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Hypercom’s POS Transaction Technology Solves Issues Experienced in Today’s Healthcare Industry.

As successive governments keep discovering, getting an efficient healthcare service from sustainable budgets is an exercise in getting a quart out of a pint pot. It’s not just a British problem; countries as diverse as the US and the Philippines are facing the same problems.

In the US, the Health Care Financing Administration’s HIPPAA (Health Industry Portability and Accountability Act) is putting the public Medicare and Medicaid programmes under pressure to do measurably more for considerably less. In the Philippines, very limited resources, combined with a poor communications infrastructure, meant that the administration of primary healthcare lagged far behind the treatment process — so far behind that the real costs of keeping the nation healthy were unknown.

Common Problems

Both these countries face many of the same problems as Britain; how to let healthcare professionals spend more time with patients and less with paper; how to monitor the cost/benefit equation in treatment; how to respond more quickly to health crises; how to measure the nation’s health. At the heart of many of these sorts of problems is the fact that healthcare administration is still a major consumer of paper and ink. Patient records, claims forms, clinic referrals, prescriptions and booking systems are largely unautomated. Where automation exists it is in island form. And islands that, in technological terms, still communicate by the equivalent of the dugout canoe.

Eastern Promise

In attempting to solve some of these problems through increased automation, a new technical solution has been found, based on tried and trusted technology originally developed for the shop counter. Already installed in three Asian countries, the first European and American rollouts are expected before the end of the year.

One of the key players is AIZ International (www.aiz.com and its parent company, the Zuellig Group. AIZ has long experience of developing healthcare systems in diverse countries and cultures. As these systems have been implemented, so the model has been refined to suit the user’s exact needs at every level, whether they are health ministers, paramedics, doctors or practise nurses. And for those who think that for any IT problem, the PC is the automatic answer, the shape of those systems may come as something of a surprise.

According to Patrick Kriesemer of AIZ, the main result of installing PC-based systems is a slowing down of patient treatment and an overload of helpline switchboards. "There is one unavoidable conclusion. Frontline healthcare staff are trained in medicine, not computing. What we needed to give them was a system which is robust and easy-to-use at the primary care stage; the doctor’s surgery, the A&E department and the pharmacist’s counter."

Searching for the Black Box

And it was in the pharmacy that AIZ spotted the answer to that ease-of-use requirement — the point of sale terminal, the black box that for 25 years has been reading customer’s credit cards. "A shop assistant can be trained to use a card-swipe machine in five minutes," says Patrick. "Why then should we struggle to train thousands of healthcare professionals how to use complex computing when some lateral thinking could provide a tick-and-click terminal which would require, if not five minutes training, then no more than ten. When we began in-depth thinking about this possible solution, it soon became clear that the shop-counter box was just a little too simple for our requirements. What we needed was a device that combined a few of the attributes of the PC with the simplicity of the counter-top terminal. Happily, when we described our vision to the point-of-sale terminal manufacturers, one of them told that they had just such a device under development in their labs."

That manufacturer was Hypercom. One of the giants of the POS world, Hypercom was anticipating changes in the retail and finance industries by developing a next-generation terminal.

Mark McMurtrie of Hypercom comments: "Over the first few years of the 21st century, the plastic cards we carry in our purses and wallets will change. The magnetic stripe that for 30 years has held the card’s secrets is soon to be replaced by a microchip — the so- called smart card. To use these cards the existing population of card readers in-store would need to be replaced or modified. We decided that changeover would give us a once-only opportunity to change the entire nature of the payment terminal."

"Our vision was a machine that had a big touch-screen. It would be wedded to a fast modem, a web-browser style interface and enough memory to run simple programs. We added digital signature capture and wrapped it all in a package which was proof against the semi-hazardous conditions of a shop counter."

Patrick Kriesemer had found almost exactly the device AIZ wanted to put into primary care. Hypercom’s vision has since evolved into a product family with sales exceeding a million units a year. And increasingly some of those units are going into the healthcare industry.

How does the system work? There are, of course, variations from one national or insurance scheme to another. But the principal remains the same.

The patient carries a card, either magnetic strip, or smart. All this card does is identify the carrier as a patient of the national authority or a medical insurer. At the point-of-care the card is inserted into a Hypercom terminal. The healthcarer — doctor, nurse, receptionist or paramedic — also swipes a smart card, which authorises access to patient detail. Instantly the terminal goes online to a local, regional or national database to retrieve and print a short statement of the patient’s medical status including items like notifiable diseases, known allergies, blood group, etc.

