2. Develop policy and planning activities to provide seamless access to data and information in a way that allows students, faculty and staff to integrate these resources effectively in their work.

4. Establish a policy and a collaborative process for the organization and integration of information management units to achieve effective utilization and strategic management of data and information resources.

5. Develop the key functional objectives and strategies for an IAIMS implementation program that can begin by the end of the planning project, the major elements of which can be achieved within five years after implementation begins.
 

The WVU Clinical Enterprise (WVUH/UHA) operates thirty-three information systems. Sixteen of these are directly related to patient care delivery, billing, or analysis. The normal flow of patient information through these systems includes: patient registrations, laboratory orders and results, billing and patient accounting, utilization and management reviews, transcriptions, departmental records systems, and registries such as trauma and tumor.
A Token Ring/Ethernet joint network spans the major health care sites: the Group Practice Plan's Physicians Office Center (POC) and West Virginia University Hospitals' Ruby Memorial Hospital. Additional outlying sites are connected via leased (ISDN, 56 Kbps, T-l Frame Relay) lines or dial up access (56 Kbps and 9600 baud). Both the enterprise networks and the leased/dial access can be configured to deliver access to any operating information system from any access point. Existing fiber backbones and IBM 8260 concentrators, with Ethernet switches, support management of the network via IBM Netview. More than 1,100 devices are attached to the network. Appendix B contains a diagram of the WVUH/UHA network.

The HSC Data Network comprises five Virtual LANs (VLANs) and are implemented utilizing Cisco Router and Switch technology. Management of the network is performed using CiscoWorks and 3COM Transcend software in an HP Openview environment. The current configuration of the HSC Network provides a Switched 100MB Fast Ethernet Collapsed Backbone, upgradable to ATM OC-3 bandwidth, and switched 10MB Ethernet to servers, high performance workstations, and shared 10MB Ethernet hubs. 100BaseTX hubs are used for connecting highly utilized HSC servers and high performance workstations to the network. The HSC Data Network currently supports 1500 network nodes. By August 1997, the network will support approximately 2000 users. A fiber optic/copper network backbone interconnects connects the Health Sciences Center departments within the HSC and provides connectivity to WVU's main campus FDDI network. This network provides a transmission media for all data, video, and voice applications at the HSC.

The Clinical and Academic Enterprises both rely on external services to provide information services. Figure 1 is an illustration of functional relationships among major systems in our information environment. The HSC, as part of West Virginia University, participates in the WVU Campus LAN (WINnet). Some of our users have more than one option for connectivity to the HSC, depending on the type of service being accessed. These relationships are explained in greater detail in the following sections.

In 1991, West Virginia began two initiatives dedicated to providing experience in rural practice settings for health sciences students. These two programs, the Kellogg Community Partnerships Program, funded by the Kellogg Foundation, and the West Virginia Rural Health Initiative (RHI), funded by the State of West Virginia, were integrated into a single West Virginia Rural Health Education Partnerships (WVRHEP) program on July 1, 1996. The mission of WVRHEP is to work in concert with rural communities to increase the supply of health professionals in rural, underserved areas. Today, the WVRHEP program consists of 13 rural health education consortia, each consisting of a lead agency with satellite training sites. Over 344 field faculty at 165 primary sites provide rural health care training for our health professions students. A location map of current sites is contained in Appendix B.

WVRHEP coordinates the three months of educational experience in a rural setting that all medical, dental, nursing, and pharmacy students are required to complete prior to graduation. Related programs provide rural clinical experiences for allied health students, including medical technology, physical therapy, dental hygiene, psychology, physician assistant, and social work students. While in rural placements, students need access to clinical reference materials and to continuing communication with their home institutions and faculty.

WVRHEP sites include at least one Learning Resource Center (LRC) with equipment and materials for students and field faculty. Each LRC has personal computer hardware and software with at least dial-up communication capabilities for linkages with computer systems, databases, and library systems at the HSC and other state university system institutions as well as Internet access. Students can use some of these tools to do bibliographic searches, but they have limited access to the full text of desired articles and publications. The LRCs maintain reference literature, texts, and other materials although these collections are limited in depth and breadth. The LRCs also contain audiovisual equipment, photocopiers, fax machines, and related support equipment.

