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SRISHTI Software progress through creation... R - Delivering World Class Healthcare IT Solutions - Delivering World Class Healthcare IT Solutions ARAS

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Page 1: Paras Healthcare

SRISHTI Softwareprogress through creation...

R

- Delivering World Class

Healthcare IT Solutions

- Delivering World Class

Healthcare IT Solutions

ARAS

Page 2: Paras Healthcare

Current Challenges

A. Alternative delivery model to multiply reach

Low reach/inaccessibility as well as insufficiency (where available) of quality care

Presence of specialist doctors is restricted to the metro and major cities

Low focus/risk of under-utilization of capacity (beds, doctors, nurses)

The Healthcare Revolution

Roadmap

Healthcare is undergoing a distinct movement along a logical

trajectory from its historical focus on Acute Care to Long Term

Care. While Acute Care deals with immediate and severe

outbreaks of illnesses, Long Term Care focuses on continuous care

over a significant span of time, ideally a life time covering both -

episodes of acute illnesses and exacerbations of chronic illnesses.

This shift leads us to Preventive Care, delivered through early

detection & treatment, resulting in reduced morbidity load on

individual and society. And finally, this logical journey ends at

Predictive Care, i.e. not waiting for early signs of illness but

predicting and thwarting it before the illness has the chance to take

root.

We are moving towards a consulting/service based healthcare with

focus on lifestyle changes and behavior adaptation to

prevent/cut-out the roots of any instance of illness.

There are clear challenges within the current health-care ecosystem that must be overcome before realizing the benefits of

above mentioned revolutionary changes.

USA

UK

Germany

France

Spain

IndiaEgypt

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1.00

2.00

3.00

4.00

6.00

7.00

8.00

5.00

Port-said

Egypt

0.00

1.00

2.00

3.00

4.00

5.00

India

UP

Delhi

Cairo

Alex.

Kalyubya

Monofeya

Care Beds / Population of 1000

2. Chronic Care

4. Predictive Care

1. Acute Care 3. Preventive Care

Fragmentation of patient data and medical know-how across entities

in the ecosystem

Lack of one-point complete patient record

High Cost/Low Productivity due to bottom-up recreation of

diagnosis/analysis at every instance

Fulfillment

Specialist

Orthopaedist, etc.

Patient DataHealthcareEntities

B. Integrated Healthcare Information

Page 3: Paras Healthcare

But, at the base, are technologies ready to convert these challenges into opportunities - and make the revolution actually happen?

PARAS - The Healthcare IT Suite from Srishti

Srishti's Healthcare IT solutions support modern healthcare service providers with future proof initiatives, best in class delivery

models and emerging technology conformance. To address the need of various hospitals at different stages of their Healthcare

Informatics deployment, Paras comes in three different configurations - Paras Lite, Paras and Paras Premium. This ensures that

our customers need not change their platform with their growing needs and changing work flows. Basic philosophy behind

PARAS is to achieve integration of entire spectrum of healthcare technology enablers and is built using Srishti's powerful tool-kit

approach. This two pronged strategy ensures that healthcare services don't hit a technology roadblock as business models

change. PARAS is the answer to the need for a one-stop technology solution for healthcare service providers.

C. Alternative transaction models .

4. Predictive Care

1. Acute Care 3. Preventive Care

2. Chronic Care

Business models are currently focused on Acute

Care across the healthcare ecosystem. Models

catering to Chronic, and more advanced

Preventive Care need to be explored by insurance

companies and healthcare service providers

alike.

Salient Features

Fully compatible with NABH & JCI criteria

Conforms to HL7, HIPAA & ITIH standards

Capable of integrating with standard CMVs like ICD 9,

ICD 10, CPT 4, SNOMED CT etc.

