ONC introduced the Strengthening the Technical Development and Readiness of Public Well being Companies by way of Well being Knowledge Trade (STAR HIE) Program in 2020 the use of investment from the Coronavirus Help, Reduction, and Financial Safety Act (CARES Act). This system was once expanded in 2021 to extend beef up for efforts to enhance vaccination information sharing between jurisdictional Immunization Knowledge Methods (IIS) and HIEs. The West Virginia Well being Knowledge Community (WVHIN) was once a number of the 22 recipients that won a mixed $20 million in budget from ONC by way of the CARES Act.
We sat down with WVHIN’s Government Director, Sonia Chambers, to be informed how the STAR HIE Program helped WVHIN beef up the state’s public well being company change well being data all over the COVID-19 pandemic. (Solutions had been edited for readability.)
What was once the STAR HIE Program investment used for?
ONC’s STAR HIE Program in reality served as a catalyst for a lot of our COVID-19 actions, each throughout the direct investment and by means of developing a better courting between the WVHIN and the state’s Bureau for Public Well being. If truth be told, the Bureau for Public Well being have been those who spotted the STAR HIE Program Request for Proposal (RFP) and despatched it to us. That engagement between us and the Bureau for Public Well being sparked higher coordination and collaboration which has additional larger all over the pandemic.
The STAR HIE Program enabled us to create two necessary equipment to help with COVID-19 vaccine monitoring and outreach: (1) The ImmuTrack software to beef up suppliers and payers, and (2) the WVHIN Reporting Products and services Warmth Maps to beef up public well being officers. The ImmuTrack software allows suppliers to view their complete affected person panel and the vaccination standing of the ones sufferers in a single record. The software is searchable by means of dose, age, geography, race, and ethnicity and comprises power prerequisites for Medicaid sufferers. The similar information may also be fed into extra subtle methods. In the past, suppliers needed to question the state’s IIS on a patient-by-patient foundation, which is extremely tedious and gradual.
The WVHIN Reporting Products and services Warmth Maps show vaccine information at a inhabitants stage and is also custom designed in quite a lot of tactics, together with by means of county, ZIP code, Census Tract, age, race, ethnicity, Facilities for Illness Keep an eye on and Prevention (CDC) Company for Poisonous Components and Illness References (ATSDR) Social Vulnerability Index, by means of general quantity or proportion in comparison to averages, and extra. As you’ll believe, some of these maps had been very useful in concentrated on vaccine outreach efforts. The ensuing stories had been utilized by the WV Bureau for Public Well being, regional epidemiologists, native well being departments, Federally Certified Well being Middle (FQHCs), the Partnership for African American Church buildings (PAAC) and better schooling.
Either one of the ones equipment have been important to the state’s being higher ready to care for COVID-19 because the pandemic spread out.
FIGURE 1: Unvaccinated people by means of county
FIGURE 2: Unvaccinated, Black people by means of county
What issues/demanding situations existed and the way did the STAR HIE Program investment assist?
We had a number of demanding situations. When COVID-19 first hit West Virginia, solely 4 hospitals or sanatorium methods within the state have been reporting COVID-19 lab effects to the state electronically. We were operating with them on connecting to the Digital Lab Reporting (ELR) program, however West Virginia’s ELR certification procedure is long, taking a number of months to finish, and plenty of hospitals had different priorities associated with era. Because of WVHIN’s current, robust relationships with hospitals, we have been ready to spouse with the state public well being company to rise up 21 COVID-19-only lab feeds in hospitals in simply two brief weeks. We’re now operating on increasing the ones feeds to complete ELR feeds in order that we’re higher ready for the following huge outbreak.
Some other problem was once race and ethnicity identity. It’s transparent that minority populations are much more likely to be disproportionately impacted by means of COVID-19 and within the quick scramble to habits as many checks as conceivable when the pandemic first began, race and ethnicity data was once steadily no longer captured. On the other hand, we have been ready to leverage demographic information from WVHIN’s current sanatorium and supplier information feeds, which we name our Grasp Affected person Index (MPI), to assist the state cut back the proportion of unknown race and ethnicity classification by means of part! We also are offering this serve as for vaccine distribution. The WVHIN Reporting Products and services Warmth Maps have been and proceed to be instrumental in pinpointing spaces which can be lagging relating to vaccination charges. This allows us to paintings immediately with network organizations just like the PAAC to interact communities of colour and establish high-risk sufferers who’ve no longer but won a vaccination.
Knowledge cleanliness is every other chronic problem since information is steadily incomplete or incessantly adjustments. For instance, many West Virginia citizens trip to a bordering state like Ohio for care and vice versa. If a West Virginia resident have been to get a vaccination at a Walgreens in Ohio, that might pose demanding situations with incomplete and even reproduction information. Our MPI is still instrumental in matching vaccination information that’s erroneous or incomplete, and/or merging duplicated entries.
How are you going to construct in this paintings and what are some long run tasks for WVHIN?
We’re making plans to increase ImmuTrack to be used past COVID-19 vaccines since it can be helpful for different vaccinations like monkeypox and even adolescence vaccines. We’ll additionally construct out the warmth maps to policymakers and public well being officers to higher perceive gaps in vaccination standing relative to geographic location.
No longer solely was once the STAR HIE Program investment instrumental in catalyzing our COVID-19 actions, it additionally enabled us to exhibit development which ended in us receiving two further CDC grants, (1) The Nationwide Initiative to Cope with COVID-19 Well being Disparities Amongst Populations at Top-Chance and Underserved, Together with Racial and Ethnic Minority Populations and Rural Communities grant and (2) The Vaccination Fairness and Prioritizing Populations Disproportionately Suffering from COVID-19 grant, to proceed our paintings. Moreover, we’re proceeding to paintings with public well being officers and with IIS on information clean-up as a part of the Immunization Knowledge Trade, Development and Sharing (IDEAS) collaborative. We’re additionally leveraging CDC well being disparities and vaccine fairness grants to offer analytics on such things as step forward circumstances and reinfection charges. Moreover, we’re offering automatic stories that mix vaccine standing, certain COVID-19 checks post-vaccination, deaths, and any related inpatient or outpatient visits.
We’re additionally exploring some paintings associated with social determinants of well being (SDOH), particularly with the ability to display referrals to community-based organizations for such things as meals lack of confidence, transportation lack of confidence, and so forth. In the end, that paintings seeks to near the referral loop and provides extra context a few affected person’s general scenario to a affected person’s care crew.
What function do you assume HIEs play in bettering well being?
Our enjoy in supporting the state’s Bureau for Public Well being with COVID-19 reaction confirmed us that HIEs are well-positioned to bridge the gaps inside our present national public well being infrastructure. I believe the most important factor we have been ready to turn is that HIEs are nimble and versatile, two attributes which can be completely important in a time of disaster like a world pandemic.
HIEs have current connectivity and robust information and analytic functions which many native governments don’t have. HIEs additionally be capable to backfill affected person matching and information cleansing. For instance, if anyone strikes and therefore adjustments their title, we will be able to assist determine that out. One more thing is the facility of HIEs not to solely beef up public well being companies to get entry to information but in addition then supply that information again to suppliers to enhance affected person care. HIEs play a uniquely necessary function.
Be told extra about WVHIN. Be told extra about ONC’s STAR HIE Program.