Turn up the light

Beacon Communities provided serious community change
By Bernie Monegain
12:00 AM
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As Asaf Bitton, MD, views the Beacon Communities across the country as having provided serious community change in how care is delivered.
Bitton, who works at Brigham and Women's Hospital in Boston and at the Harvard Medical School Center for Primary Care, calls the Beacon program"an audacious move."
It is that. And, now, as the Beacon initiative comes to an end, we hope the existing Beacons will grow and continue the work that they have just begun in their communities. It has been only three years, after all - just enough time to put up the scaffolding, as Bitton suggests, but there is so much more to accomplish.
For one, the Beacon approach needs to be adopted beyond the 17 communities that were selected and funded by ONC over three years with a total of $250 million. That was always the intent - to spur a new and robust model of care delivery.
The aim of the program, as stated by ONC, is threefold, and it is sweeping and demanding.
• Build and strengthen the health IT infrastructure and exchange capabilities within communities, positioning each community to pursue a new level of sustainable healthcare quality and efficiency over the coming years;
• Translate investments in health IT to measureable improvements in cost, quality and population health; and
• Develop innovative approaches to performance measurement, technology and care delivery to accelerate evidence generation for new approaches.
The 17 Beacons were to "illuminate the path," as ONC chief Farzad Mostashari put it.
As communities across the country look to the 17 Beacons for guidance, they will see a multitude of projects aimed at getting the communities to the broad goals set by ONC. Healthcare IT News spotlights three Beacon Communities in the cover story that begins on P. 4.
New York partnered with the Veterans Administration and with Blue Cross Blue Shield on patient registries. Partnerships seem to be key to many of the Beacons. New models of care seek to break down silos and improve collaboration.
One of the hallmarks to providing topnotch care is the easy exchange of information from one entity to another. In San Diego data flows freely among Kaiser Permanente, UC San Diego Health System, San Diego Department of Veteran's Affairs and Rady Children's Hospital.
The Tulsa, Okla. Beacon achieved a 24 percent reduction in unnecessary specialty care visits because nearly a quarter of the time, specialists advised the referring physician online rather than seeing the patient in person.
These are just a few samplings of Beacon achievements. All the Beacons juggled several initiatives aimed at achieving the goals set by ONC. One obvious common thread seems to be a focus on data exchange.
We hope the 17 Beacon Communities that are already on their way to meaningful change will push harder and further in their quest to reshape care. We hope, too, that they turn their lights on high - the better to inspire and light the way for other communities across the country to follow in their footsteps. Each effort will be unique as each community is distinctive, but there will be common threads: A focus on population management, data exchange, improved quality and reduced costs and, always, on metrics.
Some of the work seems intractable. However, in spite of the challenges - or perhaps because of them - Beacon Communities have shown remarkable progress on many fronts.
One way the Beacons plan to light the way for other communities is through a series of learning guides, packed with lessons learned.
It is hard work.
Bitton suggests that if it were not hard, you'd know you're working on the wrong problem.
"We have a limited amount of time right now to seriously structure how we deliver care, the way we prioritize patients, the way that we value providers and certain types of care within our systems," he says.
He's right. At no other time has there been so much impetus, so much energy devoted to putting healthcare information technology to work on solving some of healthcare's most difficult issues and to reshaping this behemoth, clunky healthcare system of ours, and to putting patients at the center. The wind is pushing efforts forward. The time is now.