Commissioning a new hospital in Africa
Bokamoso Private Hospital in Gaborone, Botswana is the first hospital in Africa to be designed and operated to U.S. healthcare standards. As a new organization created in 2008 by two health plan trusts, Bokamoso was a greenfield project of US$300 million to build and commission a 220 bed hospital and clinics.
Before the opening of Bokamoso Private Hospital (BPH), there were no functioning dialysis units in the country and only on CT scanner. The investment into and design of BPH provided a full range of clinical diagnostics and treatment. The hospital recruited 83 physician specialists from 22 countries. BPH opened with the ability to provided just about any type of treatment with the exception of transplants.
Bringing world-class healthcare to Botswana allowed its citizens to be treated close to home and avoid four hour drives to Johannesburg, South Africa.
Although the building of the new hospital and organization had a sizable budget, clinical and business technologies were only allocated US$6 million. The major challenges included:
- The IT budget was drastically undersized for the scope this hospital and planned clinical services.
- Although the hospital was to be designed and commissioned with U.S. standards, the restricted budget did not permit the selection of U.S. clinical and business applications.
- Local firms had little or no healthcare IT experience and their management of technologies was considerably below what was acceptable in western healthcare organizations.
- When we engaged with the client, the first floor of the hospital had been constructed and there was no space allocated for a data center or datacomm closets.
- To complicate matters, the property was located just outside of the city and there were no telecom or data communication services. The government owned telecom wanted to charge US$3 million to extend services to the site.
- All equipment for the hospital was sourced from the U.S. or Europe which incurred additional freight costs and longer supply lead times.
With the US$6 million IT budget we accomplished the following:
- Organized a technologist team in the U.S. for developing the requirements, design and configuration to meet the clinical and business needs
- Collaborated with the hospital architect and general contractor to allocate space and build a 80 sq. meter secure data center
- Identified an application vendor in India that offered a systems for integrated EHR, revenue cycle and diagnostic imaging (PACS)
- Contracted a South African IT firm for local implementation services
- Installed all technologies and customized the EHR, integrated the PACS with the diagnostic imaging modalities (MR, CT, CR, US, NM).
- Utilized creative network engineering to bypass the government telecom and built a redundant private wireless microwave network for all voice and data services to the hospital
- Recruited a technical staff of eight people and trained them for the support of all technologies and systems
- Provided training for all clinical and business staff
From the time that we were engaged, the opening of the hospital was completed within 19 months. The major achievements included:
- All IT services and applications were implemented with the US$6 million budget
- The hospital opened on time per the original schedule
- All staff were properly trained and provided enhanced support for 60 days after hospital opening
- Substantial training and knowledge transfer was provided to the local IT team
- Transitioned all support services to the local teams four months after hospital commissioning