1. ARAS - Delivering World Class
Healthcare IT Solutions
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SRISHTI Software
progress through creation...

2. The Healthcare Revolution
Roadmap
Healthcare is undergoing a distinct movement along a logical
2. Chronic Care
trajectory from its historical focus on Acute Care to Long Term
Care. While Acute Care deals with immediate and severe
outbreaks of illnesses, Long Term Care focuses on continuous care
over a significant span of time, ideally a life time covering both -
episodes of acute illnesses and exacerbations of chronic illnesses. 1. Acute Care 3. Preventive Care
This shift leads us to Preventive Care, delivered through early
detection & treatment, resulting in reduced morbidity load on
individual and society. And finally, this logical journey ends at
Predictive Care, i.e. not waiting for early signs of illness but
4. Predictive Care
predicting and thwarting it before the illness has the chance to take
root.
We are moving towards a consulting/service based healthcare with
focus on lifestyle changes and behavior adaptation to
prevent/cut-out the roots of any instance of illness.
There are clear challenges within the current health-care ecosystem that must be overcome before realizing the benefits of
above mentioned revolutionary changes.
Current Challenges
A. Alternative delivery model to multiply reach
Low reach/inaccessibility as well as insufficiency (where available) of quality care
Presence of specialist doctors is restricted to the metro and major cities
Low focus/risk of under-utilization of capacity (beds, doctors, nurses)
Care Beds / Population of 1000
8.00 5.00
Germany Cairo
7.00
4.00
6.00 Port-said
Delhi
5.00
3.00 Alex.
France
4.00
USA Spain 2.00
3.00 India Egypt
UK
2.00 Egypt India
1.00 Monofeya
1.00 UP
Kalyubya
0.00 0.00
B. Integrated Healthcare Information
Fragmentation of patient data and medical know-how across entities
Fulfillment
in the ecosystem
Specialist Lack of one-point complete patient record
Orthopaedist, etc. High Cost/Low Productivity due to bottom-up recreation of
diagnosis/analysis at every instance
Healthcare Patient Data
Entities

3. C. Alternative transaction models . 2. Chronic Care
Business models are currently focused on Acute
Care across the healthcare ecosystem. Models
1. Acute Care 3. Preventive Care
catering to Chronic, and more advanced
Preventive Care need to be explored by insurance
companies and healthcare service providers The current payment 4. Predictive Care
alike. models, focus mainly
on Acute Care
But, at the base, are technologies ready to convert these challenges into opportunities - and make the revolution actually happen?
PARAS - The Healthcare IT Suite from Srishti
Srishti's Healthcare IT solutions support modern healthcare service providers with future proof initiatives, best in class delivery
models and emerging technology conformance. To address the need of various hospitals at different stages of their Healthcare
Informatics deployment, Paras comes in three different configurations - Paras Lite, Paras and Paras Premium. This ensures that
our customers need not change their platform with their growing needs and changing work flows. Basic philosophy behind
PARAS is to achieve integration of entire spectrum of healthcare technology enablers and is built using Srishti's powerful tool-kit
approach. This two pronged strategy ensures that healthcare services don't hit a technology roadblock as business models
change. PARAS is the answer to the need for a one-stop technology solution for healthcare service providers.
Healthcare Management IT Platform v 5.7
Public Portal Patient Portal Clinician Portal eGov Portal
Bedside Monitors Specialty Formsets Clinical Protocols Isabel CDSS KPIs / QOFs Disease Registries
Bio Terrorism Alerts
DICOM Devices EHR - CPOE EHR Centric Modules - Nursing, Consultant, OT EHR - eMAR Disease Surveillance
Lab Equipments RIS, PACS & Image LISIntegrated EHREB
BB, CBB eMAR
Pharmacy CSSD, eMAR
Diet, Therapy Clinical Analysis
RFID Tags ADTRF Mgmt IP - Bed / LIS Mgmt
Ward IP - Billing Mgmt Plan & Payer Mgmt Business Analysis
Smart Card Registration Mgmt OP - Clinic Mgmt OP - Billing Mgmt Help Desk Mgmt Actuarial Analysis
Ambulances HR & Duty Mgmt Finance Mgmt Procurement & SCM Support Services Mgmt Program Effectiveness
PACS Repository Application DB ICD 10 / SNOMED-CT Knowledge Repository
PACS: Picture Archival and Communication System BB, CBB: Blood Bank, Cord Blood Bank RCM: Revenue Cycle Management eGov: Electronic Governance
RIS: Radiology Information System LIS: Lab Information System CDSS: Clinical Decision Support System QOFs: Quality Outcome Frameworks
SCM: Supply Chain Management IP Mgmt: In-Patient Management OT: Operation Theatre KPIs: Key Performance Indicators
Ref / FU: Referral / Follow up CPOE - Computerized Physician Order Entry CRM: Customer Relationship Management eMAR: Electronic Medication Admin Record
ADT: Admission, Discharge, Transfer EHR: Electronic Heath Record EB: Eye Bank CSSD: Central Sterilization & Supply Dept.
Salient Features
Salient Features
Fully compatible with NABH & JCI criteria Best in class image recording & communication platform
Conforms to HL7, HIPAA & ITIH standards Clinical Pathways conforming to global standards
Capable of integrating with standard CMVs like ICD 9, Integrated with ISABEL CDSS, world’s best clinical
ICD 10, CPT 4, SNOMED CT etc. decision support system
Internationalization & localization with multilingual Modular approach to deployment & implementation
support
Capable of generating clinical performance indicators
Fully functional EHR integrated with relevant modules

