What is HealtheMe?
This initiative originally started through funding provided by Medicaid and the state of West Virginia. West Virginia’s Department of Health and Human Resources was awarded a Medicaid Transformation Grant in 2007. This funding was subsequently awarded to Shepherd University, partnered with KRM Associates Inc. Under the grant, there were three elements these two organizations collaborated on:
- An evaluation of the existing status of Electronic Medical Record (EMR)s within the state of West Virginia, and a comparison of features and functionality of implemented solutions.
development and deployment of a Personal Health Record (PHR) system as a proof of concept.
- A proof of concept demonstration of an Electronic Medical Record interacting with a Personal Health Record through a Health Information Exchange.
The overarching goal of this project was to establish a baseline understanding of Electronic Medical Records throughout the state, and use this information to develop a model for the advancement of EMR technology. Through this exercise, the unique needs of West Virginia could be addressed.
In approaching the Personal Health Record component of their proof of concept, KRM’s initial intention was to leverage an existing PHR solution, also developed by Department of Veteran’s Affairs, titled “My HealtheVet”. This highly successful and award winning PHR provides critical patient services to veterans, and has been lauded as an benchmark for the industry. However, upon a technical assessment of the solution, it was determined My HealtheVet was too tethered to the VA’s Vista EMR to make a publicly interoperable installation of this solution too difficult to merit the time and effort.
The decision was instead made to develop and deploy an internally created solution. Through this approach, the solution’s interoperability with the open-source community could be assured. Additionally, through working with medical staff, both patient and provider needs could be addressed to assist the project in its relevance and growth. To provide an adoptable and sustainable solution, KRM recognized that patient and provider feedback in an ongoing manner would be of critical importance.
In beginning project design, KRM and Shepherd University reached out to various resources in the state of West Virginia, including prior Veteran’s Administration employees involved in the My HealtheVet program. Through working with this staff, KRM was able to leverage lessons learned from the My HealtheVet initiative in their product design. Additionally, by working with clinicians and medical professionals within the state, the product has been developed with their ongoing appraisal and input to guide the project towards meaningful functionality. To ensure interoperability, KRM examined standards emerging throughout the industry relative to document formats and exchange protocols. By conforming to federally provided guidelines, the solution could exist on a standard capable of interacting with nearly any medical system. In selecting an EMR format to conform to, KRM used the standards set forward by the Certification Commission for Health Information Technology (CCHIT). Within this context and for this specific pilot, the continuity of care record (CCR) standard was selected for its robust architecture and XML-extensible format. For information exchange, this format is also well suited for transfer using the NHIN CONNECT standards.
This product needed to be widely adoptable in order to function in West Virginia, so the decision was made to build this project in open source technologies. Currently, the installation exists with a MySQL database back-end, accompanied by Java-based middle tier and front end. By using widely adopted and low-cost technologies, the solution could provide a more readily distributable and affordable alternative in the healthcare technology market. This project was furnished to the healthcare community as an open-source solution.