Primary care then serves the patient in the appropriate way — examination, treatment, medication, prescription, onward referral. Once again the professional’s and the patient’s cards are swiped, and in seconds the outcome of the visit is entered into the terminal, using menus and the touch screen.

Goodbye Keyboard

Medical conditions, drugs, dosages and treatments are described according to the World Health Organisation (WHO) codification. So, too, are the treatment regimes. With, at most, a dozen screen touches the patient’s centralised record is updated. No alphanumeric keying is required. Onscreen help will walk healthcarers through operations with which they are less familiar.

If a prescription is required, all the patient needs do is visit a pharmacy within a stipulated time period. The pharmacist swipes both the patient’s card and his or her own and the prescription, authorised by the doctor’s digital signature, appears on screen and can be dispensed. Instructions on dosage and timing can be printed by the terminal on adhesive paper, to be attached to the medication packaging. In total, administration of the patient’s treatment is reduced to not much more than a minute’s work, allowing the professionals to deal with the next case and shorten queues.

The benefits, according to Patrick Kriesemer, are several. "What the health service is using is a technology which has been proven over many years in a demanding retail/financial environment. In the same way that a retailer uses a simple interface to access a banking system and be sure that a shopper’s credit card is valid, so a doctor or nurse can make enquiries against a patient’s medical history. On the frontline the main benefits are time saving, and space saving — many square metres of record storage can be freed up. Treatments and medications are not only posted to the patient’s record but are transmitted to insurance schemes or national health authorities, allowing for less bookkeeping and quicker settlement of claims. And the problem of reading the doctor’s handwriting becomes a thing of the past!"

At the Centre

"For health authorities or insurers, the database analysis tools which commerce has been using for years can be employed. Spotting local patterns of disease quickly becomes possible and preventative treatment can be used if appropriate. Drug consumption by individual practises or by different disease types can be compared. Practitioners that regularly use branded drugs rather than generics can be identified, allowing cost savings. The success of different treatment regimes for the same conditions can be compared on a macro scale."

"There’s another very real benefit," adds Mark McMurtrie. "On any healthcare system the front end is where the most equipment is deployed, and where the least technologically aware staff are employed. Using a low-cost, easy-to-use, robust device at the patient interface helps produce a system where capital and support costs are somewhere between 50% and 80% of comparable PC-based solutions. Even on a local scheme the savings are important. On a national scheme we’re talking of saving tens of millions of pounds up front, and hundreds of millions over the life-cycle of the system."

Hypercom’ s family of ICETM (Interactive Consumer Environment) terminals include models with GSM wireless capability, allowing them to be used at accident sites, or in emergency vehicles. Other models offer mono or full colour screens and local area network or modem connectivity. The ICE family is proving to be just a reliable and popular in the healthcare industry as in its original retail industry. Hypercom’s ICE beings high security, fast communications, ease-of-use and allows innovative new services to be introduced. Countries that have implemented the Hypercom AIZ scheme include the Philippines, Malaysia and Singapore. Central European health services and American health insurers are now showing considerable interest. Hypercom is recognized as the Global Leader in Electronic Transaction SolutionsTM. Its retail point-of-sale products have now been found to be equally suitable for healthcare applications. They are easy to use, reliable, highly secure and take up little space. You can expect to see increasing numbers of medical applications running on Hypercom equipment over time. Terminals will be installed at hospitals, pharmacies, doctors’ surgeries and other healthcare providers. These electronic transaction solutions automate today’s manual paper-based systems, provide eligibility verification and speed up communications between different parts of the industry.

Hypercom Corporation (NYSE: HYC) is the leading global provider of electronic payment solutions that add value at the point-of-sale for consumers, merchants and acquirers, and yield increased profitability for its customers. Hypercom’ s products include secure web-enabled transaction terminals that work seamlessly with its networking equipment and software applications for e-commerce, in-commerce, smart cards and traditional payment applications. The company’s widely-accepted ePOSinfocommerceTM (epic) framework of consumer-activated, EM V-certified, touch-screen ICE (Interactive Consumer Environment) terminals enable acquirers and merchants to decrease costs, increase revenues and improve customer retention. Headquartered in Phoenix, Arizona, Hypercom is independently acknowledged as the leading provider of point-of-sale card payment terminals worldwide. Demand for Hypercom’ s terminals surpassed one million units last year alone. Hypercom today maintains an installed base of more than 4 million terminals in over 100 countries, which conduct over 10 billion transactions annually.

Lucy MacDermott

Nexus.PCM

+44 (0)2077611 734/lucy@nexus-pcm.com