There's no clear winner in hospital information systems

Pharmacy directors looking for the perfect hospital information system are in a bind. There are computer systems that are strong in business management, systems strong in laboratory or imaging or medical practice management, and systems strong in pharmacy. But no system is strong in every area.

"This is a very challenging and complex area," said Jason Hess, business development director for KLAS Enterprises, which reported on comprehensive pharmacy information systems late last year. "GE Centricity leads the way, according to pharmacy directors and other providers we surveyed, but no one product has all the answers."

KLAS surveyed more than 300 hospital executives to create a snapshot of the pharmacy information system world based on 40 different indicators. The 2004 report showed improvement from 2003, but KLAS concluded that pharmacy information technology remains challenged.

Overall, Hess said, pharmacy system vendors scored below the KLAS health information technology (HIT) norm of 77.5 for overall performance.

In the small, under-200 bed category, only QuadraMed exceeded the HIT norm, with a score of 81 on a 100-point scale. The other top scorers, CCA (67.1) and McKesson (67.2), fell below the HIT norm. Among larger hospitals with more than 200 beds, only GE Centricity Pharmacy beat the HIT norm. And despite placing best in the category, GE's score dropped from 81.6 in 2003 to 78.4 in 2004. The other top four vendors in the large hospital category, Siemens, Cerner, Mediware, and McKesson, all improved their scores in 2004.

The basic problem, Hess explained, is that every vendor has different strengths. GE, for example, has a robust imaging system but is weaker in other areas. Mediware is best known for its laboratory and surgery management modules. Neither system has an integrated pharmacy system, he added. That makes both vendors a tough choice for pharmacy directors, even though they score well in other areas. As hospitals move toward CPOE, pharmacy integration is becoming the vital piece, he added.

More than a third of KLAS' 304 survey respondents were hospital pharmacy directors. Other major groups included corporation information officers, pharmacy managers, information systems managers, and information systems directors. Overall, 48% of the panel were pharmacy execs.

"The KLAS people do an even-handed job in the evaluation," said Tom Ward, director of pharmacy at Katherine Shaw Bethea Hospital in Dixon, Ill., and a KLAS respondent. "They talk to people who actually use the products to get at the genuine strong and weak points. All of the systems give you 75% to 85% of what you really want. Nobody is really on top of it all."

One reason no single manufacturer has been able to beat the market is that market demands keep changing. Not long ago, Ward noted, CPOE was seen as a minor component that looked good in theory but was not ready to roll out at the ward level. Today, COPE is a vital function. Bar-code capability will be the next big change, he predicted.

At this point, according to KLAS, CPOE is just starting to make significant inroads. More than 90% of respondents still enter pharmacy orders from paper. A few hospitals have gone live with CPOE, including 11% of Mediware users. Nearly 70% of hospitals reported that CPOE has been prioritized for implementation within the next two years, and 78% said their current vendor already supports CPOE.