Like many CIOs, Steve Stanic has a love-hate relationship with Meaningful Use. While he takes issue with patient engagement requirements and the lack of an identifier, he still believes “it was what needed to be done.” In this interview, Stanic shares his honest thoughts about the program that has helped revolutionize the industry, and discusses the biggest projects on his plate, including the migration to McKesson Paragon, and a statewide effort to create a clinical integrated organization. He also discusses his team’s five-point engagement strategy, the valuable lesson he learned during his time in consulting, and what drew him to Mississippi Baptist.
- About Mississippi Baptist
- McKesson clinicals & financials
- “Testing” Paragon at a CAH — “Standardize as much as you can.”
- Migrating from Horizon to Paragon
- Building up the clinician hub — “It’s just like anything else; you can’t get there quick enough.”
- Paragon v.13 pilot
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They didn’t have anything at all. They had just an electronic billing system. They had no EHR, no clinical applications at all, so knowing that we were going to go to Paragon on the main acute side, we brought them up first.
It was great because they really embraced moving to the electronic world. You’re not trying to compare to a product that might have been in there before, so it was exciting.
We wanted to make sure that we standardized as much as we could with regards to things like order sets, physician documentation templates. That took a lot of the variation out.
One of the things we do like about Paragon is the pace of new functionality that you get is much accelerated compared to the Horizon world. You would wait a long time in Horizon to get enhancements; with Paragon, you get them at a pretty steady clip.
Gamble: Hi Steve, thank you so much for taking some time to speak with us today.
Stanic: No problem at all.
Gamble: Why don’t you give a little bit of information about your organization to lay some groundwork for our listeners, and then we’ll go from there.
Stanic: Sure. I’m the vice president and CIO at Mississippi Baptist Health System, located in Jackson, Mississippi. We’re what I will consider from a Mississippi standpoint to be large acute care provider. Jackson is located in Central Mississippi. We also have three critical access hospitals we own throughout the state that act as feeders into Mississippi Baptist. We pretty much provide all what I would consider the big services — orthopedics, cardiology, large cancer center. It’s all anchored by the main center, which is about 620 beds. So that’s the background on Mississippi Baptist. I’ve been here five years now.
Gamble: In terms of the application environment, what type of EHR system are you using in the acute care hospital?
Stanic: In the main hospital, we’re an all McKesson shop. We’re probably their largest Paragon customer now, and we actually will be using that in our critical access hospitals as well. It’s a full suite of products, both on the financial and the clinical side, that’s the EHR. We have a lot of what I’m going to call the ancillary type applications wrapped around that, so you have cardio PACS, regular PACS, radiology, lab, all that kind of stuff.
That’s it from a clinical standpoint. We’re pretty big on CPOE as well and physician documentation, which is we’re in the final stages of rolling that out now. But that’s taken a little bit of a longer of an adoption process. So that’s where we’re at. We do have a number of clinics and physicians we own; they’re on NextGen.
Gamble: Now as far as the critical access hospitals, you said the plan is to get them on Paragon?
Stanic: Right. The one that we first acquired is on Paragon now; the other two we just acquired. They have a system NextGen acquired called Opus. Once we get them stabilized, you run into these situations. There are always a lot of other burning issues that have to be resolved first, with bringing them on a standard platform, so we’ll eventually get them to Paragon down the road.
Gamble: And the one that has been actually acquired is in the process now?
Stanic: No, they’ve been on Paragon for probably about a year and a half now. They actually went on Paragon, believe it or not, before we converted over at the main acute hospital. It’s just that we acquired them a little bit early. They didn’t have anything at all. They had just an electronic billing system. They had no EHR, no clinical applications at all, so knowing that we were going to go to Paragon on the main acute side, we brought them up first. So they actually went up before us.
Gamble: What’s the name of that hospital?
Stanic: We actually call it Baptist Leake County. It used to be called Leake County Hospital, then when we acquired, it’s now called Baptist Leake.
Gamble: That’s interesting that that hospital was on Paragon first. That’s kind of an interesting test.
Stanic: Yes, they were our test case. And I will tell you, what’s great about it is that not only were we able to learn about Paragon and how to build it, but I’ve always said that the easiest implementation you do from a clinical aspect is to an entity organization that was all paper. It was great because they really embraced moving to the electronic world. You’re not trying to compare to a product that might have been in there before, so it was exciting.
Gamble: Were there any lessons learned as far as taking that same implementation to a larger hospital?
Stanic: I think probably the biggest lesson we learned is to standardize as much as you can. That’s the whole idea when you go to what I’m going to call a totally integrated system, so that the financial and the clinical side are really sharing one patient database. We wanted to make sure that we standardized as much as we could with regards to things like order sets, physician documentation templates. That took a lot of the variation out. That was probably our biggest lesson that we brought over to the main acute side.
Gamble: Was the main hospital on Horizon?
Stanic: We were a Horizon shop, that’s correct.
Gamble: As far as that migration, was that something that pretty much went as expected? I’m sure there were some challenges along the way, but how did that go in general?
Stanic: Yes, and to kind of set the environment tone, in the Horizon world, we basically were just CPOE. We did not have physician documentation in the Horizon world. That was probably the last module of Horizon we were going to implement, then we kind of stepped back and made the decision to move to Paragon. We had a pretty fair CPOE adoption rate in the Horizon world. I want to say that we were probably only around 40 or 50 percent. One of the things that was good about Paragon is we were able to build a lot more order sets than we were in the Horizon world. Horizon was a very complicated technology to build order sets in, so that was the kind of good news-bad news. When we moved to Paragon, we were able to make more order sets available to our physicians, so our CPOE rate increased.
One of the things that was good in the Horizon world was their physician portal. Basically the view that the physician looked at was a lot more robust than it was in Paragon. So we made a little bit of sacrifice when we moved to the Paragon world for that integration in that there was a pretty robust physician portal the physicians liked.
Now, McKesson is making great strides at trying to improve that. I’m not going to say it’s a work in progress; Paragon is a growing application. One of the things that we do like about Paragon is the pace of new functionality that you get is much accelerated compared to the Horizon world. You would wait a long time in Horizon to get enhancements; with Paragon, you get them at a pretty steady clip. So we’re confident the McKesson is going to get there with the clinician hub. They have this clinician hub that eventually both nurses and physicians will use for one total view of the patient. I think it’s a great concept and we’ll eventually get there. It’s just like anything else — you can’t get there quick enough. But McKesson’s working hard to get there.
Gamble: Now being, like you said, a large hospital using Paragon, it is something where you are called upon to give more input or not necessarily test things out, but is it something where you are almost like testing something?
Stanic: You mean from a McKesson standpoint?
Stanic: Well, we are on version 13; that’s the newest version of Paragon coming out. We are a version 13 pilot. We’re one of four, and I only know one of the other four, so I can’t name the names. The other one that I know is Holzer up at Ohio. We did an extensive amount of testing for them. They’re getting close, I guess, to announce the GA date, if they haven’t already for version 13. We probably tested or from a pilot standpoint have been in that mode for the last six to eight months — six for sure.
Gamble: I can definitely see the benefits of that, just as far as getting to have input into how some things will hopefully be.
Stanic: That’s it exactly.