Axional ERP/HMIS

An Enterprise Hospital Management
System for highly demanding organizations

Axional ERP/HMIS is a large-scale integrated solution for the operative management of:

  • Hospitals
  • Clinics
  • Medical centers
  • Mutual healthcare providers

Aimed at covering even the most demanding needs, its modular architecture and industry-specific adaptation allow it to provide coverage to all types of healthcare organizations regardless of their size.

Features

Finance

The Financial module boasts General Accounting, Cost Accounting, Budgetary Control, Project Management, Treasury, Accounts Collections, Accounts Payable and Fixed Assets, which allows it to have a complete accounting and financial management application, integrated with the hospital’s back office system and completely adapted to sector-specific needs.

General Accounting
  • Unlimited unique or differentiated accounting journals.
  • Account formatting definable by the user.
  • Flexible definition of accounting periods.
  • Multi-company and multi-hospital.
  • Allows you to work with several fiscal years at once online.
  • Aggregation and consolidation of companies and hospital groups.
Cost accounting according to cost center
  • Up to seven levels of analytical allocation which facilitate and relax the allocation of costs to homogeneous functional groups (HFGs).
  • A module for the division and allocation of costs, which combines economic magnitudes with statistical data (cost drivers) and allows the costing system to be adapted (direct costing, full costing, ABC, etc.) as chosen by the company.
Tax management
  • Treatment of the pro rata rule (partial deduction of supported indirect taxes).
  • Settlement of indirect taxation.
  • Variable deductions for professionals.
  • Generation of magnetic media for dispatch to the Internal Revenue Service.
  • Automated management of the REGE.
Budgetary control of income, expenses, investment by cost center and account
  • Multi-budget. Initial budgets for the opening of new centers, for the review of conditions.
  • Supports the generation of budgets from current balances.
  • Generation of incremental budgets, increasing or diminishing current balances on the basis of fixed amounts or percentages.
  • Budgetary tracking reports. Comparisons of actual balances and balances budgeted at any level of cost center.
Accounts receivable and accounts payable
  • Implementation of any kind of charge or payment.
  • Management of payment authorization circuits.
  • Partial payments and advances made to providers.
  • Debt reclassification.
  • Mass generation of remittances for collection and for discounting.
  • Risk control of parametrizable customers, which allows you to define a point in the sales cycle or provision of service from which you wish to establish control.
  • An accounts receivable management assistant which facilitates the automatized sending of payment claims.
Fixed assets
  • Allows the definition of a three-tiered pyramidal structure.
  • Locations of fixed assets by building, by floor and by functional center.
  • Control of fixed asset depreciation and useful accounting life.
  • Simulations of the impact results due to changes in depreciation criteria will have on the account.
  • Projections regarding supplies for depreciation of current assets at every moment.
  • Management of the asset purchasing cycle and its corresponding inventory.
  • Integration with the project management module.
Treasury
  • Integration of bank statements with automatic settlement between the movements accounted for by the company and those registered by the bank.
  • Automatic accounting of banking activity arising from automatic reconciliation.
  • Treasury budget monitoring.
  • The treasury situation at the date of operation, the value date, etc.
  • The settlement of interest from credit policies for comparison with that carried out by the bank.
  • Management of requested guarantees as well as guarantees granted.
  • Management of leases and loans.
Project management
  • A budgetary control system and financial tracking of projects.
  • Control at the budgetary level and the structuring of budget allocations.
  • Allows users to record income and expenses derived from medium and long-term investment projects.
  • Direct allocation, differentiating between the level projected and the level applied.
  • Monitoring the degree of execution of the project.
  • Freezing of documents if budgetary entries assigned to each project are surpassed.
  • Integration with treasury’s budget.
Cash Management
  • Record cash movements and control cashflow.
  • Automatic accounting integration.
  • Processing of cash vouchers (cash withdrawals to be justified).
Integration with patient billing
  • Allows communication with the billing-to-patients application (insurers, mutual societies, private entities).
  • Integration with the general accounting module for the accounting entries generated from the invoices sent at the patient’s/entity’s cost.
  • Integration with the accounting module of the value of allocations by cost center, derived from the invoices sent.
  • Integration with the tax module and with the module for receivables, based on the entries corresponding to invoices sent.

Floor Area

The system aims to achieve maximum efficiency in floor-level operations, thereby reducing costs and optimizing back office operations. The system helps with managing workflows, improving processes and resource planning.

