Montreal firm retools financial reporting health-care app

Financial reports in Quebec hospitals are about to undergo a revolution with the help of a decades-old solution developed south of the border.

Montreal-based Central Network Communications Inc. announced that it has modified a

hospital reporting software program originally created by an American firm and will now market it in Canada. The Pyramid software, in use for 22 years in the U.S., allows for real time detailed reports of hospital expenditures per patient, says CNC executive vice-president Carol Brunet. The company has been working since December 2002 on the first Canadian implementation of the Pyramid software at Montreal’s Sacré-Coeur Hospital. The system is expected to be fully operational in March of 2003, Brunet says.

Targeted first at hospitals, the solution is unique in that it allows a health-care organization of virtually any size to investigate the costs of a patient’s stay and treatment at their facility, Brunet explains. The system interacts with the facilities’ existing clinical software, pooling the data they generate and essentially tracking the patient as he or she moves though the hospital.

By pooling together the information on costs of medical procedures as well as administrative and other indirect costs –like laundry services and food for example — Brunet says the solution can give the hospital an accurate picture of where its costs are coming from. It can also unveil areas where the hospital can improve upon procedures to increase efficiency, he says.

Getting a detailed view of hospital finances has been a huge challenge for the Canadian health-care sector up to now, says CIM Facility Planning and Management Inc.‘s vice-president of business development Luc Bouchard. The health-care consulting company, also based in Montreal, advised CNC on its entry into the market, something which was a bit tricky to do, both men admit.

“”Any time you go into a hospital and you want to analyze their performance they will tell you: ‘Well, you know we’re not the same as our neighbour. We have a special practice.’ They always have justification for saying that they’re not comparable,”” Bouchard says.

He points out that while there are differences in costs, with teaching hospitals generally having higher expenditures for example, there are some things that should remain the same.

“”A pill in one hospital should be the same pill in another hospital, whatever the environment is,”” he says.

Previously a hospital administrator trying to get to the bottom of perceived discrepancies had no small feat on their hands. Bouchard explains that, except for the few large hospitals with sophisticated IT systems, finding out case by case financial information meant manually going through tons of information from separate systems.

Pyramid alters the isolationist environment by essentially acting as a courier between the existing systems. Brunet says the solution can work with virtually any system already in place. It does not require a disruptive overhaul of the existing IT infrastructure and the implementation is done in phases to reduce possible disruptions even further, he says.

“”In the end (the solution) will enable the health-care manager to know exactly what’s going on in the establishment”” Brunet says. “”He will know exactly how he can reduce the deficit, or he will be able to improve a specific department.””

Pyramid was first developed by Atland-based Kreg Information Systems in 1980s, but Brunet says it took some time before Canadian health-care facilities developed any interest in it.

Increasing talk of deficit reductions was what finally tipped the Canadian market towards favourable reception of cost analysis software, Brunet says. Bouchard agrees, and points out that Quebec’s health-care industry has been in a particularly difficult situation of late.

“”Budgets are tight. Physicians are not on strike, but they want salary increases,”” he says. “”Emergency problems, overcrowding in the emergency services. Very long waiting lists, people going to the American hospitals to get their treatment. It’s a very chaotic situation.””

The troubles have made the whole industry introspective and provide opportunity for solutions such as Pyramid, which Brunet plans to market to smaller clinics next. The company also aims to interest hospitals outside of Quebec in the solution, with Ontario being the next reported target market.

Ontario has been looking at case costing for a number of years actually. In early 1990’s the Ontario Case Costing Project, later to become the Ontario Case Costing Initiative, first began collecting case cost data. That ongoing project is a government-funded initiative undertaken by the Ontario Ministry of Health and Long-Term Care.

Officials for Sacré-Coeur Hospital would not respond to interview requests at press time.

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