4. Hospital Management Information System (HMIS)
KPI Reports Isabel CDSS Clinical Pathways
CPOE Module Integrated EHR Module eMAR
Lab Investigation Order Handling Demographics Physician Ordering
Radiology Request Management Allergies & ADRs Drug Interaction Validation
ADT Order Handling History Details Pharmacist Dispersing
Procedure & OT Request Episode & Problem Details Nursing Compliance
Nursing Order Handling Review of Systems Nursing Station Charting
Physical Examination
Clinical Notes
RIS Module Drawings & Image Management LIS Module
Protocol Management
Radiology Workstations Lab Admin Microbiology
Specialty Specific Formsets
Image Storage Management Lab Store Cytology
Standing Orders
Image Manipulation Haematology Histopathology
Disease Registries
Analysis & Reporting Biochemistry Immunology
Pharmacy Module Support Services Module
Pharmacy Store Management Operation Theater Management House Keeping & Laundry
Pharmacy Request Management Central Sterilization [CSSD] Vehicle Management
Pharmacy Cash Management Blood Bank Management Building Maintenance
Cord Blood & Stem Cell Management Library Management
Diet & Kitchen Management Eye Bank Management
ERP Module
Human Resource Management Material Management Finance Management
Employee Database Stores Management Accounts Payable /Receivable
Leave Management Equipment Management Statements of Accounts
Payroll Management Inventory Management General Ledger
Duty Roster & Personnel Asset Management Cash Flow Analysis
Performance Management Vendor Management Profit & Loss Statement
Purchase Management Trial Balance / Balance Sheet
PAS & CRM Module
Registration In-patient Management· Billing
Patient Registration Admission Management General Billing
Token Management Discharge Management Advance Payment
Telephonic Registration Transfer Management Package Billing
Web Registration HL7 CDA Documents Lab Billing
Investigation Billing
Ward Management Appointment & Scheduling Corporate Billing
Bed wise patient details Clinician Appointment Insurance Billing
Vacant bed status Lab Scheduling Final Settlement
Bed utilization report Radiology Scheduling
Bed / ward nurse roster OT Scheduling
PARAS Lite
PARAS Lite, an out-of-box product has been created by retaining the essential PARAS modules & is targeted at
Small & Medium hospitals, and IT starters among big hospitals.
PARAS
PARAS is an end to end customizable solution for a hospital providing Complete Clinical & Administrative Integration
across the enterprise including highly sophisticated integrated EHR.
PARAS Premium
The PARAS Premium is a framework based solution and is targeted at hospital-chains with number of beds numbering in
thousands. This high-end solution handles, at a centralized location, the heavy-duty data management and complex
information access needs of all branch hospitals. Moreover provides Complete Clinical Informatics Framework conforming to
International Standards.
Tele Medicare Solution
Tele Medicare is a rapidly developing aspect of clinical care where Medical & Health information is transferred via Telephone,
Internet or other Networks to facilitate Consulting, Assessment or for Performing Procedures. Srishti’s Tele Medicare
Solution, anchored at both ends to an integrated EHR & HMIS, provides Unfragmented and Complete
Clinical & Administrative data to all stakeholders at point of care.
Thus, PARAS products address all the segments of the market. This facilitates the customer to grow on the same platform
without changing the solution as and when their business & IT needs grow.

