ONC looking to Beacons for database of insights from HIT frontier
The 17 Beacon communities around the country that have brought providers together within regions to use health IT and clinical interventions to elicit better patient care have each demonstrated measureable improvements, including for outcomes around chronic disease and preventive screenings.
These health IT model communities, which the Office of the National Coordinator for Health IT has funded, will wrap up their grant status in 2013. ONC hopes to gain an evidence database from the beacons’ experience to inform its policies and to share with other providers and organizations, according to Janhavi Kirtane, director of ONC’s clinical transformation and dissemination.
“The beacons are exploring new frontiers for health IT, generating a lot of different insights — some clinical, some technical, and some on the measurement side. We’re hoping to connect that with ONC, serving even as test beds for standards and policies,” Kirtane said at a recent meeting of the Health IT Policy Committee.
Each of the 17 model health IT communities aimed to strengthen health IT and health information exchange; improve quality, cost and population health; and test innovations for care delivery and performance measurement. Each of the communities has executed those in different ways, Kirtane added.
From Mississippi to San Diego to Maine, the lessons apply to different types of markets. Some beacons are in highly competitive markets and some with one dominant integrated delivery network. “So we’re hopeful that most providers across the country will be able to find themselves in some of these examples,” she said.
Some beacons have formed partnerships with other groups, such as the Robert Wood Johnson Foundation, and are participating in additional healthcare delivery and payment pilots to continue their objectives and to create a path toward sustainability.
For example, Bangor, ME Beacon Community is participating in the Pioneer Accountable Care Organization program, and three communities are involved in the Center for Medicare and Medicaid Innovation’s Comprehensive Primary Care Initiative. Those are the Greater Tulsa Health Access Network Beacon Community, Colorado Beacon Community, and Greater Cincinnati Beacon Community.
Recent developments among beacons have included:
- San Diego Beacon connected with Kaiser Permanente for health information exchange
- Central Indiana Beacon’s small remote monitoring technology pilot at St. Vincent’s Hospital helped to cut readmissions, and Ascension Health, a national hospital system, is considering scaling it
- Greater New Orleans HIE launched with a focus on safety net providers
- Pennsylvania’s Keystone Beacon technology enables skilled nursing facilities to share patient information without an EHR
In 2012, seven communities, including the Delta Blues Beacon in Mississippi and Southeast Michigan Beacon, established new exchange capabilities. And eight beacons are using health IT to connect a broader group of partners, such as public health agencies and schools.
Southeastern Minnesota Beacon, for instance, has partnered with 11 county public health agencies and 47 school districts, Kirtane continued, to explore how technology can drive the results they want to see for kids with asthma.
Beacons have demonstrated progress on process and intermediate outcome measures for chronic conditions, including cholesterol control for patients with cardiovascular disease in Bangor and diabetes screening rates in New Orleans. Measures for preventive care, such as cancer, behavioral health and depression screening, also improved, she said. For example, in Grand Junction, Colo., depression screenings for diabetics jumped from 68 percent to 93 percent.
“Driving the results are things like IT-enabled care management, which is affecting utilization in Bangor, Maine, and readmissions in Keystone in Pennsylvania. We’re also seeing some results around screening rates and management of chronic diabetes by just looking at the data and using that data to drive improvements,” Kirtane said.
Beacons are also using innovative tools, including tele-monitoring, personalized clinical decision support (CDS), and personal health records (PHRs) with their patients.
“What we’re hoping is to build evidence that will help people understand where we see consumer-facing technologies are making a difference and how that gets operationalized,” she said.
The next step is to consider linking the beacon lessons with ACOs, perhaps through a new Health IT Policy Committee panel, which could explore how “health IT can support the business needs of ACOs and some of these future payment pilots and innovative care models,” Kirtane said.