MaineGeneral Health

Source: Healthcare Digital

Date :02/07/2007 16:32:46

MaineGeneral Health is seeking to reinvent the way it provides healthcare by immersing itself in the technology revolution

Written and produced by James Buchanan & Thomas Venturo

If you think of healthcare as comprised of three categories – ailments and injuries, the treatment of those conditions, and the system of paying for those treatments – all three of these elements have been touched by the technology revolution.

We can diagnose to a more precise degree common and uncommon ailments, doctors have a plethora of new regimens to treat and cure these ailments, and the bureaucracy of paying for those treatments is quickly becoming a paperless exercise.

Adoption and acceptance of the indomitable sweep of technology is by no means universal in the healthcare industry, but it is unavoidable.

For MaineGeneral Health, a semi-rural healthcare provider in central Maine, systemic integration of technology is a continuum it has fully embraced.

“This is really a transformation from a business standpoint and, importantly, from a clinical standpoint,” says Kash Basavappa, senior vice president and CIO of MaineGeneral Health. “We will have reached certain milestones in our current strategic technology plan relatively soon, but I see this as just a beginning and not an end.”

According to Basavappa, MaineGeneral Health is the parent corporation of a network of acute care hospitals, physician practices, rehabilitation centers, long-term nursing care, and assisted living and retirement communities. All of the entities are non-profit and are governed by a board of directors.

“Basically, we are an integrated healthcare system located up in central Maine, with approximately 3,600 employees and our primary reach is the Kennebec Valley,” he says. “And our mission is to provide comprehensive care to our patients in this region.”

MaineGeneral Health’s facilities are located in the communities of Augusta and Waterville. Both campuses provide a full range of care that includes emergency, medical/surgical, maternal and child health, and inpatient/outpatient diagnostic services.

In total, the organization services 578 beds, has annual admissions of 13,600, provides $5.5 million in annual charity care, and has net operating revenues of $296 million.

The organization has also recently added an oncology center that Basavappa says is regionally focused to serve patients throughout Maine. The center provides medical, radiation and surgical oncology services.

Basavappa is clearly most enthused by MaineGeneral Health’s technology plan. He paints its adoption as a transformation, which is a word he puts great emphasis on - as it aptly describes what he and his organization are trying to do, which is use technology to transform everything from business operations to patient care.

“Over the past six years I have been here, we have put together a strategic information technology plan to put MaineGeneral as one of the leading technology driven health services provider in the state of Maine,” he says. “From an administrative and financial standpoint, we are looking at how to better attain efficiencies through financial and materials management software, ERP [enterprise resource planning] software called PeopleSoft by Oracle, which automates our entire general accounting and supply chain workflow processes from a management standpoint.”

Implementation of the system is ongoing, says Basavappa but has already streamlined workflows and automated business transaction processing.

“Implementation so far has reduced turn-around times on inventory and allowed us to transition to a just-in-time inventory system, which has minimized costs, reduced paper use, vendors are getting paid in a faster time period, there is faster throughput, and tracking and reporting on these transactions is better,” he says. “The critical question we asked ourselves when implementing the system was; how do we look at doing things better at MaineGeneral in terms of improving efficiency.”

Basavappa adds that the users of these systems work interactively with the applications.

“A department manager ordering supplies can go to a Web-based product and order them directly rather than filling out a form and having to wait for the supplies to be ordered,” he says. “The turnaround time of the actual delivery is faster, because we have reduced the number of handoffs and reduced the amount of paper used, which reduces total cost.”

The implementation of new technologies has been no less transformative on the clinical side as MaineGeneral is in the process of implementing a clinical information system for all of its campuses.

One key component of the system is to create an integrated electronic inpatient medical chart/record at the MaineGeneral’s hospitals and acute care clinics. The system they are using is Sunrise Clinical Manager by Eclipsys.

The system will place everything that was contained on a manual chart – think of the stereotypical notebook at the end of a patient’s bed – into an electronic computer-based format. The intent is to help clinicians better track and treat patients through the inpatient setting.

“As part of the implementation, we are deploying point-of-care devices in each patient’s room,” says Basavappa. “These are PCs mounted in the patient’s room so that the clinician won’t have to carry a chart. They will be able to look up a patient’s information while they are in the room interacting with the patient.”

Basavappa plans on evolving the system to include hand-held devices connected to MaineGeneral’s wireless network.

“The new charting process also includes evidence-based guidelines, which were developed using the best care practices by experts in the various fields, which includes oncology, cardiology, and so on,” he says. “These are documented during the charting process and are essentially notes to the clinician of issues related to a particular patient that he or she should be aware of.”

The intent is to improve on the quality of care provided by MaineGeneral, while reducing the potential for medical errors, adds Basavappa.

“The system will notify a clinician of a drug contraindication, which improves patient safety and leads to reduced costs to the hospital, clinician and patient because a possible issue has been averted,” he says. “I can’t think of anyone else in the state, and very few in the nation, that are using knowledge - based charting and alerts.”

While the above relates specifically to acute/hospital care, MaineGeneral is also integrating technology into the ambulatory side of the equation.

One such system being deployed by MaineGeneral is an ambulatory electronic record of care called TouchWorks by Allscripts. This system is designed to track and chart patient visits to all of the organizations physician practices. The intent is to create a paper-less environment with clinical decision support tools to assist practitioners achieve positive outcomes for patients.

“There is also a knowledge-based component where information is given to the doctor and the patient on the patient’s care,” says Basavappa. “The big piece is that we are trying to create a common health record where the majority of practitioners in our region, if they adopt this product, will have access to all of the information regarding a particular patient.”

He adds, “We will be one of the very few organizations creating a community-wide health record.”

In fact, according to an internal publication put out by MaineGeneral titled “MaineGeneral IT: Transforming Healthcare for the People of Kennebec Valley,” fewer than 10 percent of U.S. hospitals have implemented health information technology and only 16 percent of primary care physicians have.

MaineGeneral is also working to implement a series of other IT initiatives, which includes picture archiving and communication systems (PACs) to allow clinicians easy access to medical images; bed tracking and patient placement to keep better track of the status of all of the beds under their watch; remote homecare patient monitoring; Self - service tools for employees, and an Enterprise Master Person Index (EMPI) by Initiate Systems to create a unique patient ID upon registration tied to the information regarding a specific patient.

Basavappa concludes, “This is only the beginning for MaineGeneral and we want to continue to implement tools that will better facilitate patient care delivery and improve overall business operations.”