West Virginia Health Information Network

The West Virginia Health Information Network (WVHIN) was launched in 2006 by the West Virginia legislature. In 2010, federal funds were given to the West Virginia Department of Health and Human Resources as part of the State Health Information Exchange Cooperative Agreement Program. WVHIN has since been using these funds to work to make electronic HIE a reality across West Virginia. The vision of this effort is to foster high quality, patient centered care facilitated by health information technology.

David Partsch, Chief Information Officer of the West Virginia Health Information Network (WVHIN) shares his experiences in the world of healthcare as it evolves to rely on technological solutions. He discusses the importance of a defined sustainability model, integrating the provided information into clinicians’ established workflows and a focus on providing solutions to stakeholders.

I started attending Annual HIMSS conferences in the mid-2000’s in support of gaining knowledge about several HIT vendor solutions for some of the projects my team and I were engaged in at that time. Seeing the value in the organization, I quickly joined the local chapter and started participating in various committees and workgroups.

Over the years, I’ve had several opportunities to participate on many different local and national HIMSS work groups/committees. Doing so has allowed me the opportunity to help shape HIT narratives and positions put forward by HIMSS. I’ve also been able to establish a valuable network with other healthcare IT professionals through local HIMSS chapters as well as national groups that I’ve been a member of across time. Being able to interact and work with professionals that share common goals in HIT is extremely valuable.

West Virginia Health Information Network (WVHIN) major milestones include:

  • The WVHIN was created by the West Virginia Legislature under Chapter 16 Article 29G in 2006 in order to “promote the design, implementation, operation and maintenance of a fully interoperable statewide network to facilitate public and private use of health care information in the state.”

  • The WVHIN’s first technology deployments were Direct secure messaging services followed by connectivity to the NwHIN in 2011.

  • The WVHIN successfully integrated with the WV Center for End of Life Care’s e-Directive Registry to deliver real-time access of POLST forms, advanced directives, DNR cards, living wills, and medical power of attorney documents to clinicians in May 2012.

  • The WVHIN’s first full data sharing and clinical query portal participants – Wheeling Hospital and WVU Health – were brought on board in May and June 2012. The WVHIN offers both HL7 and IHE-based connectivity for data sharing.

  • The WVHIN started providing support for submissions of Immunization and Syndromic Surveillance data to the WV Bureau for Public Health and CDC BioSense registries in April 2013. The WVHIN also started supporting electronic lab report submissions in May 2015.

  • The WVHIN deployed care alert notifications for patient ER visits as well as inpatient admissions, discharges, and transfers in October 2015 in order to provide better coordination of care with the patient’s primary care provider as well as payors and ACO’s operating within the state.

  • The WVHIN successfully integrated with NABP’s PMP InterConnect and Appriss’ NARxCHECK prescription monitoring analytics services in June 2016 to deliver real-time access to patient prescription information and risk-based scoring to assist clinicians in the prescribing and dispensing of narcotics, sedatives and stimulants.

Over the course of my career, healthcare has evolved from a paper-based supported environment to one that has become saturated with technology solutions across all types of organizations (hospitals, provider practices, LTAC, payers… etc.). There has also been a shift from service-focused delivery of healthcare by a singular entity to a more coordinated approach focused on patient wellness through care coordination that has led to a greater need for real-time information exchange between organizations.

Acknowledgement of the Health IT field that standards developed and defined for use in today’s “internet of things” (IoT) environment are needed to catch up with all other industry verticals is a welcome change. Now, the trick is to use these advances in technology and standards to maximize the amount of relevant information provided to a clinician to make medical decisions and to optimize the useful life of data across all operations, both clinical and non-clinical.

Probably the biggest lesson learned is that while having an information exchange portal is beneficial, it should not be the primary delivery method. The most benefit is derived from providing patient information within a clinician’s native system within their established workflows at the appropriate time. The delivery of information from the exchange into the EHR should be seamless and transparent to the clinician.

I would also say that a sustainability model should be defined and implemented as early as possible in the stand-up of an exchange. The level of uncertainty and stress associated with financial operations will grow over time and that will affect the solutions you can provide to your participating organizations. You don’t want that hanging over your head.

As standard practice, the WVHIN works with each participating organization on a case-by-case basis to determine what solutions offered by the WVHIN will be of value to and then executes deployment accordingly. From a historical standpoint, the WVHIN has focused rollout of services to healthcare organizations in major metropolitan areas in the state, followed by those organizations with confirmed interest in exchanging data. Hospitals were the primary focus initially, followed by connectivity to physician practices and long-term care facilities.

From my experience, I would advise:

  • Leaning on more practiced, longer-tenured HIE’s. They’ve been through the fire and can offer great insight on learned experiences.

  • Continuous engagement with your stakeholders in order to find out what HIT and exchange solutions are truly valuable to them.

  • Making sure you have a good plan of action to compare and contrast the services and value add the HIE provides versus the vendor-led national exchanges (e.g. CommonWell, Carequality, etc.) proliferating across the country.

  • Focusing more on being a solutions provider than an information exchange.

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