factors. We then formulate the policy of the new hospital and introduction plan of necessary medical functions and medical supply system. |
| (2) |
In the basic design stage, we formulate a project plan by deciding the size of the hospital and by developing the facility/function design, organizational chart, and income and expenditure plan based on the concept design. We then specify the preconditions of the architectural design in accordance with the project plan. |
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| Development of Operation System |
Operation system is developed aiming to facilitate daily work of hospital staff. It involves human(staff and patients), material(drug, medical record), and information.
Operation system is developed in the following steps:
(1) Formulation of the operation policy (2) Fixing the scope of work and functions (3) Formulation of the operational organization plan (4) Formulation of rules and procedures of operation
In the last step, we prepare the operation manual for stabilization and continuity of the operation, and follow up with the hospital until its opening.
Utilization of manuals brings the following merits:
(1) Effective utilization of the personnel and materials, optimization of work procedures, and reduction of the administration costs.
(2) Enhancement of the overall level of the hospital routine.
ITEC provides the continuous consultation services until the opening of the hospital for the perfect operation. |
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| Development of Logistics Management System |
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Controlling the costs, especially controlling material costs, is a hard task for many hospitals due to difficulties of systematization.
ITEC has been providing consultation services based on our knowledge and experience of developing the logistics management systems for many hospitals. We develop the system from the standpoint of the client hospital, offering a choice of whether in-house development or outsourcing to a third-party software developer. We also provide instruction on how to operate the new system at the hospital.
For these years, more and more management companies specialized in the inventory control are offering their services. Costwise, they can contribute to reduction of the personnel. However, some cases have been reported where the hospitals did not get expected results after utilization of the management companies and even having troubles.
ITEC gives appropriate advice on how to outsource the inventory control to a third party. We also propose how to conduct routine work economically and smoothly at the client hospital. |
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| Preparation of Outsourcing Plan |
Outsourcing is an effective method to prevent overstaffing and to enable low-cost operation. However, it could generate conflicts and problems in unsuccessful cases.
In order to ensure a good result, it is necessary to fix the scope of work outsourced to the third party, after determining the purpose of outsourcing and required level of work.
In order to get the best results, ITEC supports hospitals with preparation of specification sheets for outsourcing, selection of management company, and assistance for starting the outsourcing in compliance with legal restrictions. |
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| Introduction of Information System |
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It has been decades since the medical accounting system started to be introduced in medical facilities in Japan. In recent years, it has been a trend to connect the stand-alone system of each division (such as medical accounting system) to other divisions' stand-alone systems on the network and utilize them for the main system (such as ordering system and the medical record system).
The purpose of introducing an integrated medical information system connected on the network is to improve the operation of the hospital, as well as facilitating information control.
For the successful introduction of the integrated information system, it is necessary to set the common goal and operational standards in the hospital by integrating the four aspects of the hospital. |
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The following points must be met when introducing the unified medical information system:
To clarify purposes and expected results of computerization
It is necessary to narrow down the purposes and expected results in order to make the best of the limited time and budget.
To fix decision-making procedures at the hospital
Information system is a unified body of each division's system. Therefore, decision-making as a whole hospital is necessary because each division's system tends to be developed at each division.
To keep compatibility between the main system and each division's system
It is necessary to develop each division's system (radiotherapy, examination, pharmacy, etc.) considering smooth exchange of information with other systems.
To keep compatibility between medical equipment/facilities and each division's system
It is necessary to keep compatibility between medical equipment and each division's system. Our specialist team assists hospitals with both information system and medical equipment.
Remodeling of operation system
It is necessary to formulate a new operation system when introducing the new information system, organizing the flow of human (staff, patients), material (medicines, bills), and information (orders, accounting information, etc,). We prepare the operation manual tailored to the hospital. We can provide those services to both existing hospitals and new hospitals.
After introduction of new information system, work routine and methods are supposed to change at each section. It is necessary to design the new system to maximize time and resources and to avoid disproportional workload on limited sections. We provide assistance for introduction of information system, giving comprehensive advice and solution. |
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| Planning for Introduction of New Medical Equipment |
Introduction of new medical equipment improves diagnosis and treatment standards, enhancing the satisfaction level of patients.
However, introducing the latest models can be a burden on hospital management if future income and expenditure is not calculated precisely in advance.
Introduction of medical equipment is related to diagnosis standards and management. It is necessary to introduce medical equipment so that the invested amount can be collected.
ITEC is acknowledged by many public institutions (JICA, etc.) and municipalities as a fair professional healthcare consulting firm which is not involved in selling medical equipment and has been engaged in selection of medical equipment for the public sector. We provide fair consulting service for the selection of medical equipment from the standpoint of client hospital. |
| Flowchart for introducing medical equipment is as follows: |
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| Consultation for Receiving the Evaluation of Medical Practices by JCQHC (Japan Council for Quality Health Care) |
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The purpose of receiving evaluation of medical practices by JCQHC is not only obtaining certification mark but also motivating staff and improving hospital rules, patient services, and hospital operation. |
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< Expected effects >
- Process to obtaining the evaluation motivates hospital staff and improves management.
- Hospital rules and regulations are complied into a manual and the work is standardized for stable quality.
- The hospital management understands the hospital's position and can narrow down future goals.