Internationalization & localization with multilingual

support

Fully functional EHR integrated with relevant modules

Salient Features

Best in class image recording & communication platform

Clinical Pathways conforming to global standards

Integrated with ISABEL CDSS, world’s best clinical

decision support system

Modular approach to deployment & implementation

Capable of generating clinical performance indicators

The current payment models, focus mainly

on Acute Care

Bio Terrorism Alerts

Disease Surveillance

Business Analysis

Clinical Analysis

Public Portal Patient Portal Clinician Portal eGov Portal

PACS Repository Application DB ICD 10 / SNOMED-CT

Disease RegistriesBedside Monitors

DICOM Devices

RFID Tags

Lab Equipments

Knowledge Repository

EHR - CPOE EHR Centric Modules - Nursing, Consultant, OT

RIS, PACS & Image Integrated EHR eMAR

LIS

BB, CBB Pharmacy

EHR - eMAR

eMARCSSD, Diet, Therapy

Specialty Formsets Clinical Protocols Isabel CDSS KPIs / QOFs

Actuarial Analysis

Program EffectivenessAmbulances

Smart Card

Healthcare Management IT Platform v 5.7

LIS EB

ADTRF Mgmt IP - Bed / Ward Mgmt IP - Billing Mgmt Plan & Payer Mgmt

Registration Mgmt OP - Clinic Mgmt OP - Billing Mgmt Help Desk Mgmt

HR & Duty Mgmt Procurement & SCMFinance Mgmt Support Services Mgmt

PACS: Picture Archival and Communication System

RIS: Radiology Information System

SCM: Supply Chain Management

Ref / FU: Referral / Follow up

ADT: Admission, Discharge, Transfer

RCM: Revenue Cycle Management

CDSS: Clinical Decision Support System

OT: Operation Theatre

CRM: Customer Relationship Management

EB: Eye Bank

BB, CBB: Blood Bank, Cord Blood Bank

LIS: Lab Information System

IP Mgmt: In-Patient Management

CPOE - Computerized Physician Order Entry

EHR: Electronic Heath Record

eGov: Electronic Governance

QOFs: Quality Outcome Frameworks

KPIs: Key Performance Indicators

eMAR: Electronic Medication Admin Record

CSSD: Central Sterilization & Supply Dept.

Page 4: Paras Healthcare

Hospital Management Information System (HMIS)

Human Resource ManagementEmployee DatabaseLeave ManagementPayroll ManagementDuty Roster & PersonnelPerformance Management

Pharmacy Store ManagementPharmacy Request ManagementPharmacy Cash Management

KPI Reports Isabel CDSS Clinical Pathways

Operation Theater ManagementCentral Sterilization [CSSD]Blood Bank ManagementCord Blood & Stem Cell ManagementDiet & Kitchen Management

House Keeping & LaundryVehicle ManagementBuilding MaintenanceLibrary ManagementEye Bank Management

Support Services Module

Radiology WorkstationsImage Storage ManagementImage Manipulation Analysis & Reporting

RIS Module

Lab AdminLab StoreHaematologyBiochemistry

MicrobiologyCytologyHistopathologyImmunology

eMAR

Physician OrderingDrug Interaction ValidationPharmacist DispersingNursing ComplianceNursing Station Charting

DemographicsAllergies & ADRsHistory DetailsEpisode & Problem DetailsReview of SystemsPhysical Examination Clinical NotesDrawings & Image ManagementProtocol ManagementSpecialty Specific FormsetsStanding OrdersDisease Registries

Integrated EHR Module

Lab Investigation Order HandlingRadiology Request ManagementADT Order HandlingProcedure & OT RequestNursing Order Handling

CPOE Module

LIS Module

Pharmacy Module

ERP Module

Finance ManagementAccounts Payable /ReceivableStatements of Accounts

Cash Flow AnalysisProfit & Loss StatementTrial Balance / Balance Sheet

General Ledger

Material ManagementStores ManagementEquipment ManagementInventory ManagementAsset Management Vendor ManagementPurchase Management

PAS & CRM Module

RegistrationPatient RegistrationToken ManagementTelephonic RegistrationWeb Registration

In-patient Management·Admission ManagementDischarge ManagementTransfer ManagementHL7 CDA Documents

BillingGeneral BillingAdvance PaymentPackage BillingLab BillingInvestigation BillingCorporate BillingInsurance BillingFinal Settlement

PARAS LitePARAS Lite, an out-of-box product has been created by retaining the essential PARAS modules & is targeted at

Small & Medium hospitals, and IT starters among big hospitals.

