ONC launched the Strengthening the Technical Development and Readiness of Public Well being Businesses by way of Well being Info Trade (STAR HIE) Program in 2020 utilizing funding from the Coronavirus Assist, Aid, and Financial Safety Act (CARES Act). This system was expanded in 2021 to extend help for efforts to enhance vaccination information sharing between jurisdictional Immunization Info Techniques (IIS) and HIEs. The West Virginia Well being Info Community (WVHIN) was among the many 22 recipients that acquired a mixed $20 million in funds from ONC by way of the CARES Act.
We sat down with WVHIN’s Govt Director, Sonia Chambers, to learn the way the STAR HIE Program helped WVHIN help the state’s public well being company alternate well being info throughout the COVID-19 pandemic. (Solutions have been edited for readability.)
What was the STAR HIE Program funding used for?
ONC’s STAR HIE Program actually served as a catalyst for a lot of our COVID-19 actions, each by means of the direct funding and by creating a better relationship between the WVHIN and the state’s Bureau for Public Well being. In reality, the Bureau for Public Well being had been those who observed 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 better coordination and collaboration which has additional elevated throughout the pandemic.
The STAR HIE Program enabled us to create two vital instruments to help with COVID-19 vaccine monitoring and outreach: (1) The ImmuTrack software to help suppliers and payers, and (2) the WVHIN Reporting Companies Warmth Maps to help public well being officers. The ImmuTrack software allows suppliers to view their total affected person panel and the vaccination standing of these sufferers in a single doc. The software is searchable by dose, age, geography, race, and ethnicity and consists of power circumstances for Medicaid sufferers. The identical information will be fed into extra refined methods. Beforehand, suppliers needed to question the state’s IIS on a patient-by-patient foundation, which is extremely tedious and gradual.
The WVHIN Reporting Companies Warmth Maps show vaccine information at a inhabitants degree and could also be custom-made in varied methods, together with by county, ZIP code, Census Tract, age, race, ethnicity, Facilities for Illness Management and Prevention (CDC) Company for Poisonous Substances and Illness References (ATSDR) Social Vulnerability Index, by whole quantity or share in comparison with averages, and extra. As you may think about, these kinds of maps have been very useful in focusing on vaccine outreach efforts. The ensuing reviews have 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.
Each of these instruments had been important to the state’s being higher ready to take care of COVID-19 because the pandemic unfolded.
FIGURE 1: Unvaccinated people by county
FIGURE 2: Unvaccinated, Black people by county
What issues/challenges existed and the way did the STAR HIE Program funding assist?
We had a number of challenges. When COVID-19 first hit West Virginia, solely 4 hospitals or hospital methods within the state had been reporting COVID-19 lab outcomes to the state electronically. We had been working with them on connecting to the Digital Lab Reporting (ELR) program, however West Virginia’s ELR certification course of is prolonged, taking a number of months to finish, and lots of hospitals had different priorities associated to expertise. Due to WVHIN’s present, sturdy relationships with hospitals, we had been capable of companion with the state public well being company to face up 21 COVID-19-only lab feeds in hospitals in simply two quick weeks. We’re now engaged on increasing these feeds to full ELR feeds in order that we’re higher ready for the subsequent giant outbreak.
One other problem was race and ethnicity identification. It’s clear that minority populations usually tend to be disproportionately impacted by COVID-19 and within the rapid scramble to conduct as many exams as attainable when the pandemic first began, race and ethnicity info was typically not captured. Nevertheless, we had been capable of leverage demographic information from WVHIN’s present hospital and supplier information feeds, which we name our Grasp Affected person Index (MPI), to assist the state cut back the share of unknown race and ethnicity classification by half! We’re additionally offering this operate for vaccine distribution. The WVHIN Reporting Companies Warmth Maps had been and proceed to be instrumental in pinpointing areas which can be lagging when it comes to vaccination charges. This allows us to work straight with group organizations just like the PAAC to have interaction communities of colour and determine high-risk sufferers who haven’t but acquired a vaccination.
Knowledge cleanliness is one other persistent problem since information is commonly incomplete or often modifications. For instance, many West Virginia residents journey to a bordering state like Ohio for care and vice versa. If a West Virginia resident had been to get a vaccination at a Walgreens in Ohio, that would pose challenges with incomplete and even duplicate information. Our MPI continues to be instrumental in matching vaccination information that’s inaccurate or incomplete, and/or merging duplicated entries.
How will you construct on this work and what are some future tasks for WVHIN?
We’re planning to broaden ImmuTrack to be used past COVID-19 vaccines since it could be helpful for different vaccinations like monkeypox and even childhood vaccines. We’ll additionally construct out the warmth maps to policymakers and public well being officers to raised perceive gaps in vaccination standing relative to geographic location.
Not solely was the STAR HIE Program funding instrumental in catalyzing our COVID-19 actions, it additionally enabled us to reveal progress which led to us receiving two extra CDC grants, (1) The Nationwide Initiative to Handle COVID-19 Well being Disparities Amongst Populations at Excessive-Danger and Underserved, Together with Racial and Ethnic Minority Populations and Rural Communities grant and (2) The Vaccination Fairness and Prioritizing Populations Disproportionately Affected by COVID-19 grant, to proceed our work. Moreover, we’re persevering with to work 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 issues like breakthrough circumstances and reinfection charges. Moreover, we’re offering automated reviews that mix vaccine standing, optimistic COVID-19 exams post-vaccination, deaths, and any related inpatient or outpatient visits.
We’re additionally exploring some work associated to social determinants of well being (SDOH), particularly having the ability to present referrals to community-based organizations for issues like meals insecurity, transportation insecurity, and so forth. Finally, that work seeks to shut the referral loop and provides extra context a few affected person’s general state of affairs to a affected person’s care crew.
What function do you suppose HIEs play in enhancing well being?
Our expertise in supporting the state’s Bureau for Public Well being with COVID-19 response confirmed us that HIEs are well-positioned to bridge the gaps inside our present nationwide public well being infrastructure. I believe the largest factor we had been capable of present is that HIEs are nimble and versatile, two attributes that are completely important in a time of disaster like a worldwide pandemic.
HIEs have present connectivity and robust information and analytic capabilities which many native governments don’t have. HIEs even have the power to backfill affected person matching and information cleansing. For instance, if somebody strikes and subsequently modifications their title, we will help determine that out. One different factor is the power of HIEs to not solely help public well being companies to entry information but in addition then present that information again to suppliers to enhance affected person care. HIEs play a uniquely vital function.
Be taught extra about WVHIN. Be taught extra about ONC’s STAR HIE Program.
