ASPECTS OF TOTAL QUALITY MANAGEMENT APPLIED IN ...

Annals of the University “Constantin Brâncuşi”of Tg-Jiu, No. 1/2008, Volume 2,
ISSN: 1842-4856
We must acknowledge that systems designed for other industries sometimes don’t work well, but it is
important to examine the potential of ERP in health. Health is complex, and it will be introducing ERP
will be difficult.
The reform in the medical system is lagging much behind. The health budgetary allocations
that place Romania on the last rank among the candidate countries to the EU [3] have a strong impact
on the ICT penetration in the health sector. Due to insufficient financing and lack of strategic policies
between the main actors (MCIT, MER and the Ministry of Health), ICT plays a minor role to the
quality of health care and of people’s access to these services. However, 43% of hospitals and 33% of
health clinics [5] have Internet access. In 2004, MCIT launched a project to deliver a health portal as a
unique access point to the information regarding services in the health sector. In the first phase the
portal will be used to supply medical information by electronic means and to assure on-line
presence of the institutions from the sanitary field [6].
The low penetration rate of ICT in the health sector creates an important potential for the
development of e-health applications. There are also some notable success stories of ICT
implementations in hospitals. The ambulance management system put into service in Bucharest in
1996 has been extended later on in other seven cities. The system is covering a wide range of
ambulance activities from call centre activities to cost calculation [7]. Developments of specialized
ERP system - for the management of patients, observation sheets, medical investigations and
treatments, management of drug consumption, human resources, admin activities and accounting
etc. - exists in 60 out of 446 hospitals in Romania [7]. In the past, the Ministry of Health had the
initiative to start ICT projects for the health sector. Currently, there are a high number of ERP
solutions for hospitals available on the market.
The negative feature as regards the e-health development is, besides a somehow chaotic
development, the lack of a real market and the use of all kinds of software products (some
obtained through donations and not customized). In spite of the fact that many researchers are
partners in EU R&D projects, the developed products are not adopted by industry.
Even projects financed from EU funds “are forgetting” their existence. What is missing is a
coherent strategy between all stakeholders responsible for the development of e-health services in
Romania (the opinion of the author of the report on Romania in the “Telemedicine Glossary” IST EC)
[4].
3. ERP Organizational Design and Change Management in Romanian health system
3.1 Pharmaceutical field
A fully integrated system should be used by Healthcare at Home to streamline business
processes particularly in the supply of pharmaceutical products, and nursing services.
Patient details should be held into the ERP system, providing data about insurance, prescription and
treatments details and include attached documents such as medical reports. The expert system should
also be used to schedule activities for patients such as a visit by a nurse or despatch of medical supplies
from Healthcare at Home's national distribution centre.
Additional benefits of this new kind of enterprise-wide relationship management system should
include more efficient invoicing of patients, by drawing patient details and amount of homecare
received directly from a data base, and pricing and service codes from the expert system.
Such expert system should consolidate all patient information to which permitted staff will have
access, maintaining patient confidentiality.