- The hospital obtains financial merits by establishing palliative care ward.
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1. Support for analyzing self-check sheet
We assist hospitals with analyzing self-check sheet. We clarify problems and propose solution for the problems found. We also list necessary documents and records to pass the evaluation.
2. Assistance for preparation of documents
We first collect documents necessary for evaluation. We then prepare templates and samples for lacking documents. We also unify the document format to the simple one, and formulate documentation rules if necessary.
3. Assistance for preparation of document survey sheet
After completing lacking documents, we assist the hospital with preparing for document survey sheet. We prepare templates for hospital function survey sheet(facility, divisions, diagnosis, management) and assist person in charge of survey. We support to clarify weak points and to improve them.
4. Simulation of evaluation
We assist the client in preparing model answers for the evaluation. We also prepare Q & A, and conduct mock test for some important points. We keep close communication with the client to solve all the remaining problems until the evaluation date. |
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ITEC has provided PFI advisory work to many hospitals beginning from Kochi Medical Center(opened in March, 2005) which is the first hospital to utilize PFI method in Japan.
We have also been engaged in PFI projects of Tama Regional Hospital & Child Care Center(1,350 beds), Ehime Prefectural Central Hospital (800 beds, renovation), Tokyo Metropolitan Matsuzawa Hospital (800 bed), and Tsukuba University Hospital (800 bed, renovation project).
PFI(Private Finance Inisiative) is a new method for public projects, in which municipality entrusts a private company with financing, construction, maintenance, and operation. Application of PFI method to a public hospital has the following merits:
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- Improvement of service by monitoring system
- Cost-cutting by outsourcing
- Efficient risk management by clarifying the roles and scope of responsibilities
- Improvement of working conditions and enhancement of hospital functions by a proper outsourcing
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[ Outsourcing of management ]
In PFI, the public hospital outsources all the operation and management to SPC(special purpose company). SPC controls the service of the hospital by itself and aims to improve its activities. In Tokyo Metropolitan Hospital's case, SPC is granted wider range of control of the hospital.
[ Utilization of private sector's ideas and knowledge ]
By employing performance specification contract, private sector can use its own ideas and knowledge for the operation of the hospital.
Public sector used to specify all the operation and management procedures before, but it did not lead to improvement of medical services. Therefore, private sector's contribution by its own ideas is now regarded to be more important for improvement of hospital work.
[ Stabilization of standard of medical services by monitoring system ]
Monitoring system promotes the PDCA(plan-do-check-act) cycle. It also enables implementation of the penalty system such as reduced payment or non-payment, which helps to keep necessary standard of medical services.
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Application of PFI method to a public hospital involves a revised operation system and work procedure, contributing to the improvement of work efficiency. A long-term outsourcing contract enables the private management company to provide efficient medical services and to procure required medical equipment from a long run, compared to a single year contract.
There are some tasks to tackle, though, due to special nature of the hospital management. Hospitals always need to adjust to the change of the social trend, such as demographic change. Hospitals are also supposed to introduce new medical equipment periodically in response to the progress of technologies. The management company needs to consider those points in a long span.
Because hospital staff and management company work together every day, allocation of work and risks is another task to tackle. It is necessary to examine each problem carefully under supervision of medical specialists because it will affect contract negotiation with the private company, monitoring, and VFM calculation, and preparation of performance specification sheet. |
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We try to apply PFI method tailored to the client hospital, preventing problems seen in the case of Tama Regional Hospital and Child Care Center, which is the first PFI project in Japan in compliance with the WTO's tendering system.
We will continue to promote utilization of PFI method for hospital projects, and will provide consultation services catered to each hospital. |
| PFI: |
Private Finance Initiative |
| VFM: |
Value for Money (Difference of cost between conventional public operation and private operation utilizing PFI method. If the cost utilizing PFI method is lower, it can be said that "there is VFM". If the cost utilizing PFI method is higher, it can be said that "there is no VFM". It is a must that there is VFM in PFI project. |
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| Feasibility Study for PFI Project |
A feasibility study is always conducted at the first stage to judge if it is appropriate to apply the PFI method to the project. We study possibilities of improvement of the medical service standards by utilizing the PFI method, and check the number of private companies interested in joining the PFI project, and simulate the VFM(value for money) in comparison with the conventional method. We then judge if application of the PFI method to the target project is appropriate or not.
We have wide experience in conducting feasibility studies for PFI projects as part of PFI advisory services, and are confident of providing accurate study report and proposal to the client.
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| Improvement of Management |
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Nowadays, environment around the hospital has been changing drastically; trend of major diseases due to the aging society, new medical policy by government for optimizing medical system, change of patients' opinions and demands. We are now in the era when hospitals are evaluated and selected by the patients.
Therefore, it is required for the hospitals to provide patient-oriented medical services and stabilize the management from a long-term view.
We clarify problems by
- Analysis of balance sheet
- Marketing Research
- Research on hospital functions and operation
and provide the following four programs for stabilization and improvement of management.
- Optimization of business fields and functions in order to match the needs of the region
- Improvement of profitability by increasing the number of patients
- Optimization and improvement of efficiency of work to enhance competitiveness and activities
- Formulation of management plan and midterm business plan with a clear vision.
Based on the above programs, we support the hospital working in step with the hospital staff.
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