Nationally, chronic diseases such as cardiovascular disease, diabetes and arthritis account for roughly 78 percent of health care costs annually. More than 800,000 (over 40%) West Virginians have one or more chronic conditions. These conditions account for:
° 70 % of hospital admissions and 80% of all
days spent in a hospital;
° 72% of physician visits and 88% of prescriptions
filled;
° nearly 60% of emergency room visits; and
° 70 cents of every dollar spent for health insurance
by employers and workers.
(Source: Robert Wood Johnson, Partnership for Prevention,
Health Affairs
In West Virginia, studies have shown our citizens either suffer from or are at-risk for a number of chronic conditions. These studies indicate that, of our population:
° 64% are obese or overweight;
° 32.4% have high blood pressure (with another
28% at-risk with pre- hypertension);
° 37.5% have high cholesterol;
° 28.2% are current smokers;
° 8.8% have diabetes (and another 3% are undiagnosed
diabetics);
° 40% are pre-diabetic; and
° 85% have one or more risk factors for chronic
disease.
(Source: various health promotion publications and
web-sites within the
West Virginia Department of Health and Human Resources)
Medical research has shown that living with a chronic
condition can be managed and many of the complications
of these diseases can be avoided through regular contact
with health care providers, patient education and
self-management, with regular physical activity and
dietary modification. The Network and its members
have identified a number of clinical areas for significant
health improvement opportunities based upon the foregoing
information and have targeted:
° diabetes,
° cardiovascular risk reduction,
° depression,
° weight management and physical activity; and
° asthma
as focus areas of its health improvement program.
The Network has worked closely with the Governor's Office, West Virginia State Medical Association Foundation, West Virginia on the Move and health promotion specialists within the Department of Health and Human Resources on a Healthy Lifestyle initiative to promote healthier schools, workplaces and communities.
Access to and coordination of health care in rural West Virginia is hampered by the large number of people living in remote and rural areas, transportation barriers and an uneven distribution of health care providers. Forty-five of West Virginia's fifty-five counties are designated as rural and eighty percent of the state's population lives in communities of less than 5,000 people (most served by community health centers). To overcome these barriers, the Network and its member centers are using technology to improve health services, especially those focused on the targeted chronic conditions listed above.
A central part of our health improvement project involves the application of new health information technology. Our Network was one of three organizations nationally to participate in a demonstration project to test and evaluate the use of the Veteran's Administration's VistA software in the community health setting as part of an initiative by the Centers for Medicare & Medicaid. This initiative also involves collaboration with the Bureau of Primary Health Care within the Health Resources and Services Administration, Indian Health Services and the Agency for Health Research and Quality focused on improving the health of individuals through outcome performance measures and implementation of chronic care systems in community health organizations.
As a result of this demonstration project, CHNWV has chosen to base it electronic health information system on the VistA platform as used by Indian Health Services. IHS and CHNWV share a commitment to improving the health of our constituents through the use of proven disease management and patient tracking technologies. Partnership announcements will be coming to this site soon!
The Network is also establishing the West Virginia Telehealth Network (WTHN) as a component of its health improvement project. The WTHN will link member health centers with academic health care organizations and health improvement partners to enhance disease management services and to make diagnostic services such as digital retinopathy available in remote rural communities.
To better facilitate the change management process that must accompany the realignment of clinical processes to achieve the objectives of disease management and the chronic care model, the Network has established the Community Health Institute. The Institute will utilize a combination of distance-learning and classroom sessions to train health center leaders on improved leadership skills and change management techniques. The Network has partnered with the West Virginia University College of Business and Executive Education to replicate the successful MBA Essentials program of WVU as a core curriculum for the Institute.
The Network is one of the founding participants in United Community Health Networks, a collaborative of health center-controlled networks operating in West Virginia, Florida and Ohio, and the West Virginia EHealth Initiative, a collaboration among West Virginia health care providers, payors and interested parties to promote the adoption of electronic health records and the ability of health care providers to exchange information electronically.
Funding for these Network projects has been provided through membership contributions and fees and through generous grant support from the Bureau of Primary Health Care within the Health Resources and Services Administration (Integrated Service Development Initiative [ISDI], Shared Integrated Management Information System [SIMIS] and Information and Communication Technology [ICT] grants, the U. S. Department of Commerce (Technology Opportunity Program [TOP] grant), the Division of Primary Care and the West Virginia Health Care Authority, both within the West Virginia Department of Health and Human Resources and in-kind support from the Robert C. Byrd Center for Rural Health within the Department of Family and Community Health of the Marshall University Joan C. Edwards Medical School and from the West Virginia Primary Care Association.