N4HC is a project by Negentis Solutions that aims to implement an advanced planning and control system for healthcare based on industrial accounting principles. The system integrates all components of health authority accounting systems in an organic, self-powering process flow supported by custom applications. A key feature is the Bill of Material (BoM) which associates healthcare activities to their related costs. The BoM allows for accurate cost calculation and feeds budgeting and management accounting. N4HC is compliant with Lean Management and standards like HL7 and RFC for interoperability.

1. Negentis Solutions
N4HC - Nesp 4 Health Care

2. N4HC – The Project
Inspired to
Lean Management
philosophy
The specialization of NESP
dedicated to Health Care

3. N4HC – Key Features
AN ADVANCED MODEL
OF
PLANNING&CONTROL
SYSTEM
BASED ON INDUSTRIAL
ACCOUNTING
PRINCIPLES AND
INSTRUMENTS
ABLE TO PREVENT
ANOMALIES AND GAPS
FROM SET-UP
BUDGET OBJECTIVES

4. N4HC – Concept Core
TOTAL INTEGRATION
OF ALL THE MAIN
COMPONENTS OF
HEALTH AUTHORITIES
ACCOUNTING SYSTEMS
IN AN ORGANIC, SELF-
POWERING AND
SEAMLESS ACTIVITIES’
PROCESS FLOW
SUPPORTED BY
CUSTOM
APPLICATIONS

5. N4HC – A driver of a Change
To a decentralized
system managing&
integrating
operational activities  Detailled data
of each department collection
in a seamless flow  prompt detection
From a centralized
control of of gaps from
accounting defined
management and objectives
ex-post analysis of  progressive
data removal of Muda
and Kaizen

6. N4HC – The Architecture
 BUILT ON TOP OF NESP FRAMEWORK
ENTERPRISE INFORMATION SYSTEM
 REAL-TIME INTEROPERABILITY
 END-TO-END INTEGRATION OF BUSINESS
PROCESSES, APPLICATIONS AND SYSTEMS
 INTELLIGENCE FOR AUTOMATING
OPERATIONS AND OPTIMIZING DECISIONS
 A SUITE OF INTEGRATED
MODULES, SPECIALIZED
AND INTEROPERABLE
 (RE)CONFIGURATION OF
NETCENTRIC PROCESS
ORIENTED SOLUTIONS IN
AN AGILE, FLEXIBLE AND
COST-EFFECTIVE WAY

7. N4HC – Data Integration from Healthcare Subsystems
N 4HC USES NESP
FEATURES TO
INTEGRATE DATA
FROM MANY
DIFFERENT
HEALTHCARE
SUBSYSTEMS WHICH
FEED ALL THE
PLANNING&CONTROL
COMPONENTS
(BUDGETING,
REPORTING,
MANAGEMENT-
ACCOUNTING, STOCK-
ACCOUNT,
FORECAST..)

8. N4HC – BoM Bill Of Material 1/3
• BoM IS THE HEART OF
PLANNING&CONTROL SYSTEM
• IT IS THE MATRIX WHICH ASSOCIATES
ACTIVITIES TO THE RELATED COSTS OF
PRODUCTION FACTORS
• BoM ALLOWS A CLOSE TO REAL
CALCULATION OF HEALTHCARE
SERVICES’ COSTS
• BoM IS FILLED-IN BY DECENTRALIZED
UNITS OF THE ACCOUNTING
MANAGEMENT SYSTEM IN ORDER TO
REPORT REAL COSTS OF ACTIVITIES
• IT FEEDS BUDGETING AND
MANAGEMENT ACCOUNTING
• IT ALLOWS BUDGET SIMULATION
SCENARIOS
• BoM IS SUPPORTED BY A USER-
FRIENDLY REPORTING SYSTEM WITH
CONFIGURABLE DASHBOARDS

9. N4HC – BoM Bill Of Material 2/3
WITH THE BoM IS NOW POSSIBLE TO
ACCURATELY CALCULATE THE REAL COST OF A
SURGERY FROM THE BEGINNING TO THE
FOLLOW-UP
BoM ASSOCIATES TO THE
ACTIVITIES OF THE SURGERY
ALL THE RELATED FACTORS OF
PRODUCTION

10. N4HC – BoM Bill Of Material 3/3
FOLLOWING LEAN MANAGEMENT CONCEPT
OF DECENTRALIZATION, BOM IS FILLED-IN BY
DEPARTMENTS UNITS (CDR) TO OBTAIN A
MORE ACCURATE CALCULATION OF COSTS FOR
EACH UNIT
THE WHOLE CONTROL OF THE PROCESS IS
ANYWAY OF PLANNING&CONTROL OPERATORS
WHICH SUPERVISE OPERATIONS
MONITORING&CONTROL OF BoM CREATION IS
SUPPORTED BY DASHBOARDS

11. N 4 HC – BoM : a strategic instrument
• To prepare the budget BoM costs in the budget drive to a close–to-real
forecasts and minimize gaps from set up objectives
• To take Make or Buy decisions depending on where they are made
(internally or by an external provider
• To take benchmarking decisions (qualitative and not merely quantitative
evaluation of different BoMs within the same department )
• To Make ROI evaluations (simulation of different scenario by changing the
combination of factors or activities in the same BoM

12. N4HC – BoM and performance evaluation
PROCESS MONITORING&
CONTROL IS PERFORMED BY
NESP BAM (BUSINESS
ACTIVITY MONITORING)
MODULE
NESP BAM OFFERS USER-
FRIENDLY AND
CONFIGURABLE DASHBOARDS
TO MONITOR& CONTROL
OPERATIONS TO DETECT
ANOMALIES ALSO USING KPIS
DASHBOARDS REPORT THE “AS IS”
SITUATION TO RE-ENGINEER PROCESSES
TO REACH THE “TO BE” SCENARIO

13. N4HC – A case of success

14. N4HC – Acknowledments
ASF WAS AWARDED WITH THE
FORUM PA PRIZE:
”MENO CARTA, PIÙ VALORE”
IN 2011
IT WAS THANKS TO THE
ADOPTION OF THE BOM
THE INNOVATIVE MODULE
DESIGNED BY NEGENTIS

15. N4HC – Standards&Compliance
N 4 HC is compliant with:
 The Lean Management philosophy
 HL7 (Health Level Seven International): A standard for the exchange,
integration, sharing, and retrieval of electronic health information that
supports clinical practice and the management, delivery and evaluation of
health services
 RFC (eToscana Compliance): A standard for the interoperability among
different protocols through which local authorities have to exchange
information and documents