Category Archives: News

Update on the WV e-Directive Registry as of Nov 2013

Update on the WV e-Directive Registry


Since its inception in October 2010, the Registry has received over 22,000 forms. In the last year the percent of forms received each month is up over 30% with the largest increase in POST forms which are up over 40% per month. There are now 50 institutions or agencies including hospitals, nursing homes, home care agencies, hospices and private practice physician offices that have obtained Registry use status and the number is increasing every month.  The West Virginia Center for End-of-Life Care staff are often called with the four questions that appear below and their answers. The Center encourages you to submit advance directive and medical order forms (DNR card and POST forms) to the Registry so that your patients’ treatment wishes will be known and honored.





















Recently received questions about the Registry –


1.            Must I be a Registry user to submit forms to the Registry?

No, you do not need to have access to the Registry to submit forms.  You can submit DNR cards, POST forms, advance directive documents, surrogate selection forms, guardianship papers, and durable powers of attorney with a health care clause by FAX to the Registry.  You can also call the WV Center for End-of-Life Care during regular business hours (877.209.8086) if you are searching for an advance directive, medical order, or other document.  We do, however, encourage you to complete the documents necessary to access the Registry on your own.


2.            Can I still obtain documents from the Registry while I am waiting for my facility to complete the documents necessary for Registry access?

Treating health care professionals can request Registry documents from 8:00 am – 4:30 pm Monday through Friday by sending the request on your facility FAX cover sheet or letterhead, the face sheet from the patient/resident chart from your facility, and a signed copy of the Health Care Provider Request for Registry Information that can be found on the e-Directive Registry page of the WV Center for End-of-Life Care website (  or clicking on the link in this answer.



3.            If my facility is considering signing up for full service with the WV Health Information Network (WVHIN), can we sign up for Registry access while we are waiting for the additional documents to be completed?

Yes, you can sign up for the Registry individually.  Access to the Registry requires the completion of the WVHIN Participation Agreement, WV e-Directive Registry Agreement, and the Business Associate Agreement.  If you are considering services other than the Registry, contact the WVHIN offices at 304-558-4503 for assistance.


4.            Can my facility have more than one Authorized Administrator to assign usernames and passwords to the Registry?

Yes, you can.  Several facilities have done this because of an anticipated extended medical leave of one Administrator.  New Registry users can be provisioned in a timely manner and employees who leave the facility can have their access removed.

Toll-free number – 877-209-8086

WV e-Directive RegistryFAX 304-293-7442

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Supported by funding from the WV Department of Health and Human Resources




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Improving the Health of your Patients and your Practice – Vaccine Purchasing Program

According to the CDC, many seniors are still not being vaccinated for the potentially fatal conditions of influenza and pneumonia.

Effectively addressing this problem is just one of the key reasons we are working with Atlantic Health Partners, the nation’s leading vaccine buying group.  Atlantic offers our members the most favorable pricing and terms for Merck and Sanofi vaccines, along with outstanding customer service.  Atlantic’s mission is to positively impact medical practice performance and public health outcomes by empowering physicians to more cost-effectively and efficiently provide immunizations to patients.

Atlantic’s program is especially effective for Family Physicians, and can help you with everything from back to school immunizations and the influenza season, to more effectively immunizing Medicare patients including vaccines covered under Part D.

WVAFP members currently participating with Atlantic are most satisfied with the pricing, support, and ease of administration.   We strongly recommend you contact Cindy or Jeff at Atlantic at 800-741-2044 or email at to better determine how Atlantic can help your practice.   You can also visit their web

Download (PDF, 55KB)

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Kimberly Becher, MD — Marshall Family Medicine Resident elected to AAFP Board of Directors

imberly R. Becher, MD, a family physician in Culloden, W.Va., serves on the board of directors of the American Academy of Family Physicians. The AAFP represents 110,600 physicians and medical students nationwide. Becher was elected to a one-year term by the National Congress of Family Medicine Residents and was confirmed by the governing body of the AAFP, the Congress of Delegates.

As the resident member of the board of directors, Becher represents the interests and opinions of the National Congress of Family Medicine Residents to the AAFP Board of Directors and Congress of Delegates. In addition, she will advocate on behalf of family physicians and patients nationwide to inspire positive change in the U.S. health care system.

