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In the new system, nurses will use pull-down screens to note their findings. A handwriting recognition application is part of the mix as well, he adds. With the application, nurses can write a number or phrase and the tablet will convert it to digital format, offering alternative meanings if the software is unclear about the lettering. For example, a nurse could jot down a blood pressure reading on the screen, thus avoiding having to type it. Regardless of how well the software functions, the project could be in jeopardy without easy-to-use wireless devices that accommodate the working style of peripatetic clinicians.
In addition to designing documentation screens, the module will require an accompanying clinical data repository. The repository will include data from multiple sources, including the lab, pharmacy, ED and physicians. Currently, the lab and pharmacy data will be interfaced from MediTech. But in time, the MediTech system could be scratched altogether as Sampson develops the new modules. The repository will also include all dictated physician notes. Radiologists' notes in the Agfa PACs will be a direct feed, while other notes would come through an interface to Sampson's Dictaphone system.
It is a complex mix of technologies. That's why Ziolkowski is hedging his bets on which of the 90 modules Sampson will ultimately adopt. For example, the financial and billing modules may wait. "How well Agfa does on the clinicals is the key question," he says.
But the CIO is keenly aware of the costs of building and maintaining interfaces. It's just that he can only push so fast--the hospital has a modest IT crew, and the new applications represent changes in workflow.
2. Closed loop medication administration. The clinical data repository will serve as the foundation of Ziolkowski's second big push: automating medication ordering, tracking and dispensing. In phase one, the hospital will build the medication order function, designing screens and interfacing with its old pharmacy system. At first, nurses will enter the orders on behalf of physicians. By the fall of 2008, physicians will begin direct order entry themselves, with an Agfa module in place as the new pharmacy system. In between, Sampson will settle on a bedside medication management system to facilitate identification of drugs. "It will either be barcode or RFID," says Ziolkowski.
The vast number of moving pieces does not seem to faze the CIO, who traveled to Germany to see the Orbis package in action. "The technology is rock solid," he says. Ziolkowski does concede that "the human element" will be far more difficult to manage. "We won't shortchange the handholding," he says.
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