5. Integrated Electronic Health Record System (EHR)
At the heart of Srishti's PARAS is an Integrated Electronic Health Record – EHR, a complete, updated and accurate one
point patient clinical database across entities in the healthcare universe.
Summary
EHR Home Health Info
Location
EPR
Social Workers Specialist
EPR EHR
GP Nursing
EPR
Aged Care EPR Large Hospital
Path Lab Local Hospital
Imaging Lab
RIS & PACS
PARAS’s RIS can work as a stand alone module or with a PACS server - own or institution’s existing server.
Remote Teleradiology
DICOM Modality Workstation
PACS Server
Radiology
DICOM Modality Workstation
Radiology
Workstation
eMAR
Over & above a standard eMAR module (diagram 1). Paras has a robust drug interaction alert generation (diagram 2).
Interaction Level Alert Type
Pharmacist:
Dispenses medication
Level 5
Physician:
Writes order for medication. The Staff Nurse: Fatal
application in the background Is notified that ordered
checks for possible interaction medication is available
using the “Drug Interaction Alert” for administration Level 4
functionality
Electronic Medication
Administrative Record Level 3
Data: Staff Nurse:
Is added to patient’s Verifies and cross
electronic medical record checks against
medication order(s) Level 2 Mild
Staff Nurse:
Completes medication
administration and
electronic documentation
Level 1
eMAR diagram 1 eMAR diagram 2

6. Isabel: The Award-Winning Diagnosis Reminder System
Isabel is a validated, web-based diagnosis decision support and knowledge mobilizing system with accuracy of more
than 91% designed to help reduce and manage diagnosis error at the point of care.
Isabel addresses the causative factors that have a significant impact on the level and quality of patient care.
Diagnosis error – a compelling patient-safety issue
Medical diagnoses that are wrong, missed, or delayed make up a large fraction of all medical errors and cause substantial
suffering and injury. A 3-year project by the Cook Country Rush Developmental Center for Research in Patient Safety,
funded by the Agency for Healthcare Research and Quality (AHRQ) and published in 2005, found that 10 – 30% of
errors are errors in diagnosis and the diagnosis errors far outnumber medication errors as a cause of claims lodged. A
review of 53 autopsy studies found an average rate of 24% missed diagnoses.
A 2006 Medical Liability Insurance study found that errors in diagnosis were the leading allegations of closed
claims. In Family Medicine, Internal Medicine, Pediatrics and Radiology more than 50% of lawsuits alleged a
failure to diagnose.
Source : ProMutual Group study reported in the American Medical Association Newsletter, March 2006.
Failure to consider reasonable alternatives – single most common cause of misdiagnosis
A 2005 Veterans Administration study funded by the National Patient Safety Foundation analyzed cases of diagnostic error
involving internists and found that cognitive factors contributed to diagnostic error in 74% of cases. Premature closure, i.e., the
failure to continue considering reasonable alternatives after an initial diagnosis was reached; was the single most common cause.
Isabel addresses the very issue of premature closure and has been proven in clinical studies to minimize diagnosis error by
reminding physicians to consider important diagnoses.
Constructing a complete differential diagnosis – reinforcing basic medical training
Professor Arthur Elstein, PhD at the Department of Medical Education and the School of Public Health at the University of
illinois at Chicago, and expert on diagnostic reasoning in clinical medicine, spent a lifetime's work on answering questions such
as: How do physicians make decisions? How can we help them make better ones? Elstein has suggested the value of compiling
a complete differential diagnosis to combat the tendency to premature closure, the most common cognitive factor identified to
contribute to diagnosis error. Medical students and residents are trained to construct a complete differential diagnosis for each
patient.
Diagnosis Reminder System
Isabel, either as a standalone system or interfaced with PARAS EHR system gives dynamic clinical decision
support, enabling clinicians to:
Quickly obtain a list of likely diagnoses including bioterrorism diagnoses and causative drugs for a
given set of clinical features
Learn more on investigations and treatment for each diagnosis, either through a cursory quick-read, a
more detailed read, or clinical information on bioterrorism from the CDC, USA
Access the clinical lessons learned and errors that have been reported in relation to the diagnosis
being considered
View diagnosis specific annotated images or helpful list of investigations that can be performed to
confirm or rule out a diagnosis
Stay up to date with recent advances clinically sorted into diagnosis categories - and avoid time
consuming office research using online and library resources

