Sampson has a nursing informatics committee to weigh in on the system. And the hospital has designed a process for physician validation of any order sets that will be built into the system. For its part, Agfa will have software engineers on site working on the project. "For our PACs project, we had two to three Agfa staff here for a month, plus we had access to more than a dozen analysts, engineers and testers," Ziolkowski says.
The end-game is clear. Medication administration will be facilitated by IT from the moment the order is placed through the moment it is delivered. Bedside screens will record and monitor dispensing activity, with alerts built into the system throughout the spectrum of events that occur. In Ziolkowski's view, having the multiple components that comprise medication ordering on the same technological platform is a big step to improving patient safety. "It is so important to have tight integration between CPOE and pharmacy," he says.
3. Revenue cycle. By late 2009, Ziolkowski hopes to have the patient registration module of the Agfa suite in place, knocking out its MediTech predecessor. That will entail a file conversion of old patient account names. After that might come the accompanying billing system. "We don't want to put the revenue cycle at risk," Ziolkowski explains. "We have not yet validated Agfa's billing system. It is still a question mark. In theory, Orbis could handle hospital financials, but Agfa will have to prove they are capable."
Ziolkowski's skepticism over the financial module highlights the risk the hospital is taking on as a beta partner with Agfa. But his doubt is only partly about the software. "The U.S. reimbursement system is an animal of its own," he observes. The big challenge will be tailoring the financial software to handle to multiple rules and encumbrances of inpatient hospital billing.
Tangled payment rules aside, the CIO understands that Agfa has plenty of incentive to make its information system work. "If we fail, they fail," he says. "They're not in a hurry to push a product on us just to get it out the door to the market." Even if the development of the registration and billing modules goes smoothly, there will be plenty of other applications to fine-tune down the road. In later years, Sampson will tackle operating room and lab modules. In addition, the Orbis software could also accommodate the documentation needs of the physician clinic.
"We want to become an Orbis hospital," Ziolkowski concludes, ever mindful of the Herculean task ahead. "We are convinced it will become the premier EMR. It is a platform for the future. But it is tough to determine the end-point."