The Grill: Kathy Moore, CIO, West Virginia Health Information Exchange

The West Virginia Health Information Network was created by the state of West Virginia and charged with building a secure electronic health information system so providers could access and exchange patient data. The goal is to improve the quality of patient information and thereby enable providers to more quickly offer better care at lower costs. Among those leading the effort is Kathy Moore, CIO of the network. Moore is now working with hospitals and other healthcare providers in the state to get them connected to the exchange. "The exchange is now up and live, and we're focused on rollout and bringing on as many as possible," says Moore, a former deputy CTO for the state of West Virginia. Here she shares her thoughts on leading this huge IT project.

Kathy Moore

Family: Married, with four grown children

What accomplishment are you the most proud of? "I feel like I've helped a lot of others with their careers, and I feel good about that."

What's the best advice you've ever given to anyone? "Don't take it personally, it's just business."

And what's the best advice you've ever received? "'Never go down with an issue.' I got that from a college professor who used to be a state official who went down with an issue."

Hobbies: Gardening

How do healthcare providers need to prepare for the new network? Technically [the electronic health records] need to be in one place, and organizationally [the providers] need to be ready, too. That's a big part of the onboarding process. You can connect up technically, but if you don't know how to use it, what data you want to contribute, how your employees are going to implement that, then you're not really ready.

What are the biggest challenges in building this system? Orchestrating everything. There are just so many players and so many factors. For example, for a single hospital to onboard, you've got a governance team, a technology team, a training team, patient notice, and support. Then there's our staff, the vendor, their staff, their policies, our polices, training and ongoing support. So getting all those moving parts working is a challenge. And there are so many different vendors selling [electronic health record systems] to doctors, so each one is a different connection.

Is the technology side a bigger challenge than the other parts of the project? I think they're equally impactful because it really is any one of those pieces that can cause the entire thing to not work well or not get adopted. On the technology side, everybody is hitting the market with [application options] at the same time without necessarily seeing what's ahead with some of the future requirements. A lot of people are offering the same services, so you have to be careful not to step on each other's toes in what you're trying to provide to the customer. We don't intend to, but sometimes it appears that way, because some of the larger vendors are offering their own private [exchanges]. What they end up doing is connecting anyone who has their product together.

Does that mean you have to sell your organization and its mission? Sometimes I feel like we get put in that position. It's more negotiating what makes sense to do: participating in this state exchange versus participating with the vendor. It looks sometimes to the customer like the same thing, and we have to sort it all out for them.

Do healthcare providers have to pay to be part of your group? Eventually they will. We will be developing our sustainability model. We have funding to last us approximately four more years, and our sustainability requirements aren't great because we're not a profit-making organization. But it will be one of our future challenges.

What are other challenges? Short term is developing that sustainability model, driving the value and managing the initiatives with limited resources. But longer term, it is consumer engagement. We have a patient portal, so there will be a point where patients could access their records, regardless of who contributed that information.

Is the patient portal active? It is active, but we haven't deployed it. We have a pilot coming up in the next few months. We expect that to be managed by the providers themselves, for them to give patients access. But we're hosting the application, and we have to develop the policies around the use of the patient portal and how the providers can provision and manage within that portal. Then patients would be able to access and see and download any information in there to their own personal health records.

What are the biggest opportunities around this initiative? It is really for improving access to information to healthcare providers so they can make decisions sooner with the right information, and they can improve outcomes and lower costs. To me, it's really hitting home because I'm having this type of experience. My father has [healthcare providers] coming to the home and they're asking the same questions. But if they had the information through an exchange, they'd have those answers before they walk through the door. It's almost like they're working with blindfolds on. It's amazing to me to think about how much of a difference it can make in the future.

Are you seeing that difference now? We are. The stories are starting to come through. Yesterday we worked with a public health [official who was] able to access and validate information about a disease. It was a public health mandatory reportable disease. We were trying to see if the system had information valuable to her. In three minutes, she found information that before would have taken her three days to find.

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