A recent visit to a small hospital just a couple of miles from my home opened my eyes to how much can be accomplished on the health information technology front even with modest means.
At Parkview Adventist Medical Center in Brunswick, Maine, I met with the CIO, Bill McQuaid, who is clearly proud of what the 55-bed hospital has been able to get done with an IT team of six. I also met with CMIO Lawrence Losey, MD, who manages to balance a busy pediatrics practice with his IT role at the hospital.
McQuaid and Losey work in tandem to make happen what might seem to others impossible.
Parkview serves Brunswick, with a population just a smidge above 15,000, surrounding - mostly coastal - towns and the City of Bath, with a shipyard that builds high-tech war ships. MidCoast Hospital is also located in Brunswick, not much more than a mile up the road from Parkview. The competition between the two hospitals is legendary, evidenced by "Take me to Parkview" bumper stickers. But that's another story.
McQuaid, who worked in IT at famed outdoors outfitter L.L. Bean, came to Parkview in 1999 with a can-do attitude. It never left him.
"At Parkview, I feel we're ahead of the game," he said when I asked him about meaningful use. Like many other community hospitals across the country, Parkview has a Meditech electronic health record system. To date, Parkview has collected government EHR incentives for Stage 1, and he expects to be fully ready for Stage 2 by Oct. 1, 2013, with attestation scheduled for January 2014.
"Everything we've done here at Parkview, we've done with our own staff, McQuaid says. We use no outside consultants."
As CMIO, Losey serves as liason - he calls it interface - between the IT techies and the practicing physicians, smoothing the way for projects, and taking physician concerns and problems back to the IT team.
A champion for IT?
"I'm a champion for healthcare improvement, and technology is a fabulous way to improve the quality of healthcare, the accessibility of healthcare, the repeatability of healthcare, the efficiency of healthcare," he said.
CPOE and clinical decision support are part of Stage 4 on the HIMSS Analytics adoption model. It's a piece that is especially tough for many hospitals, HIMSS Analytics Executive Vice President John Hoyt told Healthcare IT News Managing Editor Mike Milliard (Page 31). Hoyt also noted "astonishing" growth in the number of hospitals achieving Stages 5, 6 and 7 in the past year, but at the "upper-end." Critical access and rural hospitals lag behind.
CPOE is what McQuaid calls "a no brainer." At Parkview, everyone is onboard.
Parkview rolled out its Meditech EHR in 2004. By the time meaningful use came along, Parkview was well positioned. The implementation may have cost millions, but the system that serves both the hospital and physician practices, had already paid for itself in efficiencies.
McQuaid says Parkview, to date, has collected $3 million in meaningful use incentives on a $320,000 investment.
When he came to Parkview in 1998, the hospital did not even have email and there were only about 20 PCs scattered about.
"I thought, there's so much I can do to help them out," he said. "I thought all hospitals were fully electronic."
"We didn't realize what we were doing until we became the 26th hospital in the country to make HIMSS Anyaltics' Stage 6," he said. It was then that McQuaid realized, "we are doing something unique over here, and we we're doing it with our own staff."
My takeaway? Parkview shows that small does not have to be an impediment. I've heard so often that IT comes easy for the Kaisers, the Intermountains, and the Mayos of the world because they have so many resources. We all know, though, that for IT to work, for data to be shared, for transformation to occur, everyone - big, small and in between - must play. McQuaid's best advice? "Keep it simple."
