"We are really at a tipping point here; providers and patients alike have come to realize that the modernization of healthcare is long overdue and that we all have a role in its broad adoption."
So said Jason Kunzman, project officer for the Office of the National Coordinator for Health Information Technology, as he moderated the "Beacon Communities: Leveraging Health IT to Fuel the Quality Revolution" education event at the recent HIMSS 2012 Virtual Conference and Expo.
The session featured presentations by officials from two Beacon Communities: Southeastern Minnesota (SE MN) Beacon Community and the Keystone Beacon Community of central Pennsylvania. They grappled with the "tipping point" referenced by Kunzman: how has health IT been fueling the quality revolution? Especially, how has it benefited these spotlighted health systems?
Southeastern Minnesota Beacon Community
Chris Chute, MD,, a principal investigator for the SE MN Beacon Community, discussed the IT running through the Beacon system.
The unique peer-to-peer HIE integrated throughout the community has been central to the community's infrastructure, he said. "This is distinct from most health information exchanges where the health information is the central hub and people subscribe to it. What's different about Southeastern Minnesota Beacon is that we have open-source software – the ONC-provided NwHIN-connect software – that is deployed in each and every provider," Chute said.
This diversion from a hub-and-spoke model ensures communication and engagement across providers, and the leveraging of a national model: "When we talk about provision of care in Southeastern Minnesota, we are really talking about an integrated network," he said, "and Beacon is the integrating element where all care providers are coordinating and engaged."
Along that strain, the community's public health providers utilize the Public Health Documentation System (PH-Doc) "that is an electronic medical record of public health services," Chute added. PH-Doc integrates information from public health services into the HIE network to outline "community views of ideal health information."
Running parallel to SE MN Beacon's HIE is a comprehensive CDR, said Lacey Hart, program manager for the SE MN Beacon Program. The depository allows for the tracking of clinical and population metrics in the area. To that end, researchers are able to monitor the community workflow and analyze where impacts are being seen.
Hart stressed data gaps, too, as a key aspect of area metrics highlighted by the advanced repository. "We looked at our data early on - before the repository - and now the data repository is really an excellent way to hone in on where the data gaps exist."
One timely example: SE MN Beacon has been monitoring asthma and diabetes trends, and outlining the clinical measures used to counter the disease. Using the CDR, however, researchers snagged a data hole; "…One of the things we were missing was the patient data," said Hart. Using metrics from the CDR, the Beacon team developed patient centric data gathering tools. The data exchange is now integrated with information on patient lifestyles
Keystone Beacon Community
Like its sibling in Minnesota, the Keystone Beacon Community of Central-PA is using IT to drive care improvements.
Geisinger Health System, a Pennsylvania-based health services organization, heads the Keystone HIE. The exchange connects 13 member facilities throughout the area.
The HIE began as a pilot system with three organizations, said Geisinger Health System IT Director and Keystone HIE Director Jim Younkin. It's now linked between 34 organizations. "The services that are being provided through Keystone Beacon include the EHRs being connected," he said. "EHRs now have the ability to publish and consume documents directly from the health information exchange."
The HIE includes patient and provider portal applications, and supports three distinct models of health exchange: the "pull model," the "send model," and the "push model," said Younkin.
"We started with the pull model, which is really just using the portal to do a look-up of information," he said. It hinges on "the idea of having a centralized data repository for access by members of the community."
The direct mode allows messaging between site clinicians and patients.
The push model will be rolled out this month, said Younkin: it allows clinicians "to subscribe to a patient through the health exchange, and then as activity occurs for that patient we can deliver alerts and notifications to those clinicians to inform them of certain activities."
With these various models and the portal applications supported by the Keystone HIE, Younkin says care capability is expanding in central Pennsylvania.
Similarly, IT has been catalyzing patient provision in the SE MN Beacon Community through HIE and CDR technology.
IT critical to achieving quality
The communities highlighted in the HIMSS virtual education event only strengthen the case for IT's critical place in fueling the quality revolution, said Kunzman. It's the essential ingredient, he said, in driving providers over that "tipping point" and in the right direction.
"We are at the end of year two in a three-year journey. Our Beacon Community grantees have made great achievements," said Kunzman. "They've enhanced the role that safety-net providers play in the overall continuum of care, Beacon communities and technology vendors have formed new collaborations in order to introduce efficiency in bringing the most important functionalities to market…"
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