On WORx

Two weeks ago, I received a crash course on WORx from my manager Rick. It was so interesting that I decided to recreate part of it here. For you, Dear Reader.

Inpatient patient data originate with ADT: admission, discharge, transfer. This information is sent to WBI (an interface engine), which converts the data to a form that all systems used by all hospital departments can understand. In pharmacy, WORx takes in the processed data. WORx is the inpatient pharmacy management program that supports dispensing, billing, and clinical activities. When physicians write new prescriptions in CareLink (digital prescriptions), the orders are transferred directly to WORx. WORx also keeps track of the formulary. You can consider the formulary a list of most-used drugs, with complementary drug data (names, strengths, indications, etc.) pulled from First Data Bank. In particular, the drug ID or "master code" is taken from First Data Bank, and it is saved as "product code" in WORx. An IT digression... With any kind of database (the formulary is a database), we want the item ID to be unique. Inconveniently, the drugs in First Data Bank are not sorted by manufacturer or package size. Two otherwise identical products with different manufacturers or packaging share the same master code in First Data Bank and will therefore get assigned the same product code in WORx. ID promiscuity makes housekeeping difficult. The solution? In case of duplicates, we append additional digits to the master code before storing it as product code.

With patient data from WBI/CareLink and drug data from First Data Bank, WORx is set to manage inpatient pharmacy. It is involved with labeling, documentation, and providing clinical checks. It also supplies information to other systems. Some examples:

• Health Quest is the hospital billing system. WORx provides pharmacy information for prospective billing.
• The Robot packs drugs. WORx dictates which medications and how much.
• Omnicells supply medications to nurses directly. WORx sends over the orders so that narcotics (for example) are not withdrawn for unauthorized purposes.
• CareWeb is a browser-based program that displays patient lab results, etc. WORx drops information there.

This is by no means an exhaustive summary of WORx. There is so much complexity and beauty in the system. I'm almost sorry that it will soon be replaced by Epic. Although Pete, my coworker who works with WORx most extensively, might disagree.