Eastern Maine Medical Center, the recipient of the 2008 Davies Award, is responsible for the care of two-thirds of the 33,414 square miles of the easternmost state, with the Atlantic at one side and Canada at the top.
EMMC, a 411-bed tertiary care hospital, is part of the seven-hospital Eastern Maine Healthcare System that covers central and northern Maine. It is the referring hospital for 21 hospitals in rural Maine.
It's not EMMC's geographic sweep that landed it the Davies Award, but rather the depth and breath of how hospital leaders - indeed, everyone - uses information technology to achieve excellence in patient care.
David Collins, who heads the Davies Award committee for the Healthcare Information and Management Systems Society, says EMMC has taken some inspired approaches to care.
"Maine is a rural state, so access to care is somewhat of a challenge," he said. "For EMMC necessity is the mother of invention."
He ticks off a list of the standout endeavors:
- A teletrauma program that provides a live feed to consult with trauma cases across the state.
- A virtual ICU - a grant-funded pilot that EMMC plans to expand. Nurses sit at computers and serve as supplemental staff to the hands-on floor staff in the unit. Cameras zoom in on patients' ID bracelets to confirm identity.
- A pediatric ICU with cameras in the unit and in the intensivist's home so the doctor can consult from home.
- A sophisticated regional PACS system.
- A CPOE system that has gained the hospital many efficiencies.
The way they have been successful is to establish a project management office, Collins said. "They have figured out the process and that's the win right there."
Another element for success EMMC can boast, says Collins, is "great leadership."
For EMMC's Chief Medical Information Officer Eric Hartz, MD, and CIO Cathy Bruno, who lead a large team of people who help drive innovation at EMMC, healthcare IT is a project that's been under way for years and one with no true end in sight.
Any undertaking of this magnitude requires a look into the future, and as Hartz remembers it, the foresight started sometime around 1993 with then CIO Dev Culver.
"He's the person who started the vision," Hartz said, "the vision of where we were going. He really bought into it." Not only did Culver, who now heads Maine's health information exchange effort, buy into it, but also he brought other executives on board.
Fifteen years ago it was hard for those C people to understand how informatics could transform healthcare, Hartz said.
There was never a question that EMMC would implement a CPOE system, Hartz said. The only other places in the country to do so in those days were the large academic centers.
EMMC's clinical information system is Cerner Millennium application suite. It has an Agfa PACS, and the primary care physician offices use the GE Centricity electronic record system.
According to the application for the Davies Award, it took six years to implement at a total cost of $27 million and ongoing annual costs of about $8.8 million.
EMMC employs IT to monitor and measure most everything that's done at the hospital - and at its ancillary physician offices.
"Another thing we stand out in is using the information," says Bruno. "We record for day-to-day patient care (to make sure the right antibiotics are used, fir instance), "but also we measure to become better."
