The state of West Virginia expects that 80% of the physicians in the state and 100% of the hospitals will use EMRs for clinical support by 2015 plus the state will have a statewide health information exchange in place by 2014. In addition, broadband and telehealth technologies will connect consumers and providers to help with core chronic diseases, health, and wellness needs.
Overall West Virginia has 1.8 million citizens, 70 hospitals including 52 acute care, 18 critical access hospitals, 6 rehabilitation facilities, and 4 Veterans Affairs facilities, 3,743 plus active and practicing physicians. Over 8% of the population lives in communities of less than 5,000, the state ranks in the bottom ten in State Health Rankings, and healthcare costs are estimated at approximately 19% of the gross state product.
The use of health IT is beginning to help the state deliver more efficient care. Expectations are that the Bureau for Medicaid Services will begin using automated systems, 80% of all lab tests will be ordered and delivered electronically, 100% of immunization records will be transferred electronically, and new telehealth applications such as telestroke and telecardiology initiatives as well as advanced life support for trauma cases will be integrated with the state’s Medical Command Infrastructure.
West Virginia is taking other actions to develop effective health IT in the state. The Governor’s “West Virginia Health Information Technology Statewide Strategic Plan” developed by the West Virginia Health Improvement Institute, presented their final draft revisions in September. The plan presented the vision for HIT in West Virginia and was completed to meet HIT priorities in the state for the next ten years.
The State’s strategic plan makes several suggestions:
• Establish an HIE to help physicians, public health officials, and researchers. The West Virginia Health Information Network initiative is underway and the goal is to design a system within five years
• Develop a Regional Information Technology Center to help with purchasing decisions, training, the adoption of telemedicine technology, e-prescribing, and the use of personal health records.
• Encourage the state’s broadband infrastructure and complete a statewide broadband inventory, align a reimbursement model to support a local business case for investments in infrastructure, and work with the vendor community to encourage local investments
• Leverage the Medicaid Information Technology Architecture (MITA) to establish a state data infrastructure, encourage payers to voluntarily report claims data to a centralized warehouse quarterly, report clinical data centrally on a monthly basis, and use the information to drive improvement in key areas
• Recruit and retain professionals with HIT skills by building a pipeline of HIT professionals. The goal is to contact professional societies, coordinate activities with the state university system and community colleges, and use technology to provide medical education and training not only by educational institutions but also by hospitals
• Ensure financial viability and sustainability by requiring federal partnerships with CMS, develop partnerships with ONC, and HRSA, and require user fees along with a viable marketplace supported by reimbursement reform,
Legislatively the State in 2009 launched a comprehensive strategy to establish health reform through Senate Bill 414. A variety of initiatives including administrative simplifications and chronic care management were included in the legislation. This effort resulted in the establishment of a new office called the “Governor’s Office of Health Enhancement and Lifestyle Planning (GOHELP) to help improve and expand the state’s healthcare system.
Presently, the state has several other ongoing initiatives including the West Virginia Medical Institute (WVMI) to provide quality management and HIT services. The Institute has top security clearance with CMS, DOD, and the VA. WVMI has developed technical resources for providers in accordance with its 8th Scope of Work with CMS. As part of that effort WVMI launched an e-Health Initiative to develop strategies to accelerate the adoption of health information technology throughout the state as well as the states of Delaware and Pennsylvania.
The West Virginia Telehealth Alliance also in place is a nonprofit organization to help advance telehealth throughout the Mountain state. The Alliance is one of the 69 organizations in the U.S. that is participating in the FCC’s Rural Health Care Pilot Program. The WVTA received $9.7 million in state and federal funds to improve broadband connectivity among eligible healthcare entities in the state.
Other initiatives in the state include the launching of a Center for Health Information Technology and the State University Research Consortium at Shepherd University to focus on building the state capacity for health information technology services and research opportunities.
In addition, the West Virginia Emergency Medical Command has been established and is exploring the role of HIT to support emergency responses. The West Virginia Department of the Corrections and the West Virginia Regional Jail and Correctional Facility Authority are working to acquire electronic health records.
Resources such as an online resource are available to help West Virginians understand electronic health records as the switchover takes place. The eHealthWV effort funded by a federal grant is available at www.wHealthWV.org. Also available is the Health Information Security and Privacy Collaboration Provider Education Toolkit available at www.Secure4Health.org to offer providers physician to physician advice, resource links, and information from experts.