Mountaineer Doctor TeleVision (MDTV), through funding from the federal Office of Rural Health Policy, is establishing interactive video, audio, and graphic communications with rural hospitals and clinics in West Virginia. MDTV provides facilities for medical consultation, continuing education programs, communications between HSC faculty and students at off-campus rural hospital or clinic sites, and other clinical uses. Real-time, full-duplex, digital (T-1) communications links provide the fastest transmission and sharpest images currently in use for this type ofproject. The MDTV system provides distance education capabilities to other University units through negotiated agreements.

The Center for Rural Emergency Medicine (CREM) is a rural outreach program based at West Virginia University. It is dedicated to addressing the problems unique to the delivery of emergency and trauma care in rural areas. CREM's mission to study and improve rural emergency and trauma care is being accomplished through a variety of education, research, and service projects.

The Health Sciences Center provides rural physicians with a 24-hour, toll-free telephone hotline, through MARS, for access to WVU medical specialists, sub-specialists, ancillary services, and special care centers. MARS handles about 40,000 inbased and outgoing calls a year. About two-thirds of the calls are generated by rural practitioners requesting advice about treatment for conditions of specific patients that have been referred to the Health Sciences Center. Calls may also involve facsimile transmission of laboratory test results, patient discharge summaries, and other consultation-related materials.

CONSULT's mission is to enhance access to health information and communication resources for health professionals and students, especially those practicing or learning in rural areas. Initial funding was provided through a National Library of Medicine grant. The program has been operational since 1991, and it has registered users at more than 55 West Virginia health care facilities.

CONSULT is both a gateway to external resources (e.g., Internet, MountainLynx, and MEDLINE) and a developer, often in partnership with other entities, of databases and services (Appendix B). An example of one internally developed resource is CE Link, a calendar of national continuing education events searchable by keyword, specialty, target audience, accrediting agency, and location. Another example is the New Drugs database, a compendium of on-line drug monographs and selected journal references. The full text of the references may be ordered from the Health Sciences Library via the New Drugs database interface.

While originally conceived as a multidisciplinary information service for rural hospitals, the future focus will be to encourage individual practitioners to access its resources from their local practice sites. In addition to its role as an information provider, CONSULT also provides on-line classes and other computer training opportunities for its clients. Its present x.25 packet data network, available in 53 of West Virginia's 55 counties, adequately meets the needs of the current text-only service; however, an anticipated move to a graphical environment will make it necessary to use other telecommunication options that support transmission protocols for graphical user interfaces. Adoption of a uniform interface for the suite of CONSULT services will enable a uniform method of interaction regardless which services on-line clients choose.

The West Virginia Drug Information Center is a statewide service operated by the WVU School of Pharmacy. The WVDIC has been in existence for 25 years and serves as a drug information resource to health care providers throughout West Virginia and the surrounding region. The WVDIC also educates students both on and off-campus about drugs and drug information resources. During the past year, almost 3,000 requests for information were answered by the WVDIC. Many of the calls received are from rural areas in which access to medical or drug information is either limited or non-existent. In addition to providing specific answers to drug information inquiries, the WVDIC also sends journal articles and other supporting materials as needed or requested. The types of questions received by the WVDIC are varied, and include requests for information pertaining to drug identification, dosage and administration, therapeutic uses, adverse reactions, drug interactions, and product availability, among many others.
 

The Cancer Information Service (CIS) is part of the Mary Babb Randolph Cancer Center at the HSC. The CIS provides information services to West Virginia, Virginia, and Ohio, and it is one of the largest of the National Cancer Institute’s (NCI) regional information service projects. The staff of CIS take over 30,000 calls annually and serve a population of nearly 19 million people. The CIS provides toll-free (1-800-CANCER) information to cancer patients, their families, the general public, and health care professionals. It is a source of accurate, confidential answers to questions about cancer prevention, detection, state-of-the-art treatment, and community services. Recently, the CIS initiated a new cancer outreach component with an emphasis on special populations, women, and minority groups.