Purchase order forms

Electronic forms allow the administrative processes for repeat orders to be made more agile. The forms are defined via repeat order templates which allow:

  • The definition of specific forms for each hospital, floor, and/or unit.
  • Form generation based on consumption statistics and variables such as time spent on analysis, security percentage and the forecasted consumption period.
  • Individualization of specific forms for each day of the week which allow users to, for example, modify supply patterns on weekends or holidays.
  • Establish the start date and expiry date of each form, as well as detailing which items can be ordered.
  • If the delivery management cart mode is used, forms can detail the amounts and types of medications per cart on each floor, including options for a double entry box and/or double cart.
  • A user-friendly interface is available for order generation and use of valid forms as reference; it is adapted to consult the complete catalog of items.
  • The system can generate automatic orders based on the forms, in the case that the floor’s user has not made the order themselves.
  • Incorporates a special procedure for urgent delivery requests.
  • Workflow system for authorizations on behalf of administrators.
  • Mechanisms to calculate the per-patient consumption allocation.
Floor stock control

When a hospital needs the stock on each floor to be organized, the system facilitates the automatic generation of restocking proposals for medications and other items.

Automatic proposal generation takes into account the maximum amount of stock desired for each medication in each hospital and floor.

Generated proposals remain in standby mode, waiting to be reviewed and authorized according to the established workflow.

The system includes the option to run supply orders manually from the floors. These manual requests include typical reasons for a floor request:

  • Restricted Orders for medications that are restricted to a specific hospital/ floor. In this case, justification should be provided as to why the order is being processed.
  • Refund Return medications from floor to warehouse.
  • Urgent Urgent supply of materials needed. Generally used by surgeons.
Supply Authorizations to the Floor

To control in-floor supply, the system lets you incorporate rules of business that must be met. Those not meeting regulations will be notified via the Workflow module so that they may be authorized by responsible parties. Rules of business include all the usual situations that take place in a hospital, such as:

  • A limit on ordering the same medication more than once, if an earlier order from the same hospital, floor and/or unit is found to be outstanding.
  • Medications subject to standard forms for a floor cannot be included in a normal supply order.
  • If the item is restricted to a specific floor, justification why the order is being made should be provided.
  • A limit on exceeding average weekly consumption, with the option to include an acceptable percentage increase.
  • A limit on ordering by multiple quantities, for those medications subject to this regulation.
  • Medications nearing their expiration date will be listed.
Consumption analysis
  • Consumption statistics generation by hospital/floor/unit.
  • Management features for consumption budgets by center.
  • A broad set of reports and statistics regarding consumption.
Purchases

In the healthcare environment, purchase management should consider a variety of different scenarios which may develop, as they must manage the general purchases of goods, services, works, fixed assets, spare parts, etc., as much as specialized purchases of medication and sanitary products.

Axional ERP/HMIS gives you the option to bring strategic value to your assisted information system in a completely integrated environment.

The system takes on the whole management of the entire purchase and supply cycle for distinct areas of the organization, distinguishing between standalone purchase processes and selectively managing expiration dates and batches as well as manual, cyclical, or automatic purchases.

The system mnages multiple warehouses, including pharmacy warehouses, administering costs via various calculation models.

Carries out supply management, programs automatic purchase orders, and facilitates an automatized relationship with suppliers via electronic exchange.

Price lists

When managing relationships with providers, framework agreements can be processed with commercial conditions and product services which facilitate the simplification and improvement of purchase management, with no limit on the number of conditions that can be included in each agreement.

The commercial conditions manager helps with the introduction of price lists and conditions for correct validation of received documents, as well as optimization of the purchase processes.

Amongst other features, it includes:

  • A flexible discount policy.
  • The start date and expiry date along with a record of past conditions.
  • Promotion management.
  • Foreign currency exchange.
  • Self-billing for items not included in the invoice.
  • Condition levels.
    • General
    • Group
    • Item
    • Hospital- or company-specific
  • Rates: successive and accumulative.
  • Various accounts by item.
  • Receipt of price lists via: EDI, XML or WEB Services.
Bid management

The bid module helps manage the bid process for grants to suppliers of medications and consumable goods.

