Parkview Adventist Medical Center is a 55-bed general acute-care hospital that sees about 1,200 annual admissions, receives about 12,000 emergency-department visits each year, and performs about 2,000 to 3,000 surgeries annually. As with many hospitals in the United States, Parkview has witnessed an increase in bad debts, with more uninsured and underinsured patients than before.
But despite its size and challenges, Parkview has made a firm commitment to technology. In fact, it was one of the first hospitals in the country to apply for and receive stimulus money for meaningful use. The hospital then met the criteria for meaningful use phase 1 in early 2011 and received $1.7 million for that achievement.
Currently, the phase-2 requirements have been released by the government, but the final ruling on those criteria has not been issued. Parkview, however, is prepared to meet those requirements when they are finalized.
“We are looking at all the different stages, and what we are doing is gearing the hospital to meet those measures when they are at a much higher standard,” Bill McQuaid, chief information officer, said, adding that they’ll probably receive all of phase-2 money on year-one requirements.
The hospital, he added, is “ramped up” and ready for e-prescribing and the patient portal. Furthermore, Parkview’s CPOE utilization is almost 100 percent for phase-1 standards.
Integrating a vision
Before McQuaid became CIO in 2004, Parkview had been using a best of breed approach to technology, meaning that every single department, from pharmacy to labs to radiology, was utilizing different software on a different platform, while also trying to interface with each other.
McQuaid started to look at the cost of switching to a single vendor. He did a side-by-side cost comparison on one platform versus multiple platforms.
“What it showed is if we switched to a single-vendor solution, the product would literally pay for itself just on what we saved in maintenance alone in five years,” he said.
Parkview eventually settled on Meditech and saw an immediate savings.
“For us, all of a sudden we go to a paperless environment with our physician practice being fully integrated and having one EMR and only paying $130,000 compared to having really nothing, the bare minimum, and paying $386,000,” McQuaid said.
Implementing high-tech solutions
In addition to the EMR, Parkview has implemented other systems in its quest to stay at the forefront of medical technology. The hospital has partnered with Imprivata, an IT security company that provides a fingerprint log-on that shuts down within a few seconds of the user backing away, increasing the privacy of medical records.
In early 2012, Parkview also began the implementation of a patient-monitoring system for cardiac patients with the plan to go live in May 2012. The system, by Nihon Kohden, features wireless telemetry monitoring designed to improve clinical workflow. The devices monitor ECG, respiration, and blood-oxygen saturation. Parkview is the first hospital in Maine to use this new product.
Parkview also plans to upgrade its imaging department with new MR and CT technology, as well as furthering its use of the EMR and other IT products. It will be installing the OrthoView PACS system and also offering an iPad app for physicians to access radiology images.
In implementing all of this change, McQuaid said the biggest challenge can be convincing physicians to go along with the upgrades. To aid in this, Parkview has a physician-advisory board with five or six physicians on it who are progressive with technology and who can communicate to the other physicians the benefits of upgrades.
Ultimately, the physicians, not IT, are the ones who decide whether the upgrades will be mandatory. Having a chief medical information officer (CMIO) to act as an emissary helps with this, McQuaid added.
“We prove that we’re there for them, to make it as easy as possible, and a lot of it just has to do with having a lot of communication with a physician,” he stated.
Improving quality and safety
Parkview’s technology has enhanced the hospital’s quality and safety initiatives as well. In the third quarter of 2011, the hospital reached 100 percent on all CMS Core Measures.
Parkview was able to attain this, McQuaid said, by combining IS staff with the clinical staff and collaborating with nurses and physicians on templates built around the core measures.
As a result, Parkview has been ranked the number-one hospital in Maine for medication safety administration. The hospital was also the first in the state to offer bedside medication verification.
To further improve on quality and safety, Parkview uses a software program called IHM to mine data related to core measures and other quality indicators. This software provides the quality department with a report every morning.
Parkview is also positioned to institute a patient portal that will allow patients to log into a website and get all of their clinical information remotely.
“They’ll be able to see their problem list and all the medications that they’re on,” McQuaid said. “This is going to put a lot pressure on the physicians as well because they’re going to have to cross their t’s and dot their i’s.”
Importance of optimism
It’s vital, McQuaid said, that healthcare professionals approach these changes positively. As Parkview has shown, this technology, if implemented correctly, will improve an organization’s operations.
Although he’s never noticed anyone saying that EMRs speed up a patient’s visit, he and the physicians have noticed better reimbursements, especially with relative-value units (RVUs) and compensation.
“We used to be a strip mall, meaning that you have this mall, but every single store operates a different way,” he stated. “What we decided to be is a Super Walmart.”
Parkview has achieved all of this, McQuaid emphasized, without any consultants and with an IT staff of six.
“All of my IT people have been trained in-house,” he said. “All I need is a positive, can-do attitude.”
-by Patricia Chaney and Pete Fernbaugh