PARASPARAS is an end to end customizable solution for a hospital providing Complete Clinical & Administrative Integration

across the enterprise including highly sophisticated integrated EHR.

PARAS PremiumThe PARAS Premium is a framework based solution and is targeted at hospital-chains with number of beds numbering in

thousands. This high-end solution handles, at a centralized location, the heavy-duty data management and complex

information access needs of all branch hospitals. Moreover provides Complete Clinical Informatics Framework conforming to

International Standards.

Tele Medicare SolutionTele Medicare is a rapidly developing aspect of clinical care where Medical & Health information is transferred via Telephone,

Internet or other Networks to facilitate Consulting, Assessment or for Performing Procedures. Srishti’s Tele Medicare

Solution, anchored at both ends to an integrated EHR & HMIS, provides Unfragmented and Complete

Clinical & Administrative data to all stakeholders at point of care.

Ward ManagementBed wise patient detailsVacant bed statusBed utilization report Bed / ward nurse roster

Thus, PARAS products address all the segments of the market. This facilitates the customer to grow on the same platform

without changing the solution as and when their business & IT needs grow.

Appointment & SchedulingClinician AppointmentLab SchedulingRadiology SchedulingOT Scheduling

Page 5: Paras Healthcare

Integrated Electronic Health Record System (EHR)

eMAR

Over & above a standard eMAR module (diagram 1). Paras has a robust drug interaction alert generation (diagram 2).

Level 5

Mild

Fatal

Alert TypeInteraction Level

Level 4

Level 3

Level 2

Level 1

eMAR diagram 2

PARAS’s RIS can work as a stand alone module or with a PACS server - own or institution’s existing server.

RIS & PACS

At the heart of Srishti's PARAS is an Integrated Electronic Health Record – EHR, a complete, updated and accurate one

point patient clinical database across entities in the healthcare universe.

Physician:Writes order for medication. The application in the backgroundchecks for possible interactionusing the “Drug Interaction Alert”functionality

Pharmacist:Dispenses medication

Staff Nurse:Is notified that orderedmedication is available for administration

Staff Nurse:Verifies and cross checks againstmedication order(s)

Staff Nurse:Completes medication administration andelectronic documentation

Data:Is added to patient’selectronic medical record

eMAR diagram 1

Electronic Medication

Administrative Record

EHR

Large Hospital

EPR

Health InfoLocation

Imaging LabPath Lab

Aged Care

EPR

GP

Social Workers

Summary EHR Home

Local Hospital

EPR

EPR

Specialist

Nursing

PACS Server

DICOM Modality

Radiology Workstation

RadiologyWorkstation

TeleradiologyWorkstation

RemoteDICOM Modality

Page 6: Paras Healthcare

Isabel: The Award-Winning Diagnosis Reminder System

Isabel is a validated, web-based diagnosis decision support and knowledge mobilizing system with accuracy of more

than 91% designed to help reduce and manage diagnosis error at the point of care.

Isabel addresses the causative factors that have a significant impact on the level and quality of patient care.

Diagnosis error – a compelling patient-safety issue

Medical diagnoses that are wrong, missed, or delayed make up a large fraction of all medical errors and cause substantial

suffering and injury. A 3-year project by the Cook Country Rush Developmental Center for Research in Patient Safety,

funded by the Agency for Healthcare Research and Quality (AHRQ) and published in 2005, found that 10 – 30% of

errors are errors in diagnosis and the diagnosis errors far outnumber medication errors as a cause of claims lodged. A

review of 53 autopsy studies found an average rate of 24% missed diagnoses.