  • Offer of items with the greatest turnover.
  • Notification to providers of the items on offer via: fax, email, EDI.
  • Integration of financial data with turnaround periods.
  • A system for comparative analysis between providers.
  • Bid adjudication by item/provider/hospital.
  • Financial data transfer to purchaser price lists to be applied when they place orders.
  • Generation of monthly scheduling according to consumption.
Offer Management

Management of providers’ offers allows the organization to fully monitor the cycle of requests, offers, comparative valuations and purchase decisions. The system supplies:

  • WEB services for the publication of items intended for purchase.
  • Electronic notification to regular providers when a bid is published, based on provider category: pharmaceutical, consumable, IT, laboratory, etc.
  • WEB interface which allows the provider to connect directly to the system in order to report on: prices, discounts, product image attachments, technical documentation of the equipment, etc.
  • Management of security profiles for provider access.
  • Generation of comparative analysis of prices offered by different providers.
  • Proposal to award the supplier for one or more items.
  • Electronic notification of the bid’s result to providers.
  • Generation of purchase prices based on data received from the provider.
  • Ability to generate open orders or monthly programming, based on the seasonal nature of the products.
Automatic restocking

The automated restocking system generates purchase orders according to each provider and for each one of the purchase managers.

The purchase manager defines the number of days and units for each one of the following levels:

Restocking Levels

  • Maximum. Stock to be replaced once needs analysis has been carried out
  • Warning. Material about to enter restocking level
  • Restocking. Level by which restocking needs are calculated
  • Security. Number of days you wish to have stock guaranteed available
  • Critical. Level by which an urgent purchase must be processed

From these levels, the process of automatically generating purchases takes into account the following variables:

Restocking Variables

  • Proposal. The amount requested by the provider (determined by needs analysis)
  • Consumption. Average consumption calculated by the consumption forecast formula
  • Time period. Number of days elapsed since supply need has been detected, until the moment that the material is received

From all of this data, the generated proposals are prepared for final checking and validation by those responsible.

Document Management

The document management system allows users to maintain records of the information related to the contracting process in digital form.

In this way, information relative to contracts, offers, technical specifications and any other material related to the process can be stored in a digital record.

Invoice Reconciliation

At the moment of invoice reconciliation, the system allows consolidation of the purchase orders generated by the logistical module into a single bill. Furthermore, thanks to its integration with the financial modules, the user will be able to:

  • Carry out the consolidation of items outside the bill.
  • Automatic self-billing of items not included in the invoice.
  • Have various search criteria in the consultations: center, dates, provider, etc.
  • Generation of bookkeeping entries.
    • General accounting.
    • Tax record.
    • Order book.
    • Analysis.
  • Definition and tracking of the expense budget.
  • Revert an invoice accounted for, based on the fulfillment of various security criteria.
  • Management of volume discounts/incentives based on increments and the generation of the settlement which the provider needs to pay.
  • Periodic production of accounting provisions for purchase orders pending billing, with their cancellation in subsequent accounting once the invoices have been received and accounted for.
  • Tools for the statistical reporting of purchases.
Purchase approval flow

The system allows the definition of rules of business which ensure that the buying process is managed efficiently and within control parameters.
The orders can fall under many different categories: open orders, deposits, delivery schedules, restocking proposals, automatic orders, etc.
The authorization control allows:

  • Individualization of agreed-upon conditions.
  • Workflow of authorizations should conditions vary.
  • Workflow based on the item classification.
  • Flexible management rules adaptable to each process.

Logistics

The system takes into account internal logistics operations as much as external. It controls the stock management of various entities: the central warehouse, pharmaceutical warehouse, and kitchen and provisions warehouse. It also manages the logistical platforms which provide storage services to hospitals or centers. Noteworthy logistical features include:

Item administration
  • Functionality to centralize available items based on requests made by different services.
  • Identification of items in logistics purchasing by multiple references: Internal code/EAN/Vademecum/Supplier ref.
  • The management of prostheses and deposits, integrated by the surgeon at the moment of implantation (in order to know which patient had the implant carried out), as well as communication with the provider for billing and stock replenishment.
  • Product label printing to aid with the generation of supply orders via a bar-code reader, thereby facilitating identification in surgeon usage and allocation to patients.
Procurement
  • Automatic order proposals by levels of stock replenishment.
  • Order notification via: fax, EDI, email, B2B.
  • Various logistical variables and measurement units used by Purchases and Storage.
  • In inter-company billing, automatic generation of purchase order confirmations.
  • Analysis of Service Level (ASL) provided by suppliers in terms of delivery timeline, units received, quality of service, returns, etc.
Warehouse
  • Management of expiration dates and batch numbers, proposing the extraction of batches by order of expiration date and sending alerts to those due to expire soon.
  • Handling of returns to suppliers or refunds to hospital floors.
  • Managing stock deposited by the providers, invoicing at the month’s end according to consumption.
  • Continuous inventory sampling based on the system’s proposals or on the criteria of those responsible for the warehouse.
  • Stock valuation based on average cost, FIFO or LIFO considering apportionment of taxes, if taxes are a major cost to the hospital.
  • Automatic proposals for location, extraction and order picking.
  • Managing a chaotic warehouse with a map of locations. A single item can be distributed across various locations.
  • Ability to define location and/or extraction plans according to the location/extraction map.
  • Warehouse management with radio frequencies (RF) reading the EAN-128 packing codes.
  • Connection with carousel systems (MEGALIF).
  • Administration of delivery routes to external centers.