As the resident member of the board of directors, Becher represents the interests and opinions of the National Congress of Family Medicine Residents to the AAFP Board of Directors and Congress of Delegates. In addition, she will advocate on behalf of family physicians and patients nationwide to inspire positive change in the U.S. health care system.

A member of the AAFP since 2008, Becher has served in several leadership positions at the university, state and national level. As a fourth-year medical student, she served on the AAFP Commission on Governmental Advocacy. She also was selected to serve as a resident spokesperson for the AAFP’s 2012 visit to the White House, where participants from around the country discussed care coordination efforts that improved health outcomes and reduced fragmentation and duplication of care.

On the state level, Becher served as the student member of the West Virginia Academy of Family Physicians Board of Directors and as a member of the chapter’s Legislation and Government Affairs Committee.

Active in the Family Medicine Interest Group at the Marshall University Joan C. Edwards School of Medicine, she served as the group’s president in 2011.

Passionate about health policy and reform advocacy, Becher was named one of Marshall University’s Paul Ambrose Health Policy Fellows. In this capacity, she participates in key health policy meetings of the West Virginia state legislature and serves as a physician resource to legislative leaders.

In addition, Becher has served as a volunteer physician at the Marshall Medical Outreach homeless clinic and as a volunteer at The Health Sciences and Technology Academy of West Virginia University summer camp, a math and science program that aims to empower minority, rural and underrepresented high school students. She also went on a medical mission to Honduras in 2008 as part of Global Brigades Honduras.

Becher, who grew up in West Virginia and received her medical degree from Marshall University Joan C. Edwards School of Medicine in 2011, is in her third and final year of residency and serves as one of the department’s chief residents. She earned her Bachelor of Science Degree in biology from Denison University in Granville, Ohio, in 2002.

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Michael Lewis, MD — ‘Celebration of Life’

Dr. Mike Lewis – Medical Treasure
West Virginia has lost a true medical treasure. Mike Lewis, MD, died with peace and dignity at the Hubbard Hospice House in Charleston, where he received compassionate comfort measures for his end-of-life care. This is reflective of his dynamic medical career advocacy for hospice services and end-of-life care through advanced directives. Mike was beloved by his wife Mino, daughters Beth and Tana, six grandchildren, immediate family, friends, colleagues and patients. A “Celebration of Life” service is planned for 1 PM on Saturday at Barlow Bonsall Funeral Home in Charleston.
A rural Raleigh County native and distinguished family physician, he resigned as the Department of Health and Human Resources cabinet secretary for health reasons a little over a year ago. He headed the agency for 18 months and upon leaving this position Governor Earl Ray Tomblin described Lewis as “a compassionate healthcare advocate who has provided outstanding service since he accepted the position of cabinet secretary. . . a man who is kind, intelligent, patient and dedicated to his profession and the health of all West Virginians.”  Well, that just about says it all.
In his DHHR letter of resignation, Mike expressed gratitude for the opportunity to serve West Virginia. “My life has come full circle, from the chronically-ill child raised in southern West Virginia in need of healthcare to heading the department responsible for delivery of the same,” he wrote. “Serving West Virginia has been the greatest honor of my life.”
Thom Stevens, WVAFP’s Lobbyists in a column for the Sunday Gazette-Mail on June 24, 2012, “It seems like Mike was preparing for the DHHR cabinet secretary position during his entire medical career. With his degree from the WVU School of Medicine, he also served there as Chair of the Department of Family Medicine, Associate Dean of the Charleston Division and Associate Vice President for Health Sciences.  He also was the Director of Graduate Medical Education at CAMC, Board Member of the WVU Hospitals/United Health System, and Vice Chancellor for Health Sciences at the Higher Education Policy Commission.”

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Take Five (5) Minutes to give WVSMA Your Thoughts on their Journal

Please take this short survey about the West Virginia Medical Journal (WVMJ) to help improve the usefulness of the Journal. The WVSMA wants to meet the needs and expectations of WV physicians.–Thank you!