Failure to consider reasonable alternatives – single most common cause of misdiagnosis

A 2005 Veterans Administration study funded by the National Patient Safety Foundation analyzed cases of diagnostic error

involving internists and found that cognitive factors contributed to diagnostic error in 74% of cases. Premature closure, i.e., the

failure to continue considering reasonable alternatives after an initial diagnosis was reached; was the single most common cause.

Isabel addresses the very issue of premature closure and has been proven in clinical studies to minimize diagnosis error by

reminding physicians to consider important diagnoses.

Constructing a complete differential diagnosis – reinforcing basic medical training

Professor Arthur Elstein, PhD at the Department of Medical Education and the School of Public Health at the University of

illinois at Chicago, and expert on diagnostic reasoning in clinical medicine, spent a lifetime's work on answering questions such

as: How do physicians make decisions? How can we help them make better ones? Elstein has suggested the value of compiling

a complete differential diagnosis to combat the tendency to premature closure, the most common cognitive factor identified to

contribute to diagnosis error. Medical students and residents are trained to construct a complete differential diagnosis for each

patient.

Diagnosis Reminder System

Isabel, either as a standalone system or interfaced with PARAS EHR system gives dynamic clinical decision

support, enabling clinicians to:

Quickly obtain a list of likely diagnoses including bioterrorism diagnoses and causative drugs for a

given set of clinical features

Learn more on investigations and treatment for each diagnosis, either through a cursory quick-read, a

more detailed read, or clinical information on bioterrorism from the CDC, USA

Access the clinical lessons learned and errors that have been reported in relation to the diagnosis

being considered

View diagnosis specific annotated images or helpful list of investigations that can be performed to

confirm or rule out a diagnosis

Stay up to date with recent advances clinically sorted into diagnosis categories - and avoid time

consuming office research using online and library resources

Source : ProMutual Group study reported in the American Medical Association Newsletter, March 2006.

A 2006 Medical Liability Insurance study found that errors in diagnosis were the leading allegations of closed

claims. In Family Medicine, Internal Medicine, Pediatrics and Radiology more than 50% of lawsuits alleged a

failure to diagnose.

Page 7: Paras Healthcare

Testimonials...

"Isabel suggested the correct diagnosis in 98% cases. Decision-support systems can help doctors avoid falling victim to

"premature closure" - the tendency to focus on one diagnosis that seems to explain all of the symptoms, then stop

considering other possibilities."

“There had been software products over the years ... but Isabel was the most sophisticated product I had ever seen,"

"Isabel is a great tool for difficult to diagnose cases!"

"I am impressed with the concept and its execution. This is an innovative product that I think may soon be proved to have

significant clinical utility, particularly if integrated into EMRs so that the system can operate in the background and be

selected when needed, with minimal effort from the clinician. In a world of exploding biomedical knowledge, and limited

human cognition, the arguments in favor of Isabel and other decision support systems are compelling. I will watch for the

peer-reviewed results of further study with great interest. Institutional and individual buyers should definitely give it a

look."

"Several features I feel are innovative and useful for my practice as a pediatric infectious diseases consultant. The

Diagnosis Reminder System is useful to check my differential diagnosis list against. The regional preferences search

option is one I like a lot, because of the importance of travel history and geographic exposure patterns to many of my

consults. For teaching and communicating with trainees and families, the Lessons Learnt and What's New options give

me ready access to potentially interesting PubMed articles. I find Isabel unique and uniquely helpful"

"Implementing PARAS has immensely enhanced the customer experience that we offer to our patients. Using PARAS, the

relevant details of the patients of Narayana Nethralaya are recorded and preserved in computer systems and one can

retrieve the same by just entering their name or registration numbers into the computer systems during their future visits

to the hospital. Thus resulting in effective utilization of the time and immediate treatment to the patients by having their

Electronic Medical Record available at finger tips to our doctors and other concerned staffs."

“Srishti Software has worked with us to improve every area of our hospital, from helping us to improve our production

flow and order entry processes, to reporting functions. All of this has helped us to provide excellent patient care."