7. Testimonials...
"Isabel suggested the correct diagnosis in 98% cases. Decision-support systems can help doctors avoid falling victim to
"premature closure" - the tendency to focus on one diagnosis that seems to explain all of the symptoms, then stop
considering other possibilities."
Mark Graber MD,
Chief of Medical Service at the VA, Northport, NY,
quoted in the Wall Street Journal. Nov 2006
“There had been software products over the years ... but Isabel was the most sophisticated product I had ever seen,"
Leslie G. Selbovitz, MD,
Senior VP for Medical Affairs & CMO,
Partners Newton-Wellesley Hospital, interviewed Oct 2007
"Isabel is a great tool for difficult to diagnose cases!"
Mary Lynn Allen, MD, VA - Gainesville, FL
"I am impressed with the concept and its execution. This is an innovative product that I think may soon be proved to have
significant clinical utility, particularly if integrated into EMRs so that the system can operate in the background and be
selected when needed, with minimal effort from the clinician. In a world of exploding biomedical knowledge, and limited
human cognition, the arguments in favor of Isabel and other decision support systems are compelling. I will watch for the
peer-reviewed results of further study with great interest. Institutional and individual buyers should definitely give it a
look."
Gary Kantor, MD.
Case Western Reserve University February 2006
"Several features I feel are innovative and useful for my practice as a pediatric infectious diseases consultant. The
Diagnosis Reminder System is useful to check my differential diagnosis list against. The regional preferences search
option is one I like a lot, because of the importance of travel history and geographic exposure patterns to many of my
consults. For teaching and communicating with trainees and families, the Lessons Learnt and What's New options give
me ready access to potentially interesting PubMed articles. I find Isabel unique and uniquely helpful"
Jeff Mckinney, M.D. Ph.D.
Assistant Professor In Pediatrics andMolecular Microbiology,
Washington University School of Medicine,
St. Louis, Missouri Dec 2005
"Implementing PARAS has immensely enhanced the customer experience that we offer to our patients. Using PARAS, the
relevant details of the patients of Narayana Nethralaya are recorded and preserved in computer systems and one can
retrieve the same by just entering their name or registration numbers into the computer systems during their future visits
to the hospital. Thus resulting in effective utilization of the time and immediate treatment to the patients by having their
Electronic Medical Record available at finger tips to our doctors and other concerned staffs."
Dr Bhujang Shetty, Director,
Narayana Nethralaya, Bangalore.
“Srishti Software has worked with us to improve every area of our hospital, from helping us to improve our production
flow and order entry processes, to reporting functions. All of this has helped us to provide excellent patient care."
Dr. Manjunath, Medical Director,
Sri Jayadeva Institute of Cardiology, Bangalore.
“Srishti's Healthcare Suite 'Paras' has helped us achieve full automation and better patient care. All administrative & support
processes like Registration, Billing, Store, Pharmacy, Labs; are now online. Optimal utilization of resources have reduced costs.
Availability of pertinent information at point of care has improved clinical outcomes. Logical scheduling has reduced waiting
times - leading to greater patient satisfaction.
Dr. Jeetendra Kumar, Director,
Mahavir Cancer Sansthan

8. Our Delighted Customers Include...
Zydus Hospitals & Healthcare Research Pvt. Ltd., Isabel Clientele
Ahmedabad- Multilocation
Centre for Sight, New Delhi- Multilocation
Rajiv Gandhi Cancer Institute & Research Center, New
Delhi
SUT Hospitals, Thiruvananthapuram- Multilocation
KG Hospital, Coimbatore
Narayana Nethralaya, Bangalore- Multilocation
TATA Chemicals Hospital- Multilocation
Sri Jayadeva Institute of Cardio Vascular Sciences &
Research- Multilocation
Mahavir Cancer Sansthan, Patna
Prashant Memorial Charitable Hospital, Muzaffarpur
Awards & Recognition
Isabel has been extensively featured in Fox News (Dec 2006), Wall Street Journal (May 2005 & Nov 2006), CBS (May 2006), New
York Times (Feb 2006), Forbes (Aug 2005) and CNN (Oct 2004).
Isabel has had editorials and reviews in key medical journals, including The Lancet, the British Medical Journal, Journal of
Intensive Care and Archives of Disease in Childhood.
Peer reviewed articles and results of clinical studies have been published in Archives of Disease in Childhood, Journal of the
American Medical Informatics Association, Medinfo 2004, Journal of Intensive Care Medicine, Health Management.
Technology and BMC Medical Informatics and Decision Making.
Winner of the 2005 Frost & Sullivan Healthcare Information Technology Product Innovation of the Year Award Stay up to date
with recent advances clinically sorted into diagnosis categories – and avoid time consuming office research using online and library
resources.
Recognized as one of the "outstanding and innovative developments within the IT sector" at the 2002 British Computer Society IT
Professional Awards.
A few accolades...
“For demonstrating excellence and growth in the IT channel business.” Channel World, Fast Track 100 Awards, Honouree 2008
"Consistently among the top 100 IT innovators in India” NASSCOM Survey, 2007
"Among the FIVE most promising Indian IT companies to look out for” Information Week, 2005
“One of the most innovative IT companies in India” NASSCOM, Feb 2005
R
SRISHTI Software
progress through creation...
INDIA UK
Srishti Software IntelliApp Solutions
L-174, 6th Sector, HSR Layout Suite 5-6, 46 Dorset Street
Bangalore - 560 102 London W1U 7NB
Karnataka, India United Kingdom
Ph: +91 80 4110 9060/ 61/ 62/ 63 Ph: +44 750 246 0465
Fax: +91 80 4110 9064 Fax: +44 207 224 3838
E-mail: kumud@srishtisoft.com E-mail: kdeepak@srishtisoft.com
www.srishtisoft.com
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