The West Virginia University Health System has added a host of small hospitals to its system. Kimberly Clarke of WVU Medicine says technology is the key to leveling the playing field.
Chicago - The West Virginia University Health System, now commonly called WVU Medicine, has expanded into some very rural areas in recent years.
The system has 23 member hospitals in West Virginia, Pennsylvania, Ohio, and Maryland. Since 2017, the organization has added 16 hospitals, and many of them are small facilities. WVU Medicine expects to add two more member hospitals within the next year, says Kimberly Clarke, vice president and assistant chief information officer of WVU Medicine.
“Our goal at WVU medicine is to ensure no matter where our patients live… the care is the same,” Clarke says.
“A patient treated at a facility in a rural community has the same level of care as if they went to Morgantown and the academic medical center,” says Clarke, referring to the home of West Virginia University.
(See part of our conversation with Kimberly Clarke of WVU Medicine in this video from the HIMSS Conference. The story continues below.)
Technology looms as a “major challenge” as smaller facilities join the system, Clarke says. More than half of WVU Medicine’s member hospitals and clinics serve rural communities. Clarke outlined the system’s efforts to improve care in rural communities during the HIMSS Conference.
In 2019, the organization added a member hospital that was using paper for clinical systems, so moving to WVU Medicine’s electronic health system represented a seismic change. “They’re like the Pony Express going to the rocket ship,” Clarke said.
But she says improving technology at these small hospitals is critical to offering better care in underserved rural communities.
“WVU’s approach to health equity is looking at technology as the first step to level the playing field,” Clarke said.
Changing tech and culture
Albert Wright, CEO of WVU Medicine, said the system’s IT infrastructure is “the secret sauce that makes it all work.”
When new member hospitals become part of WVU Medicine, they join the organization’s electronic health record system; WVU Medicine utilizes Epic.
Other than some minor tweaks, Clarke said the organization’s new member hospitals all have essentially the same system. “You get the WVU standard,” Clarke said.
For smaller hospitals joining the system, there can be culture shock.
“If you’re a 25-bed critical access hospital, and you’ve not seen anything like this, this is huge,” Clarke says.
“For that smaller critical access hospital, we are hitting them with so much change in a relatively short period of time, that we have to be very cognizant of what this does for their employees, for their patients, that may be in the hospital at the time we're doing the transition,” she says. “But we provide an enormous amount of support to them to make sure that we can help them over that hump and get them to where they're feeling much more confident about their new environment.”
By bringing all the new facilities into the WVU record system, Clarke says, “We all have access to the same data.”
“When we do case studies, we can see data across every hospital in the health system,” she says. “It helps point us in the right direction to help those facilities.”
WVU Medicine closely tracks the performance of new hospitals, and Clarke says, “We're definitely seeing better patient outcomes.”
“We can look at analytics across every hospital,” Clarke says. “We can see the improvement in various quality KPI’s (key performance indicators.) We actually have KPIs that we set up for each new hospital … and we track those, and we can see where we may need to go back and give him some help.”
Before joining WVU Medicine, one rural hospital had a reputation as a place patients tried to avoid if they needed anything more than a bandage, Clarke says, without naming the facility. Now, that hospital has a five-star rating from the Centers for Medicare & Medicaid Services, she says.
When new hospitals understand both the culture and capabilities of WVU Medicine and their ability to expand care options, Clarke says the local hospitals gain more excitement.
As they begin the work of adding the hospitals to WVU’s electronic record system, Clarke said they’ll ask, “Can we turn it on now?”
Improving rural healthcare
Many rural hospitals across the country are struggling to stay afloat. Clarke says one rural facility only had two days cash on hand when it joined WVU Medicine.
More than 600 rural hospitals are at risk of closing in the near future, according to the Center for Healthcare Quality & Payment Reform. Since 2010, 136 rural hospitals have closed, according to a report by the American Hospital Association.
Earlier this year, WVU Medicine agreed to take over a struggling rural facility, Welch Community Hospital, in the southern part of West Virginia. West Virginia Gov. Jim Justice said the hospital is in a rural area that “got left way, way, way, way behind.”
In an interview with Chief Healthcare Executive, Clarke offered some guidance for hospital executives who want to offer better care for patients in rural communities.
“My advice would be, take a step back and really look at, what are the biggest barriers for your specific patients when it comes to health equity? And yes, there are technologies that can help with that,” she says.
In addition, hospitals should look to partner with areas social service agencies to see if there are other needs in terms of health equity.
Health systems also should track how patients are doing outside of a clinic or the physician’s office, she says.
“Are they taking their meds? Are they following the diet? Do they have access to the support system they need to follow the plan of care that the provider has given them? I think you just kind of have to look at each one and start to tackle them independently,” Clarke said.