One-on-One with Parkview Adventist Medical Center CIO Bill McQuaid, Part I

June 17, 2009
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McQuaid talks about what it takes to steer a small hospital toward Stage 6 recognition.

Parkview Adventist Medical Center is a 55-bed, faith-based community hospital located in Brunswick, Maine. It has been serving the healthcare needs of the residents of midcoast Maine since 1959. Affiliated with the Seventh-day Adventist Church, Parkview is one of about 70 acute care Adventist hospitals in the United States and about 200 worldwide. Earlier this year, Parkview became one of 24 hospitals nationwide recognized by HIMSS Analytics for achieving the Stage 6 award. Recently, HCI Associate Editor Kate Huvane Gamble spoke with Assistant Vice President and CIO Bill McQuaid about what it took to realize this accomplishment, his plans going forward, and the importance of involving clinicians in discussions and making it as easy as possible for them to access patient data.

KG: A few months ago, Parkview became the smallest hospital to earn the HIMSS Analytics Stage 6 designation. How did you get this whole process started, and what were you looking at when you first started at Parkview?

BM: When I started nine years ago, I actually came here as a network administrator. They just had the bare minimum — your simple lab, radiology, pharmacy, registration and billing and materials management. They didn’t even have e-mail.

Four years later, I started taking over. But I was the guy supporting all those interfaces and trying to make things talk, and I kept thinking to myself, this doesn’t make any sense at all. I’m hearing all this talk about what people want in the future, and thinking, there’s just no way this is ever going to happen in this scenario. Well luckily for us, things started coming off maintenance. Vendors were being acquired by other vendors, so we had to make a decision. So with the hospital in 2004, we decided to go single-vendor. I said, I could do this with myself and with a small team, but it has to be one vendor, so that I can use my same good people throughout the whole project.

KG: Which vendor did you choose?

BM: We went with the Meditech client server.

We buy every module they sell — we’re even doing HR and payroll, scanning and archiving, physician practices. The only thing we don’t have that they sell is long-term care, because we don’t do long-term care at our facility. And every module they sell we have live.

KG: Are you doing CPOE?

BM: We are at about 60 percent. We’re 100 percent in the ER, and a little over 50 percent in the hospital, on the in-patient side. And in the last few months, a lot of our doctors started to do all their own documentation as well.

KG: Was it a situation where clinicians were on-board from the beginning, or did it take some convincing?

BM: Actually, it went really well for us because all of the success we were having with the doctors. Back in 2005 we made it so that everyone had to go e-sign. The docs were all starting to utilize the EMR, so when all that success happened, we were kind of getting pressure from the docs, saying, when are we going to go?

And CPOE is a funny story. I had two doctors that agreed to be my first go-lives; one was our hospitalist and one was an internal medicine doctor. Well it just so happened that on the week we were going to go live, one had to go away for a family emergency, and the other forgot they were going to be on vacation. So our most seasoned doctor — who has been there forever and is over 70 years old and said he’d never use a computer — came up to me and said, I’ll go first. He was live that day and hasn’t stopped since.

We were all in a frenzy, and he stepped in and things just came together. What are the odds that would happen and this guy would come out of the woodwork?

KG: That’s pretty amazing. I guess you just can’t predict what’s going to happen in these situations.

BM: Exactly. Now the reason we’re not at 100 percent is we don’t have a full-time hospitalist program, and some of our doctors only call one in every three months. I don’t have the staff for someone that can just get them in there and work through the bugs. But we’ve actually just started what we’re calling an HCIS Physician Advisory Board. So a bunch of the doctors will meet monthly, and just by forming that group and getting the doctors all talking together, we saw our numbers go up four percent.

A lot of the doctors see the benefits that others are realizing. They see how it makes their lives easier. So now our problem is figuring out how to get support for the doctors that want to go live that aren’t here at the hospital.

KG: How is that going to work?

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