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11/18/2009
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EMR Adoption Earns Hospital High Score

Achieving its high level of electronic medical records adoption has taken small Maine hospital five years.

A small hospital in Maine is among the top healthcare providers for adoption of electronic medical records, according to an organization that studies healthcare IT.

Parkview Adventist Medical Center, in Brunswick, is one of only 69 hospitals in the U.S. and Canada to score a 6 on a 0-7 scale for EMR adoption, in an ongoing study conducted by HIMSS Analytics, a not-for-profit subsidiary of the Healthcare Information and Management Systems Society (HIMSS). HIMSS Analytics looked at 5,836 hospitals total.

The rating indicates that the 55-bed community hospital is "pretty much all paperless," said Bill McQuaid, CIO and assistant vice president of Parkview Methodist. Nurses are communicating and documenting electronically, physicians are doing computerized physician order entry (CPOE), and ancillary systems like pharmacy, radiology, and labs are electronic.

Achieving the current level of EMR adoption has been a five-year process. In 2004, when McQuaid joined the hospital, it had a best-of-breed approach to adopting EMR systems, leading to a variety of different, incompatible systems in different departments.

"One of the biggest challenges I had was trying to get all these different things to talk together," McQuaid said. Many of the products the hospital relied on were being sunsetted by the vendor, leading to a need to transition to new systems. Vendors told him he needed to upgrade to a different version to achieve interoperability, which required new Oracle licenses, or hardware upgrades, or doing business with a new company because the old vendor had been sold, or overcoming other obstacles.

"I looked at what we were currently spending and told [hospital management] we could save money by going to a single vendor," McQuaid said.

The hospital selected Meditech as its single vendor. "We picked them because they were truly one of the few vendors out there that had a solution for every aspect of the hospital," McQuaid said. He liked that the vendor had 22 hospitals using the product, did not require customers to pay for training.

McQuaid also liked that Meditech offered the same product to hospitals of all sizes. "The product they offered me as a 55-bed hospital is the same as a 1,000-bed hospital. I didn't want reduced functionality. What you have to build is no different if you're two beds or a thousand beds."

The consolidation allowed the hospital to reduce staff -- from about 340 full-time equivalents in 2004, to about 295 currently. McQuaid has a six-person IT department, with no outside consultants.

McQuaid said he could not provide a precise measure of what spending was previously, because one of the changes was to consolidate IT budgets from other hospital business units into the central IT organization, so that he could more easily keep track of spending. Also clouding hte issue: The hospital acquired six medical practives since 2004.

The hospital is on track to win the federal funding set aside in the U.S. American Recovery and Reinvestment Act of 2009 for meaningful use of IT technology in 2011 -- 2015, McQuaid said. The hospital expects to receive $3.7 million of incentive money over those four years.

Parkview Adventist is working on sharing data with other facilities, including neighboring physician practices, larger hospitals, and Maine's Regional Information Exchange for EMRs, under construction.

Parkview serves an upper-middle-class community, which includes Bowdoin College, and a military base.

McQuaid previously worked in information technology at retailer L.L. Bean, and he selected a team from outside the healthcare industry. "I wanted a can-do positive attitude. When I went around researching, people said you can't do it. I wanted to shelter the hospital from all this negativity," McQuaid said. Even Meditech said they had never seen anyone implement their entire suite in two and a half years without outside help.

But McQuaid avoided using outside consultants. "Everything changes fast in healthcare. If your own people can't manage, IT consultants will take your money," he said. Regulations and care measures are constantly changing. "You need expertise in-house," he said.

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