Academic Technologies is responsible for working with HSC faculty and staff to develop and implement information and instructional technologies that support the Health Sciences Center mission of excellence in teaching patient care, research, service, and outreach. Academic Technologies is comprised of Advanced Technology, Instructional Technology, Biomedical Communications, and Academic User Support.

Areas of responsibility include development of instructional materials, management of the HSC public Internet presence, future information technologies development and integration, working with external organizations to facilitate transfer of information technologies that serve HSC mission needs, evaluation of curriculum, evaluation and selection of curriculum materials, and biomedical imaging and pre-press production of materials for publication and presentation.

B. 4. i. Health Sciences Library  (Back to the Top)

The Health Sciences Library (HSL) is a central information hub for the Health Sciences Center and West Virginia University. It is the National Network of Libraries of Medicine (NNLM) resource library for the state of West Virginia, the largest health information facility in the state, and the only health sciences library in the state with a strong research component.

The library provides for the information needs of WVU students and faculty working and learning at sites throughout the state, and the surrounding Appalachian region. The rugged terrain and the rural nature of West Virginia, coupled with the need to support students and health care providers at remote locations, requires the development of innovative ways to provide easy-to-use access to the resources maintained at WVU and through the Internet. Library resources have been made available to affiliated users within the RCB HSC through the campus backbone and to remote locations through Internet connections and via dial-up service provided by WV CONSULT and the WVU Libraries. MEDLINE access is provided currently through the fixed-fee NLM contract (locally named Mountain Med), with document delivery support through Loansome Doc. An ARIEL workstation in the HSL and at other key sites facilitates rapid delivery of interlibrary loan documents, and new software will be installed to allow conversion of documents to electronic mail formats.

Health Sciences Library resources include a conventional collection of over 270,000 volumes and extensive electronic access to literature-based resources. Among the electronic resources either currently available or planned in the near future are: NOTIS on-line catalog (including collections of the WVU Libraries, the Charleston Division Health Sciences Library, and WVU regional campus libraries); ten of the H. W. Wilson databases; networked access to NLM databases and CINAHL on CD-ROM using SilverPlatter software; CDC and other U.S. Government databases on CD-ROM; Science Citation Index on CD-ROM; Current Contents (diskette and OPAC); and Internet access to a variety of resources, including access to Internet Grateful Med, through the Health Sciences Library WWW homepage.

This wide range of information resources is supported by a solid core of experienced library faculty and staff. Instruction in use of conventional and electronic resources is provided to students, faculty, and staff from throughout the HSC in support of evidence-based instruction and practice. The HSL and WV CONSULT have created, independently and jointly, documentation and instructional materials to facilitate user access and effective use of the available resources. Direct user support is provided in the Library and via telephone and electronic means.

The size and configuration of the Library staff is an area which was addressed through the 1994-95 strategic planning process. Specifically addressed to date have been the addition of an Electronic Resources Reference Librarian and the development of another reference librarian as the Health Sciences Library’s webmaster and other staffing will be addressed when the search for the new Director is completed in the Fall of 1997. The new Director will report jointly to the Dean, West Virginia University Libraries and the Vice President for Health Sciences.

B. 4. j. HSC Information Systems Operations (Academic)  (Back to the Top)

Information Systems Operations provides networking services, user training and help desk support to Health Sciences Center students, faculty, and staff. Primary goals of the department are to provide state-of-the-art network infrastructure, user training and support in academic and clinical environments. User training is supported through the Computer-Based Learning Center (CBLC), a computer laboratory facility that provides DOS/Windows and Macintosh computing environments. Major uses of the CBLC computer laboratories are in three categories: 1) open use by students for computer-based tutorials and class assignments; 2) use by classes; and 3) workshops and seminars for students, faculty, and staff.