Click Here For Survey

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Dr. John A. Parker Jr., a family physician from Huntington, was installed April 19th as president of the West Virginia Academy of Family Physicians during the 61st Annual Scientific Assembly held at the Embassy Suites in Charleston. Parker is an associate professor of Family Medicine at the Marshall University’s Joan C. Edwards School of Medicine.

Parker serves as the medical director for the Marshall University Department of Family and Community Medicine’s Rural Residency program at the Lincoln Primary Care Center in Hamlin. Prior to his employment at the Joan C. Edwards School of Medicine, he was employed as a community physician at Tug River Health Center in McDowell County.

He has a certificate in Tropical Medicine and served more than 12 years with the U.S. Army as a physician and 12 years as a missionary serving patients in South American countries.

A board-certified family physician, Parker earned his undergraduate degree from the University of Virginia in Charlottesville, Va., and his medical degree from University of Virginia Medical School. He completed a family medicine residency at the Eisenhower Army Medical Center, Fort Gordon, Ga.


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2013 Family Doctor of the Year

James Becker, MD a family physician from Huntington, WV was the recipient of the West Virginia Academy of Family Physicians highest award – Family Doctor of the Year for 2012.  The award was presented by John Parker, MD during the West Virginia Academy of Family Physicians (WVAFP) 61st  Annual Scientific Assembly held on April 19th, 2013 at the Embassy Suites in Charleston, WV.   Thom Stevens, WVAFP Government Affairs liaison made the oral presentation.  Mr. Stevens noted that Dr. Becker has served for the past several years as the Medical Director for the WVAFP’s Doc for a Day at the WV Legislature.  During his tenure as Medical Director was responsible for establishing medical protocols for emergency care that are responsible for saving lives.  Mr. Stevens noted, ‘Jim has been a strong physician leader that has made a difference in the health and welfare of not only the legislative body when their in session but the capitol employees.”

The Family Doctor of the Year Award honors an outstanding, community-minded family physician that provides compassionate, comprehensive care.  In addition to his role as Medical Director for the Doc for a Day program Dr. Becker was recognized for being a role model to medical students and resident physicians as well as to his physician colleagues.  He is noted for his tireless devotion to improving the quality of life for his patients and bettering his community.

A board-certified family physician, Dr. Becker completed medical school at the Marshall University’s Joan C. Edwards School of Medicine in 1993.  He did his family medicine residency at Marshall University in Huntington, WV .

Founded in 1948, the West Virginia Academy of Family Physicians represents more than 1,000 physicians and medical students statewide.  It is the largest medical specialty society devoted solely to primary care.  The West Virginia Academy of Family Physicians is a chapter of the American Academy of Family Physicians.

To learn more about the specialty of family medicine, the AAFP’s positions on issues and clinical are, and for downloadable multi-media highlighting family medicine, visit  For information about healthcare, health conditions and and wellness, please visit the AAFP’s award-winning consumer Web site,

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Enhanced Primary Care Payment Info

Primary care physicians can find up-dated information regarding the Enhanced Primary Care Payment at  under News and Announcements.  Everything you need, including the self-attestation form is there.

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WV Center for End-of-Life Care: West Virginia Touted for Its Successful Program

Journal of Clinical Ethics Recognizes Advantages of POST Over Advance Directives: West Virginia Touted for Its Successful Program

In the most recent issue, the Journal of Clinical Ethics published a Legal Briefing on POLST: Physician Orders for Life Sustaining Treatment. The authors, Thaddeus Mason Pope, JD, PhD Director of the Health Law Institute and Associate Professor of Law at Hamline University School of Law, Saint Paul, Minnesota and Melinda Hexum, MS, second-year law student and Associate Editor of the Hamline Law Review, noted that there are at least fourteen different names for similar forms used throughout the United States. Originally called Physician Orders for Life-Sustaining Treatment (POLST) in Oregon, there are many different acronyms including MOLST (Medical Orders for Life-Sustaining Treatment) and four other acronyms based on scope of treatment rather than on life-sustaining treatment. Idaho, Indiana, South Carolina, Tennessee, and Virginia call their form POST as does West Virginia. Louisiana calls their form La POST and Alaska, Colorado, Kentucky, New Mexico, and North Carolina call their form MOST (Medical Orders for Scope of Treatment). The authors regard POST programs as a “national phenomenon.” As of September 2012, at least 46 states or communities had a POST program of some form. The authors note that advance directives have had limited success. They recognize several advantages of POST forms over advance directives.

