Three years ago, Grand Rapids, Mich.-based Metro Health, which includes a 208-bed hospital, began moving away from its "best-of-breed" philosophy, in which it used applications from a number of software suppliers. "We had been using lots of products from McKesson, products they had acquired, and we were trying to make their own products talk to each other," recalls Bill Lewkowski, executive vice president and CIO. In an effort to link up these disparate systems, Lewkowski bought an interface engine, from a vendor he declines to name. Every time the vendor upgraded the engine, Lewkowski's crew was obliged to rewrite all the interfaces. "We had a ton of them," the CIO says, "So we decided that integration trumps functionality." To replace its multiple legacy systems, Metro Health turned to yet another vendor, one offering the promise of an integrated suite of applications within a core hospital information system. The hospital is rolling out the suite of applications, having introduced ambulatory applications two years ago and just now beginning to automate the inpatient side. Yet, even this vendor cannot fulfill every documentation need of Metro Health, which racks up some 55,000 inpatient days annually. There's medication dispensing, a blood bank, and an automated nurse call system that still require specialty software - and interfacing. That's why Lewkowski replaced his legacy interface engine with one from Cambridge, Mass.-based InterSystems Corp. He won't disclose the price of the new system - Metro Health served as a development partner for InterSystems - but says that without it, many of the niche applications that feed into the hospital's core system would have limited value. Metro Health is using the interface engine to link up remaining components of its best-of-breed days to its hospital information system. It still runs a billing system from McKesson, for example, that it is about to jettison. In the meantime, the InterSystems technology is enabling Metro Health to capture surgery charges it once missed entirely, adds Jennifer Davis, senior programming analyst. According to Davis' analysis, Metro Health is billing an additional 10% in surgery charges simply because the manual data transfer once required to capture the services was too time-consuming. Despite his success with the new interface engine, Lewkowski takes a cautious view of what constitutes measurable ROI on hospital I.T. "We don't purchase systems with only a financial mindset," he notes. "First and foremost, we look at care. Integrated systems can bring clinicians more tightly together as a collaborative team. That is number one. We will measure ROI from a quality and care perspective." That's not to say Metro Health spends recklessly. It is looking for reduced transcription expenses and improved productivity for nurses as two of several measures of its ambulatory/inpatient network. "I need to strike a balance between quality and financial ROI," Lewkowski says. "I have the CFO on one arm and the CMO on the other." This article can also be found at HealthDataManagement.com.
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