Pharmacy and Single-Dose

The system is equipped to communicate with external systems of pharmacy management and dispensation of single doses via:

  • A reception interface for successful consumption.
  • A reception interface for returns from pharmacy to warehouse.

Maintenance

Thanks to its ability to put key information directly into play at the moment at which it is needed, the Axional ERP/HMIS system allows the resolution of three key aspects of maintenance management:

  • Activity planning and monitoring.
  • Ensuring compliance with norms.
  • Integration with central systems.

This module covers both preventative and corrective maintenance. It is based on a Work Orders (WO) agent, through which hours are assigned and monitored, spare parts and tools are received, etc. as much for planned tasks as for emergencies outside the scope of programming. Some of the distinguishing characteristics are:

  • Management of maintenance contracts.
  • Repair requests made by cost centers.
  • Automatic TAS proposal, which should handle the task based on the characteristics of the equipment and whether or not a maintenance contract is available.
  • Work orders to reduce the stock of spare parts and account for assigned hours (both real hours and hours assigned to the cost center).
  • Self-billing system to the external TASs.
  • Payroll interface to account for overtime and holiday pay for public holidays.
  • Assignment of repair costs to the corresponding center.
  • Statistical system and KPIs on maintenance behavior.

Workflow

A workflow module is incorporated into the system in order to manage authorizations from administrative processes and the rules of business applied to documents.
This module has a hierarchical (pyramidal) structure of authorizations, so that the same business rule, in certain cases, may require authorizations from more than one department.

For example: The head of the floor, the warehouse and, ultimately, the purchasing department.

Other features include:

  • Tracking for each operation. The user, date and time of the authorization of a rule are registered.
  • Ability to define certain rules such that users must justify the reason why the authorization has been granted.
  • Ability to block a request and indicate the reason.

The workflow module represents, in graphic form, the sequence of steps and requirements for document authorization, segmenting the process for each one of the groups that take part in the process.

Analysis

Regarding the managerial area, the Axional ERP/HMIS solution offers exhaustive information to analyze the key processes of the hospital:

  • Integrated control panels, based on web portals and mobile devices.
  • “Online” tracking of information aggregated to any level (cost center, service, plant, warehouse, hospital groups, etc).
  • Consolidated statistical information about the group.
  • Obtaining KPIs in real time about the development of each area (plant, purchases, pharmacy, maintenance, central services, IT, etc).
  • Drill-down features permitting navigation through information, from the maximum level of aggregation down to the smallest detail.
  • Access from anywhere. Thanks to the Axional Mobile module, information can be consulted from mobile devices to tablets.

User Scorecard

Each user has an access portal to the principal information, with operating system data channels.

These channels facilitate everything from a simplified search for information to the status of the most urgent tasks to rapid access to management systems and other applications.

The scorecard includes control panel creation capabilities and Business Intelligence reporting.

The accumulated information in the database is represented graphically, permitting the visual interpretation of the displayed information.

Interface with other systems

The system incorporates the following interfaces as standard:

  • Integration with the healthcare system in order to receive information about the implants carried out.
  • Integration with the invoicing module for the accounting of invoices and charges.
  • Integration with pharmacy in order to provide notifications on product receipt, as well as receiving consumables.
  • Integration with the Human Resources system, helping to assign the cost of personnel to cost centers and carry out an accounting audit.