  • It is signed by a healthcare provider. There is no need for interpretation and translation. It is an immediately actionable medical order.
  • It is easy to follow because it is on a single-page, standardized form.
  • Unlike Do Not Resuscitate (DNR) orders, POST addresses not just CPR but an entire range of life- sustaining interventions.
  • POST is transportable. It is a brightly colored clearly identifiable form that remains in the patient’s chart and travels with the patient from hospital to nursing home to ambulance to the patient’s home.

The authors also note that POST protects and promotes patient autonomy better than advance directives in four ways.

  • POST is created with a healthcare provider at or near the time when an acute or serious condition develops. POST has a greater chance of being more informative, more relevant to the specific medical situation at hand.
  • Since the form is highly visible, portable, and travels with the patient’s medical records it is more likely to be available when a decision must be made.
  • Since it is written in precise medical language, it is better understood.
  • Since it is signed by a health care provider, it has a greater chance of compliance by other providers.

The authors observe that POST is more than a form; it is a tool providing a framework for end-of-life care conversations between patients, families, and healthcare providers. Providers are encouraged to discuss specific scenarios and treatment options. Patients and families have the chance to ask questions and make their wishes known. In short, it gives patients more control of their end-of-life care. With POST, “healthcare providers know immediately what patients do and do not want, and they can provide treatment and care consistent with these preferences.”

West Virginia recognized 

The authors identify four states as having particularly better established POST programs: West Virginia, Oregon, New York, and California. They observe that in these four states the POST form and program have achieved broad clinical acceptance; use of POST is particularly well documented in West Virginia and Oregon since investigators in both states have published research reporting the vast majority of nursing facilities and hospices in the states use the POST form. These states have also ensured the sustainability and refinement of their programs through the maintenance of effective statewide and local coalitions and through obtaining significant financial support.

In a section in the article on statutory recognition of POST, West Virginia is cited as an example of a state whose laws provide more detail regarding the POST form but with enough leeway to allow the form to evolve without amending state law.

In the section in the article on electronic registries, West Virginia and Idaho are commended for having state registries that contain not only POST documents but also advance directives and other healthcare documents. At the end of the review on POST forms, the authors conclude:

“POST helps patients. It documents a patient’s wishes for life-sustaining treatment in the form of a medical order. It streamlines the transfer of patient records between facilities. It clarifies treatment intentions and minimizes confusion about patient preferences. It assists physicians, nurses, emergency personnel, and health care facilities in promoting patient autonomy. It optimizes comfort care of patients.”

The authors also observe that POST programs are driving other healthcare-related reforms. Most notably is greater attention to advance care planning. Because the POST form requires the patient to express his or her preferences with regard to not only CPR but also a desired level of medical intervention, completion of the POST form is promoting conversations which are helpful to patients and families to ensure the patient’s wishes are respected and families are not burdened with making decisions unaware of their loved one’s wishes.

It is gratifying to see the recognition by The Journal of Clinical Ethics of the advantages of the POST program and to see that West Virginia identified as one of the leading states in this national phenomenon!

Thaddeus Mason Pope and Melinda Hexum, “Legal Briefing: POLST: Physician Orders for Life-Sustaining Treatment,” The Journal of Clinical Ethics 23, no. 4 (Winter 2012): 353-76.

Toll-free number

WV e-Directive Registry
FAX 304-293-7442

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Innovation to Improve Health Care Quality and Reduce Costs: The Benefits of Palliative Care

Dr. Alvin H. “Woody” Moss, Director WV End of Life Center, will provide participants should be able to –
1.       Describe the elements of palliative care
2.       Discuss how to have “the conversation” with patients and families
3.       Explain how goals of care clarification improves patient care and reduces costs
4.       Demonstrate knowledge of the system in West Virginia to identify and respect patients’ end-of-life wishes
5.       Distinguish the role of hospital palliative care teams, the POST form, and the e-Directive Registry in the system.

This Webinar is approved for 1 AAFP Prescribed credit.

The FREE Webinar is available at

To receive CME you must complete the survey at

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