The Holy Grail of acute care clinical data repository, orders and charting systems is the integration of the clinical use of data, said Kent Gale, president of KLAS. The good news is that technology is responding to bottlenecks in rapid fashion. Vendors have already addressed the need for an end-user focus. Building integrated components, as opposed to interfacing various components, is the current challenge, but one that will likely be solved in the near future. The ranked list for acute care clinical data repository, orders and charting is based on KLAS’ Top 20: 2006 Mid-Year Report.

Epic

EpicCare Inpatient Clinical System

KLAS Rank No. 1

Features: EpicCare streamlines and transforms hospital-based care while increasing efficiency and reducing medical errors. It gives the care team access to targeted patient information and intuitive features, including CPOE, nursing documentation, workflow management, electronic medication administration record with barcoding, care planning and patient education. Configurable Navigators guide clinicians through admission, rounding, transfer and discharge workflows, and flexible decision support promotes best practices. EpicCare Inpatient shares a single underlying database with Epic’s other applications, providing seamless integration without interfaces.
How integrated is your solution from physician order to nurse administration of medication? EpicCare Inpatient and Epic’s EpicRx Pharmacy System provide a completely integrated solution for medication ordering, verification and administration. EpicCare and EpicRx use a shared database, where order re-entry and interfacing is unnecessary, decision support rules are consistent and each medication is represented by a single order record accessed by physicians, pharmacists and nurses.
What percent of your installed client base has CPOE implemented and live? Of the clients live on Epic’s acute care order entry functionality, 50 percent are performing computerized physician order entry.
Has your market share increased in the last three years? Yes. While Epic seeks to grow its client base by building strong relationships with a small group of leading healthcare organizations rather than focusing explicitly on market share, the number of patients that will be covered by Epic’s clinical system when clients fully roll out has increased significantly in the last three years.

McKesson

Horizon Expert Orders and Docs

KLAS Rank No. 2
Features: The Horizon Expert Orders software solution was created by clinicians for clinicians to specifically address the common barriers to physician adoption of computerized physician order entry, focusing on the clinical decision-making process instead of order entry. McKesson’s Horizon Expert Orders solution features proven clinical content driven through a simple clinical interface and intuitive workflow that supports the way physicians practice medicine.

Cerner

Cerner Millennium PowerChart, PowerOrders, CareNet

KLAS Rank No. 3
Features: Built on the unified Cerner Millennium architecture, Cerner solutions combine technology with knowledge to deliver the vital data needed for effective, real-time decision-making. Cerner PowerChart creates an enterprise-wide, multi-facility, longitudinal electronic medical record. Care team members chart once from any location and then view the chart anywhere. Always up to date, always easy to find and always complete, Cerner solutions enable the care team to plan, orchestrate and document optimal care.
How integrated is your solution from physician order to nurse administration of medication? Cerner’s clinician-designed electronic medical record (EMR) resides on Cerner Millennium architecture, which unifies the complex physician-pharmacist-nurse interactions inherent in ordering, dispensing and administering medication. Simplifying communication saves time and helps eliminate errors.
What percent of your installed client base has CPOE implemented and live? Cerner leads the industry with 106 live acute-care CPOE sites at 57 facilities and 371 live ambulatory CPOE sites at 29 client facilities.
Has your market share increased in the last three years? Yes. According to the KLAS 2006 Clinical Market Share report, Cerner Millennium leads the U.S. CIS market for all hospitals with 200+ beds among currently marketed solutions, with 25 percent market share.

Misys Healthcare Systems

Misys CPR

KLAS Rank No. 4
Features: Misys Healthcare Systems delivers enterprise clinical management with our computerized patient record solution. Providing access to comprehensive patient information and decision support at all points of care, Misys CPR helps drive higher quality of care, cost control and successful outcomes. Misys CPR provides an integrated CPR with a suite of modules including: CPR, CPOE, Integrated pharmacy, radiology and laboratory, Clinical data repository, Automated nursing documentation, Automated medication administration, Document imaging and Physician Web Portal.
How integrated is your solution from physician order to nurse administration of medication? Misys offers integrated medication management through our Misys Pharmacy IMM product. Our solution is a patient-centered, integrated, browser-based pharmacy information system that manages every aspect of medication management – starting when the order is entered, continuing through dispensing at the Pharmacy and ending when the medication is administered to the patient at the point of care. Nursing, Pharmacy and Physicians use the same information for ordering, dispensing, verifying and administering medication, fostering improved communication and greater efficiencies. Misys Pharmacy IMM operates either as a departmental pharmacy system or as part of a more complete integrated medication management (IMM) solution that can include bar code medication administration (BCMA) and computerized physician order entry. The electronic medical administration record is integrated with the Misys CPR/Pharmacy IMM system for administration and documentation, which supports bar-code administration for positive patient identification and 5 Rights checking.
What percent of your installed client base has CPOE implemented and live? Fifty-nine percent.
Has your market share increased in the last three years? Misys CPR’s share of the computerized patient record market is growing at market rates. We believe the market is currently growing 15 to 18 percent annually.