Benefits

Thanks to the integrated information that Axional ERP/HMIS offers, hospital managers have the ability to control operations and analyze their efficiency, obtaining the following benefits:

    • Cost Savings
      • Authorizations workflow, so that if a circuit does not fulfill preset rules, alerts are designed to notify responsible parties so that they can authorize or reject the user’s variation.
      • Real-time tracking of expenses versus budgets and an alert system to be able to react right away.
      • Minimized time and errors in the introduction of data about medications used, hours completed, consumables spent, etc.
      • Reduction of the time dedicated to inventory management tasks, time allocation, and back office in general.
    • Improved Use of Information Thanks to information flow control, responsible parties will be able to make decisions with greater ease. Furthermore, with the complete and integrated information the system offers, the organization will be able to:
      • Have a single piece of data for all departments, without the need to use department-specific applications to resolve management particularities.
      • Focus on the relevant information: time/hours spent, effectiveness of purchases, maintenance response time, etc.
      • Obtain consolidated information from the group rapidly and efficiently.
      • Carry out a survey of the efficiency of employees and departments according to different parameters.

 

  • Productivity Improvement
    • Greater control over patient care, thereby improving the service given to patients.
    • Improved maintenance management allows a reduction in machine and installation downtime.
    • Administrative tasks associated to operations are simplified and automated, freeing up time so as to dedicate it to caretaking activity and tasks.
    • The system registers all actions, helping management guarantee that they follow protocols and procedures, assuring quality of service.

Architecture

Axional ERP/HMIS is a three-tiered Java J2EE application designed to function in the corporate cloud or under the software-as-a-service (SaaS) mode.

Application servers

Application servers supply access to the system’s features. Each application server is redundant within the work group and individually gives:

  1. Authentication of user services via LDAP or the Active Directory.
  2. SSON integrated for Windows Active Directory through Kerberos/SPNEGO.
  3. Application services for users interacting via a 100% web-based interface.
  4. SOAP services for all system operations, allowing connection with other internal organization systems and/or external organizations.
  5. SOAP services for mobile devices which allow the application to run instinctively on a smartphone.
  6. Processing services based on programmed tasks and queues.
  7. The processing of high-performance transactions online for data capture and the execution of operations.
  8. Execution of business processes.
  9. Services for performance control and user activity tracking.

An application server only requires a Linux multi-processor set, whether physical or virtual, and a virtual Java machine.
Horizontal scalability is provided by groups of servers, while vertical scalability is provided by the database servers.

Reporting

The system incorporates a complete set of services for the generation of reports and references in PDF format, adapted to differing needs:

  • Operational business reporting for work reports.
  • Page Perfect reports for formatted documents such as delivery notes, accounting documents, etc.
  • Pixel Perfect reports for documents such as control panels or data analysis.

In the same way, any report can be requested in formats compatible with specific applications such as EXCEL, CSV or TXT.

Signature and digital verification

In cases where the signature or verification of PDF documents is required, the system incorporates necessary functions including:

  • Application of signatures to documents conforming to the PDF/A specifications.
  • Verification of signatures on PDF documents.
  • Support for longterm signatures with a timestamp.

Databases

The application includes native support for IBM Informix, IBM DB2, Oracle and Postgres including not only the data model, but also the stored procedure codes and triggers, as well as search commands and operations.

Application logic

As well as the stored logic in the database system, business processes use a powerful XML language interpreted in Java as derived from XEXPR .
This language allows for the convenient adaptation of business rules to the particularities of an organization, providing an ideal environment for the development of extensions.

Unattended processes

When the installation requires it, the system allows the programming of unattended execution tasks. These tasks allow the administrators to program activities such as:

  • Report preparation.
  • Execution of periodic processes.
  • Email notification to customers or providers by batches of automatically compiled communications.

The administrator can, for each user, likewise define the minimum time before a task begins to execute/run in asynchronous mode. In this way, the user does not have to wait for a process to complete and once finalized, it will show you the result in the inbox.

High availability

To ensure 24/7 operation, the system includes:

  • Load balancing in the application servers via DNS round-robin or load.
  • High Availability Enterprise Replication for database systems.
  • Automatic balancing of operations to the database server, adapted according to the process.
    • Writing in the primary database servers.
    • Read replication database servers.
    • Read and write in replica when faced with the failure of the primary server.

Security

The system fulfills data protection requirements and includes access control mechanisms which allow administrators to efficiently regulate which data sets and which operations are available to specific users.

These definitions are taken into consideration during the application’s materialization phase for a specific user.

In addition, the system keeps an access control providing registry information of searches and operations, which allow identification at any time consulted and modified by a specific user.

Mobile

All operations can be executed using mobile devices or tablets via a universal Axional Mobile client. This means that access to data or operation performance is always available on a smartphone in native form.