Customer Spotlight: Holyoke Medical Center Measures Up!

By:  Donna Carroll, Editor, The MEDITECH Community Bulletin

Several weeks ago, I had the opportunity to meet and visit with some of the kind IT folks at Holyoke Medical Center in Holyoke, Massachusetts.   Holyoke Medical Center (HMC) is a 220-bed acute care facility with approximately 1,200 employees, and a medical staff of more than 250 physicians. HMC serves a population of 180,000 in cities and towns around the western Massachusetts area. Annually, HMC discharges an average of 7,000 patients, and has an Emergency Department volume of approximately 45,000 visits. A full service facility, HMC offers a complete line of medical/surgical services, including Emergency, Critical Care, and an ultra modern Birthing Center. HMC is a member of Valley Health Systems in Holyoke.

A MEDITECH customer for over 20 years, HMC has long been considered a leader when it comes to MEDITECH, such as being the first site to use MEDITECH’s Point-of-Care eMAR software on pocket PCs back in 2007. They moved swiftly to implement MEDITECH’s Advanced Clinical applications, and have been LIVE with CPOE on their inpatient units since 2009. They later rolled out CPOE in their Emergency Department in March 2011. With HMC’s reputation of being a leading MEDITECH facility, it’s no surprise they’re one of the first MEDITECH hospitals to pursue Meaningful Use.

Meanwhile, in a hospital not so far away...

Meanwhile, approximately 130 miles away in eastern New York, another MEDITECH site was undertaking the same pursuit of Meaningful Use. Nathan Littauer Hospital & Nursing Home, in Gloversville, New York, is a 208-bed health care organization comprised of a 124-bed acute care hospital and an 84-bed residential nursing home. Although a good deal smaller than HMC, Nathan Littauer Hospital (NLH) is also a progressive MEDITECH site with the full complement of MEDITECH applications including Advanced Clinicals.

Tasked with implementing NLH’s Clinical Quality Measures, Moshgan Jones, Senior Clinical Applications Analyst, was researching the process when she saw a posting on the MEDITECH-L listserv. Andy Price, Programmer Analyst at Holyoke Medical Center, was sharing some information about how HMC addressed the requirements at their facility. From reading Andy’s postings, Moshgan sensed that Andy and HMC might be able to lend her facility some guidance. So, Moshgan initiated a conversation with Andy, which soon turned into a request to Carl Cameron, Director of Information Systems & Biomedical, for a site visit to Holyoke Medical Center.

Off to see the wizard

Soon enough, Moshgan Jones, along with NLH co-workers Georgeanna Dubois, RN (Clinical Application Coordinator), Jennifer Shwajlyk (Clinical Programmer Analyst, RN), and Tafhaim Quick (HIM Analyst), set out down the proverbial yellow brick road to see the wizard.

Sue Sullivan, RN, Manager of Application Services at Holyoke Medical Center, demonstrated how HMC designed their MEDITECH system to capture the various pieces of data required for reporting purposes. The design of their physician documentation process was ultimately a compromise between how much information providers were required to answer and how much information could be captured elsewhere from other MEDITECH applications. All potential answers to queries were built as group responses which are associated to SNOMED-CT codes. This forces the standardization of responses and collection of discrete data. For some queries, the list of potential answers is long, but it can be sorted to display as desired when used within the Physician Documentation (PCM) module.

Andy Price was responsible for implementing the SQL queries HMC uses to extract the data from MEDITECH’s Data Repository (DR). Although MEDITECH Inc. did create and provide the necessary SQL queries to customers, they are far from “plug and play”. Andy described to the group some general customizations required of the queries and then worked one-on-one with NLH’s Clinical Programmer Analyst to provide more technical details. In addition, Andy demonstrated how HMC uses Medisolv’s Indigo Dashboard for their business intelligence tool. The product provides easy-to-follow graphical displays of data so that management can quickly determine how they are measuring up against the various Meaningful Use requirements.

One absolutely critical piece to implementing the SQL queries to report on Clinical Quality Measures is validation of the data to ensure the queries factor in the appropriate patients and clinical data. This requires a group effort by a clinical applications specialist, an NPR report writer, and a SQL programmer. HMC actually spent approximately 2 months validating data retrieved via the SQL queries, prior to beginning their 90-day reporting period.

Carl Cameron, Director of Information Systems & Biomedical, also joined the group to discuss HMC’s approach and some of his concerns related to the requirements for Meaningful Use. Carl noted that one of the most important steps for any facility implementing major changes was to step back from the canvas to examine how such changes impact the users operationally in order to ensure proper workflow decisions are made from the beginning. Carl described the process that HMC conducted at the onset of their CPOE implementation. They held a 3-day off-site workflow event which removed the Physician Champions (one per specialty) from the hospital and focused them on analyzing their workflows. This approach was instrumental in minimizing the need to go back and re-design the system later. Another outcome of the workflow event was the decision made by the participating physicians that use of CPOE must be mandated across the organization. That’s a very meaningful decision!

Measuring up, above and beyond!

Under the leadership of Carl Cameron, the clinical guidance of Sue Sullivan, RN, and the dedicated members of their IT staff, HMC has systematically addressed each of the requirements for Meaningful Use. On September 16th, Holyoke Medical Center self-attested and has been approved as meeting all of the requirements for Stage One Meaningful Use. On October 1st, Nathan Littauer Hospital & Nursing Home began their 90-day reporting period for Clinical Quality Measures due, in part, to the assistance provided them by HMC.

The time and knowledge HMC shared with NLH is testimony that Holyoke Medical Center not only measures up, but goes “above and beyond”, by all standards known to the MEDITECH hospital community!

Photo Gallery  (hover over photo for enlarged view):

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EDITOR'S NOTE: I’d like to personally thank Holyoke Medical Center for their hospitality, and Nathan Littauer Hospital for allowing me to accompany them on this site visit.

To learn more about Holyoke Medical Center, visit them online at http://www.holyokehealth.com/.

To learn more about Nathan Littauer & Nursing Home, visit them online at http://www.nlh.org.