The Clermont-Ferrand Hospital Consolidates Data for Reliable Invoicing

Bypassing an unreliable information system, the Clermont-Ferrand Hospital improved invoicing by correlating data on hospital stays.
At first Talend Open Studio for Data Integration handled our loading and extraction needs, but quickly became our basic tool for transformations. It serves not only for verifying the quality and consistency of the data, but also for locating missing data.
Jean-Christophe Jourdy, Department of Medical Information

Three sites supporting a tri-fold mission-care, research, and teaching

The Hospital of Clermont-Ferrand employs 6,000 employees deployed over three sites, giving residents of the Auvergne region a capacity of 1,900 beds. The Hospital serves a large area (over 1.3 million inhabitants) including the town of Clermont-Ferrand (the 21st largest city in France with 300,000 inhabitants).

The hospital treats three specific hospitalization areas: short stay, psychiatry, and after-care and rehabilitation. Medicine, surgery, and obstetrics are located in the Gabriel Montpied hospital on the St Jacques plain providing about 800 beds, and the Hôtel-Dieu in the city center, built in 1773, and dedicated to gynecology and obstetrics. Because the latter site had no room for expansion, all its activities were transferred to Estaing, a former industrial site of the Michelin company located between the centers of Clermont-Ferrand and Montferrand. A third building, far from the city center, is primarily dedicated to mid-term care and geriatrics.

A very fragmented IT system

Clermont-Ferrand's global information system is characterized by a highly fragmented architecture; each department has an autonomous subsystem connected to a central core - common to all the specialties - which aggregates the administrative data.

"€œIT Management handles 35 databases-each corresponding to a medical specialty - which are distributed over approximately 25 servers,"€ explained Dr. Jean-Christophe Jourdy, of the Department of Medical Information. "€œAt the same time, the deployment of a new medical product (supplied by McKesson) was underway. We also have an administrative database (a McKesson Hospital Information System) connected to all the servers. Diagnosis and data are captured separately, service by service, and we need to reintegrate this data by combining it in a dedicated database. The aim is to recreate the full path followed by patients in order to bill them correctly and to provide reports to our governing body. Until last year we used many manual processes to consolidate this data, which resulted in multiple scripts."

Over time, the management of these scripts became more and more cumbersome. "€œIt not only required mastering a complex and very specific language, but maintaining the scripts was problematic and did not meet the evolving requirements of our activities," added Jean-Christophe Jourdy. "Because our financial models have been changing over the past few years, it has become more difficult and time consuming to manually alter the scripts to take new accounting models into account."

Towards full integration of all specialties

Initially, the IT Department used Cloverleaf, an EAI product recently acquired by McKesson, who provided the administrative core and one part of the new hospital medical information system. "€œThe implementation of this system was particularly complex and the integration capabilities were relatively limited,"€ said Jean-Christophe Jourdy. "€œWe wanted a simpler alternative that would let us develop easily modified, user-friendly processes to interface between the heterogeneous databases of our old system that was still in use, and the new system we were deploying. And so we found Talend Open Studio for Data Integration which, besides being free and surprisingly mature, has a graphical interface that is particularly easy to master. We tested it on one or two flows before disseminating it to all databases. At first Talend Open Studio for Data Integration handled our loading and extraction needs, but quickly became our basic tool for transformations. It serves not only for verifying the quality and consistency of the data, but also for locating missing data."

Today, the old scripts are migrated progressively to Talend Open Studio for Data Integration as new projects are developed and the tool is connected to all the hospital's database servers.

"€œImplementing Talend Open Studio for Data Integration was very easy,"€ added Jean-Christophe Jourdy. "€œWe can now undertake multiple tasks in a very short time, which was unthinkable before. Talend Webinars showed us many of the tool's features, as well as providing useful timesaving tips, while access to the Forums helps us resolve almost all the technical problems we face in daily operations. Today, by automating numerous procedures and easily verifying the consistency of the consolidated data, we are able to quickly review in-patient data."

Cost savings, user-friendliness, increased productivity

Clermont-Ferrand cited the cost-effectiveness of Talend Open Studio for Data Integration as one of its principal benefits. "€œTalend Open Studio for Data Integration provides many advantages compared to proprietary tools: on one hand, the solution is completely free as far as licensing is concerned and there's a very low learning curve to get started. We can conserve our IT budget and put the money toward other activities,"€ explained Jean-Christophe Jourdy. "Its ease-of-use is another major advantage that allows significant productivity savings-we perform tasks more rapidly than before and are able to sort out problems instantaneously and to meet any development request without delay. The solution also let us to take all the data into account and to bill some hospital stays which were not previously accounted for-a significant cost saving."

The IT and Medical Information Departments undertook a study to explore the possibility of deploying Talend Data Integration to meet more complex needs. "€œThe subscription service supports multi-user development, more control, and can handle projects more complex than simple data extraction, opening up new opportunities, particularly in the area of managing communication standards and the exchange of business data (HL7, HPRIM, etc.). These specialized connectors weren't a part of the solution, and we're planning to take on their development, eventually giving them back to the community as a way of contributing to open source."

"€œIt's clear that open source is an essential tool for the public sector, including hospitals. It allows us to reconcile significant budgetary and technical constraints without sacrificing the performance and the reliability of our IT systems,"€ concluded Jean-Christophe Jourdy.