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: I would imagine giving clinicians that kind of secure remote access can really help to improve satisfaction.
BM: It shows them we were listening. We brought all the physicians in to talk about their concerns, and we wrote down all their notes. We reconvened about two months later and I had the demo ready. They came in and saw it and were like, wow. That got them really excited.
But then we didn’t just go out and let them have what they wanted. They had to sign up and go through a training course. And what we did to make it even better is I had someone from IT who was enrolling them. Because if you do it right the first time, you don’t have to do it again. Your fingerprint doesn’t change. We educated them on the technology, and it was a win-win. It’s funny — they associated this with the whole project. It got the momentum going and helped build excitement.
KG: That’s a very effective strategy. So what’s next for Parkview? What are your plans for the near future?
BM: We’re fully paperless now. What I want to do next is take all of our data and merge it. With all the physician practices surrounding us that aren’t part of the hospital, I want to integrate them into our system so that we’re feeding them all of our labs electronically.
We’re also doing e-prescribing; we have one doctor live on that. That’s becoming pretty big. Actually, the federal government is reimbursing you more if you’re using that technology. So when our doctors order from our clinics, it goes directly into the (pharmacy) system. And they get a result back when they receive it. We’re hoping to have all of our physician practices live on that by the end of the year.
Another thing we’ve done is we’ve put together an advanced clinical team. Now that you’ve done all this, it’s very important to regroup and report back on what’s working and what’s not, and revamp a lot of the assessments. We don’t work with managers anymore as much as the users. We use them to help revamp and make things better, more efficient. We’re starting to look at where the quality measures are, and taking what we’ve done with our IT system and really improving a lot on our clinical indicators and our quality of care. I think we can improve quite a bit. With the more doctors that get on CPOE, which is going up exponentially, we can look at evidence-based medicine.
What we’ve done now is, a lot of our order sets strictly go by our pharmacy sets, which are evidence-based, so when they choose an order set now, it’s already re-checking everything. If they want to uncheck something, they have to put a comment saying why they did it, and that helps us ensure better quality. We’re even doing that with nursing now for things as simple as giving out an aspirin — making them document why they haven’t done something that has to be done.
KG: It sounds like a lot of your focus is on coming up with more and better uses for the data that is being collected.
BM: It’s about getting all the different groups to work together and utilize this technology that we have now to improve patient care. It really can make a huge difference. I think we’ve been number one four years in a row now in medication safety in the state of Maine.
It’s worked out really well. People say Meditech isn’t good at this and that — no one’s perfect at everything. But as a whole, you can’t beat it. I have physicians that come to us every day and say, I thought this was going to be awful. But when they see the overall picture, they don’t even notice that this takes three steps more than another. You have to look at the big picture at the end and that’s kind of what our visions was — what it’s like for the whole hospital, not just these independent areas. You have to think of it as the whole. Even the physician practices, I’m glad we integrated that into the practice as well, because now there is one EMR for all the practices and the hospital.
KG: That’s the tricky part, and it seems that the key is to tackle that early on.
BM: Exactly. It’s that integration that makes it what it is. What I’ve noticed a lot is a people go to the physician practice way more than they go to the hospital. Well now, every time they make a change in insurance, or if they change their address, it just flows right over to the hospital. It’s constantly being updated.
KG: I think that sums up the vision every CIO has.
BM: When we got our award and they told us we were stage 6, I said, I thought everyone was doing this. I thought, we were way behind the times, why are we making this so hard? I didn’t realize that’s what 90 percent of the people are doing.
Only 24 hospitals are stage 6 out of 5,166. Our CEO couldn’t believe it when he was sitting there with all the other CEOs at the bigger hospitals. He was all excited, because we are so small. A lot of people don’t realize what they have; a lot of people have been there a long time at Parkview, and they take it for granted that this is how it is.
KG: It really is impressive — there are large health systems that are nowhere near where you guys are.
BM: We have nursing students come in now. People don’t realize when I started there we had the most seasoned nurses you’ve ever seen, and now when you go through the halls, you can see that mix. They come to student-teach here. They’re used to computers; they want that. So we have a much better mix now. For the younger docs, computers help their quality of life because they’ve grown up with them. This is what they want. So it makes us attractive in that sense as well.
We’re pretty excited. A lot of what we’re doing now is revamping what we’ve done and looking at quality indicators. It’s one thing to get it implemented; it’s just as hard to get in there and just keep making it better and better.
Part III coming soon