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05/30/2003 - INHS Is Healthcare Superpower

That Inland Northwest Health Services (INHS) exits at all is amazing. That there is no organization quite like them in the United States is glorious. Given the uniqueness of their very existence, it probably isn’t surprising that they make exemplary use of all the technology available to them. What’s more, they’ve made it all happen as a 501(c)(3) not-for-profit corporation.

INHS began in 1994 as collaboration between Empire Health Services and Providence Services of Eastern Washington -- those are the management companies of Deaconess and Valley Hospital, and Sacred Heart and Holy Family. These companies were, and still are, major competitors, but they put the competition aside to create INHS in order to more efficiently provide better patient care at a better price for the entire 4-state Inland Northwest region. INHS didn’t happen overnight. After years of care from its Board of Directors, the first management team came on board in 1998. INHS personnel and programs were scattered through the various hospitals and other leased space until their move into the Holley Mason Building in October 2001. INHS occupies two entire floors at the Holley Mason, and their facility includes a state-of-the-art information resource management center with a 24 x 7 help desk.

From their headquarters in the Holley Mason Building, INHS operates a private, unified regional network using Internet Protocols (IP). This is a private network specifically for healthcare and is the basis for their Information Resource Management Division. Their Wide Area Network (WAN) in Washington serves rural areas and hospitals from Newport to Aberdeen and from Republic to Goldendale. INHS uses the NoaNet for high-speed/broadband health care delivery in rural areas where it is available.

In Spokane, INHS has a Metropolitan Area Network (MAN) that is an Asynchronous Transfer Mode (ATM) fiber ring connecting hospitals, physicians, imaging companies, pharmacies, and PAML, the reference laboratory. INHS is currently in the process of changing ATM to gigabit Ethernet. The WAN connects through INHS to the MAN. Each hospital has a Local Area Network (LAN) that also connects to the MAN. Spokane’s hospitals are among the ‘most wired’ in the world. Because this is a dedicated network, it is unified, secure and stable.

As custodian of the networks, INHS creates and implements standards and protocols making all of the networks work together, and making sure that the entire network can be used for data exchange, or video, or voice. INHS is also the trusted source for security. They have implemented security standards, security practices, and are the watchdogs that monitor network security. Additional benefits of the fiber ring and infrastructure include data backup and storage, disaster recovery, redundancy, and bandwidth management. According to Fred Galusha, CIO, the network has been five years in the making, and 300 new physicians have signed up to use it, just since January. Because the hospitals don’t have to worry about infrastructure and its management, they can concentrate on applications that serve their patients.

INHS has been inventive in their use of this network. They have instituted a program they call “Telepharmacy.” Telepharmacy began when the hospital in Othello, Washington lost its pharmacist and was unable to find a replacement. INHS, working with Sacred Heart Medical Center, helped solve the problem. Using Pyxis Corporation hardware and software and the INHS WAN, the rural physician writes a prescription, which is scanned using PyxisConnect, and subsequently entered into the hospital’s database. The scanned image is transmitted to the Sacred Heart pharmacy. The pharmacist on duty at Sacred Heart views the digitally clarified image and reviews the order. The Spokane-based pharmacist checks for adverse drug interactions, and current lab values, and then approves the order, which allows the Pyxis medication administration cabinet to authorize access to stored medications. The pharmacist and the doctor or nurse at the remote hospital can consult over a video link when needed. Using the WAN, the medication can be visually verified before administration. “No one else in the United States has this system,” says Nancy Vorhees, INHS COO.

The Information Resources Management (IRM) division of INHS is continually implementing new technology made possible by the network. They have implemented electronic clinical documentation at the bedside and radiology image distribution. IRM provides online insurance eligibility, patient registration, and appointment scheduling. The IRM, through their program called MedDirect, has a database of over 4,600 regional physicians and mid-level practitioners for patient referral, consultation, information and research. Through their 24 x 7 help desk, INHS connects these health professionals as needed. Thanks to the INHS WAN, the connection requires only 3 - 5 minutes.

The INHS networks are used heavily for many applications. There is a newly implemented system for electronic patient charts that can be viewed at bedside on handheld hardware. There is the capability for emergency medicine consultation between the Deaconess emergency room and the Newport and Ferry County hospitals. Educational programs for both patients and professionals are transmitted regularly. The network’s purpose is to provide better health care to the patient at a more affordable cost.

The list of services that INHS facilitates and provides goes on and on. In addition to IRM, INHS oversees Northwest MedStar with bases at Spokane’s Felts Field, in Moses Lake and the Tri-cities. They oversee Northwest MedVan, Northwest Telehealth, and Spokane MedDirect. INHS oversees Community Health Education and Resources, Regional Outreach and Management, and St. Luke’s Rehabilitation Institute. Finally, they are in charge of the Children’s Miracle Network.

“Our plan for the future,” says Vorhees, “is to expand the services we already have to benefit more and more people.” “We’d like to be able to provide all of Spokane’s services to the 4-state Inland Northwest Region.”

For more information about INHS, go to

Billie Moreland
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