SOURCE: Vermont Information Technology Leaders, Inc.

Vermont Information Technology Leaders, Inc.

August 04, 2016 12:31 ET

Technology Investment Will Improve Health Care for Nearly 300,000 Vermont Patients

BURLINGTON, VT--(Marketwired - August 04, 2016) - Capitol Health Associates, LLC (CHA) and Vermont Information Technology Leaders, Inc. (VITL) turned what could have been bad news for the Vermont Blueprint for Health Clinical Data Registry, into an innovative solution that will result in improved care outcomes for patients statewide.

The Blueprint Registry is a system used to evaluate the quality of care that is provided to nearly 300,000 Vermonters who receive their primary care in a practice that is a Patient-Centered Medical Home (PCMH). Clinical and social data that are collected in the registry are de-identified and aggregated with medical claims data, in order to look for patterns in patient health over time and whether patients are receiving the preventive care that is recommended in national guidelines. Reports generated from these data are used to guide continuous quality improvement activities at individual health care practices and across a health service area.

Until recently, the registry was hosted and maintained by a third-party software company. Clinical data were being collected into the registry from Blueprint practices across the state using the Vermont Health Information Exchange (VHIE), operated by VITL. Capitol Health Associates was providing consulting support to improve the quality of data being collected from Blueprint practices and to manage extraction of data from the registry for analysis. Data in the registry are the source of information for Practice Profiles, semi-annual reports provided to the practices to help them identify areas for improvement. Jennifer Fels, RN, MS and director of the Bennington Health Service Area said that the profiles "enable us to unite the community around common goals and common measures, especially as we move toward managing population health."

The Vermont Blueprint for Health provides a coordinated, statewide approach to health, wellness and disease prevention. With a network of Community Health Teams, the Blueprint works with Patient-Centered Medical Home practices and local health and human services leaders to improve primary care and improve health care outcomes at a community and state level. In the Morrisville Health Service Area, they have focused on emergency department (ED) avoidable visits to Copley Hospital. According to Elise McKenna, RN, MPH, MSED, project manager for the Morrisville Health Service Area, "we used the practice profiles to drive the conversation around avoidable ED visits. For our health service area, we have determined that we need to place an ED social worker in the hospital to ensure timely follow-ups after a patient visits the ED."

Given the importance of the registry to the overall mission of the Blueprint, the news that support would end for the application underlying the registry in 2015 was especially troubling. A new solution had to be developed quickly. The Blueprint, CHA, and VITL developed and executed a plan that minimized the impact of any system downtime while maximizing the investments already made in the current system. The key elements of the proposal were:

  • The State of Vermont secured a perpetual source code license to the software underlying the registry.
  • CHA expanded their role to include the installation, maintenance and technical support of the registry in its new environment.
  • VITL expanded their role and now manages the hosting environment for the registry.

Hans Kastensmith, principal at CHA, when talking about the project said, "it's challenging enough to bring up software that you wrote yourself, now imagine receiving 163 thousand lines of code from another vendor and having a week to verify its completeness and to make it operational." By December, 2015 CHA had reconstituted the registry on servers managed by VITL. All of the previous data from the prior system was transferred and validated as part of this effort.

Getting the registry up and running in its new environment was the first major milestone to be accomplished on schedule. Now that the system itself was up, registry services had to be restored to users and data sources had to be reconnected to bring continual updates to the system. These tasks were handled in order: First, CHA made sure that service was restored to those users who interact directly with the registry. This included social services agencies that provide important information about chronically ill patients, such as Support and Services at Home (SASH), the Community Health Teams, the Tobacco Cessation Counselor (TCC) program, and Self-Management Support Programs (SMSP). "By June 30, 2016 we had these members of the health care community back up and running using the same, familiar user interface," said Kastensmith.

Next came the reconnection of data sources. Since the VHIE -- which is operated by VITL -- was already the conduit for most of the data collected into the registry, VITL was able to shut off the outbound side and store incoming messages until the new system was available. Working with CHA throughout the winter and spring, VITL ensured that the servers that hosted the registry were operational. Reconnecting the VHIE to the registry required a secure connection, called a Virtual Private Network (VPN) Tunnel be created between the VHIE and the registry. "Once again, we were able to demonstrate the flexibility and adaptability of the VHIE and prevent the loss of any data during this transition. Without the VHIE network the task of reconnecting hundreds of data sources would have been monumental," said John K. Evans, president and CEO of VITL. A detailed project plan ensured proper testing and validation at each step along the way until production data services were restored.

With full functionality restored to the registry -- and a solid sustainability plan -- the Blueprint is once again focusing on utilizing the registry to improve health care for Vermonters. "With the registry back in place, we hope to improve the flow of information with SASH and other social services agencies that participate in our Unified Community Collaborative," said Donna Ransmeier, MS, CHTS-CP, project manager for the Upper Valley Health Service Area.

About Capitol Health Associates:

Capitol Health Associates is a boutique healthcare consulting firm located in Washington DC. Our leadership has a deep background in enterprise healthcare consulting, especially with large and complex, politically motivated healthcare systems, large scale government projects and population health management. CHA also possesses significant insight concerning the Affordable Care Act and Accountable Care. CHA has been consulting to the Vermont State Legislature and the Department of Vermont Health Access for the past 11 years on its healthcare delivery reform efforts and the Blueprint for Health.

About VITL:

Vermont Information Technology Leaders, Inc. (VITL) is a nonprofit organization that advances health care reform in Vermont. VITL assists Vermont health care providers with adopting and using health information technology, to improve the quality of care delivery, to enhance patient safety and to reduce the cost of care. VITL is legislatively designated to operate the health information exchange (HIE) for Vermont, and is governed by a collaborative group of stakeholders including health plans, hospitals, physicians, other health care providers, state government, employers, and consumers. For more information, please visit

Contact Information

  • Contact:
    Joanna Cummings
    Marketing Manager, VITL