Eclipsys

Sunrise Clinical Manager

KLAS Rank No. 5
Features: Sunrise Clinical Manager is an enterprise-wide advanced information solution that provides immediate and secure access to patients’ complete records, streamlining care processes and improving the quality and cost-efficiency of care. It features a state-of-the-art workflow engine, computerized physician order entry (CPOE), embedded evidence-based clinical content presented within context, and sophisticated interdisciplinary clinical documentation capabilities. The KLAS CPOE Digest 2006 documented that nearly twice as many physicians utilize an Eclipsys CPOE solution than any other vendor’s system.
How integrated is your solution from physician order to nurse administration of medication? With the release of Sunrise 4.5 XA in January 2006, Eclipsys delivered the industry’s first truly integrated, end-to-end medication management solution.
Sunrise Clinical Manager provides capabilities to manage even the most complex orders on a shared platform. Each caregiver involved – from the physician who places the medication order, the pharmacist who verifies and dispenses it and the nurse who administers it to the patient–shares a single clinical decision support system. This enables each clinician to work efficiently as part of a coordinated team that delivers medications safely and accurately.
What percent of your installed client base has CPOE implemented and live? Seventy percent of Eclipsys sites are live with CPOE. The KLAS CPOE Digest 2006 documented that nearly twice as many physicians utilize an Eclipsys CPOE solution than any other vendor’s system.
Has your market share increased in the last three years? Yes, Eclipsys’ market share is expanding. Overall spending by hospitals on IT is growing at 8 percent to 10 percent per year. Eclipsys’ revenues in the last three years have grown in the 21 percent to 25 percent per year range.

MEDITECH

Physician Care Manager (Client/Server)

KLAS Rank No. 6
Features: MEDITECH’s Physician Care Manager enables physicians to manage care for patient populations–in hospitals, emergency departments, physician offices, clinics, and more- through a single desktop portal, and provides fast access to the information and functions they use daily. Physician Care Manager also includes physicians’ lists of active patients; patient care records; Electronic Signature capabilities; CPOE functionality, including decision support; ambulatory ordering for departing emergency room patients; documentation tools; and Internet-based access to information.
How integrated is your solution from physician order to nurse administration of medication? Orders entered using MEDITECH’s CPOE automatically appear on the nurse’s Status Board and on the patient’s online Medication Administration Record in our Patient Care and Patient Safety software package.
What percent of your installed client base has CPOE implemented and live? As of March 2006, 112 sites were live with MEDITECH’s CPOE, or 6 percent of our client base.
Has your market share increased in the last three years? Our overall market share has increased from 21 percent of the U.S. Market in 2002 to 24 percent in 2005.

GE Healthcare

Centricity Enterprise (formerly IDX Carecast)

KLAS Rank No. 7
How integrated is your solution from physician order to nurse administration of integration? Completely integrated
What percent of your installed client base has CPOE implemented and live? Thirty-three percent of customers have CPOE installed from pilot to complete 100 percent roll-out and included ambulatory CPOE.
Has your market share increased in the last three years? Market share of CPOE customers has increased.

Siemens Medical Solutions

Soarian Clinical Access

KLAS Rank No. 8
Features: Soarian Clinical Access is a longitudinal clinical repository for the healthcare enterprise. Using the syngo common technology platform and user interface, the solution provides users with the ability to view patient histories, demographics, allergies, results and images from a single workstation. Leveraging a standard Internet browser, the solution supports any time, anywhere access to patient information. Soarian Clinical Access also provides census management capabilities and work lists that display new patient information as soon as it is available.
How integrated is your solution from physician order to nurse administration of medication? Siemens works with healthcare providers to create a “closed loop” medication administration environment, which automates workflow from the physician’s initial order to the nurse’s administration of medication at the bedside. Siemens Medication Management process includes physician medication ordering, clinical checking, drug dispensing, positive patient and drug identification at the time of administration (right drug, right dose, right patient, right time, right route and right documentation). Our solution automates, tracks, and quality assures the medication use process from end-to-end to help reduce the severity, frequency, and costs of errors. Interfacing Siemens Med Administration Check, Siemens Pharmacy, and Siemens Computerized Physician Order Entry (CPOE) solutions creates this closed loop process.
What percent of your installed client base has CPOE implemented and live? Siemens has a solid base of customers live on INVISION CPOE and Soarian Clinicals solutions. Some of these customers have been doing CPOE for multiple years. We ranked third in the KLAS CPOE 2006 Digest in the number of verified live sites and second with more than 50 percent of physicians doing CPOE at a site–this is what KLAS considers “active usage.” Soarian will continue to mature and expand on the number of sites and users established with our existing customer base. With the added value of Soarian’s workflow management system including tools such as the rules engine, process model analysis, workflow automation, output management systems, work lists and embedded analytics, it will set a “new bar” on what the key requirements of a CPOE solution are.  
Has your market share increased in the last three years? Yes, Soarian Clinical Access market share has increased in the last three years. According the HIMSS Analytics installed Clinical Data Repository database, Siemens Medical Solutions ranks third in market share for this space.