“Srishti's Healthcare Suite 'Paras' has helped us achieve full automation and better patient care. All administrative & support

processes like Registration, Billing, Store, Pharmacy, Labs; are now online. Optimal utilization of resources have reduced costs.

Availability of pertinent information point of care has improved clinical outcomes. Logical scheduling has reduced waiting

times - leading to greater patient satisfaction.

Mark Graber MD,

Chief of Medical Service at the VA, Northport, NY,

quoted in the Wall Street Journal. Nov 2006

Leslie G. Selbovitz, MD,

Senior VP for Medical Affairs & CMO,

Partners Newton-Wellesley Hospital, interviewed Oct 2007

Mary Lynn Allen, MD, VA - Gainesville, FL

Gary Kantor, MD.

Case Western Reserve University February 2006

Jeff Mckinney, M.D. Ph.D.

Assistant Professor In Pediatrics andMolecular Microbiology,

Washington University School of Medicine,

St. Louis, Missouri Dec 2005

Dr Bhujang Shetty, Director,

Narayana Nethralaya, Bangalore.

Dr. Manjunath, Medical Director,

Sri Jayadeva Institute of Cardiology, Bangalore.

Dr. Jeetendra Kumar, Director,

Mahavir Cancer Sansthan

at

Page 8: Paras Healthcare

Srishti Software

L-174, 6th Sector, HSR Layout

Bangalore - 560 102

Karnataka, India

Ph: +91 80 4110 9060/ 61/ 62/ 63

Fax: +91 80 4110 9064

E-mail: [email protected]

IntelliApp Solutions

Suite 5-6, 46 Dorset Street

London W1U 7NB

United Kingdom

Fax: +44 207 224 3838

E-mail: [email protected]

www.srishtisoft.com

Zydus Hospitals & Healthcare Research Pvt. Ltd.,

Ahmedabad- Multilocation

Centre for Sight, New Delhi- Multilocation

Rajiv Gandhi Cancer Institute & Research Center, New

Delhi

SUT Hospitals, Thiruvananthapuram- Multilocation

KG Hospital, Coimbatore

Narayana Nethralaya, Bangalore- Multilocation

TATA Chemicals Hospital- Multilocation

Sri Jayadeva Institute of Cardio Vascular Sciences &

Research- Multilocation

Mahavir Cancer Sansthan, Patna

Prashant Memorial Charitable Hospital, Muzaffarpur

SRISHTI Softwareprogress through creation...

R

All trademarks & brands are the property of their respective owners.

Our Delighted Customers Include...

Isabel Clientele

Awards & Recognition

Isabel has been extensively featured in Fox News (Dec 2006), Wall Street Journal (May 2005 & Nov 2006), CBS (May 2006), New

York Times (Feb 2006), Forbes (Aug 2005) and CNN (Oct 2004).

Isabel has had editorials and reviews in key medical journals, including The Lancet, the British Medical Journal, Journal of

Intensive Care and Archives of Disease in Childhood.

Peer reviewed articles and results of clinical studies have been published in Archives of Disease in Childhood, Journal of the

American Medical Informatics Association, Medinfo 2004, Journal of Intensive Care Medicine, Health Management.

Technology and BMC Medical Informatics and Decision Making.

Winner of the 2005 Frost & Sullivan Healthcare Information Technology Product Innovation of the Year Award Stay up to date

with recent advances clinically sorted into diagnosis categories – and avoid time consuming office research using online and library

resources.

Recognized as one of the "outstanding and innovative developments within the IT sector" at the 2002 British Computer Society IT

Professional Awards.

A few accolades...“For demonstrating excellence and growth in the IT channel business.”

"Consistently among the top 100 IT innovators in India”

"Among the FIVE most promising Indian IT companies to look out for”

“One of the most innovative IT companies in India”

Channel World, Fast Track 100 Awards, Honouree 2008

NASSCOM Survey, 2007

Information Week, 2005

NASSCOM, Feb 2005

Ph: +44 750 246 0465

INDIA UK