Transforming Health Care in West Virginia

Improving the health status of rural West Virginia residents requires a new approach to chronic care supported by information technology.

Most experts agree on the need to reform our health care system but have not reached a consensus on how to achieve a more patient-focused, cost-effective integration of care. A recent study by the National Governors Association observed: “Our current health care system is designed to treat patients experiencing episodes of acute illness and is not organized to engage patients and providers in an ongoing relationship to manage chronic illnesses. Several structural limitations lead to costly and avoidable health complications for the chronically ill.”

Transforming fragmented systems in states such as West Virginia presents an even greater challenge. West Virginia is the second most rural state, has the second oldest population, and has one of the highest levels of chronic disease and unhealthy behaviors in the nation. Many parts of the state have been designated as medically underserved and/or health shortage areas due to a lack of health care providers.

In light of these challenges, there is a great need to use technology and systems change together to improve access to care and to improve the health status of those living in rural areas. Analyses of many of the targeted disease conditions including diabetes, cardiovascular disease, asthma and depression indicate that fundamental changes in the health delivery system are needed to achieve health improvement objectives.

As a result, a network of community health centers in West Virginia has launched a health improvement project that involves a systematic realignment of primary and preventive care by implementing open access scheduling, care management using a team approach to care delivery, strong patient education, accountability tools for self-management and an integrated electronic health management system with clinical reminders. This project already has produced some encouraging results.