Presentation by Dr Aaron McKethan, who's running the Beacon Communities project at ONC. This was the presentation he gave to the Health 2.0 Community in the webinar on July 21
FDMA FLAP - The first dorsal metacarpal artery (FDMA) flap is used mainly for...
Beacons and the Health 2 0 community
1. Beacons and the Health 2.0 Community
Office of the National Coordinator for Health
Information Technology
July 21, 2010
2. The HITECH Act Vision
• A major transformation in American health care
• Each patient receives optimal care through
nationwide health information exchange
• Programs and regulations to help overcome
obstacles to adoption and Meaningful Use of
electronic health records (EHRs) and to enable
breakthrough advances in health and health
care
3. The HITECH Act
• Part of American Recovery and
Reinvestment Act of 2009 (ARRA)
• Goal: Every American to have an
EHR by 2014
• Systematically addresses major
barriers to adoption and Meaningful
Use:
– Money/market reform
– Technical assistance, support, and
better information
– Health information exchange
– Privacy and security
4. How HITECH Addresses Barriers to Adoption
Obstacle Intervention Funds Allocated
• Medicare and Medicaid EHR
Market Failure, Need for
Incentive Programs for “Meaningful • $27.3 B*
Financial Resources Use”
Addressing Adoption • Regional Extension Centers • $643 M
Difficulties • Health IT Research/Resource Center • $50 M
Workforce Training • Workforce Training Programs • $84 M
• Strategic Health Information
Addressing Technology • $60 M
Technology Advanced Research
Challenges and Providing
Projects
Breakthrough Examples • Beacon Communities Programs • $250 M
• Policy Framework Addressed
Privacy and Security • New Privacy and Security Policies across all
Programs
• NHIN, Standards and Certification • $64.3 M
Need for Platform for Health
• State Cooperative Agreement • $548 M
Information Exchange Program
*$27.3 B is high scenario
5. Unprecedented Moment for Health
System Performance Improvement
• HITECH Act
• Affordable Care Act
• Action at Local, Regional, and National Levels
– Shared urgency to seize opportunities and address gaps
– New communications and technology tools
– Growing body of evidence about effective approaches
– Strong and growing local leadership and collaboration
7. “Tribes” of Health System Improvement:
Different Interpretations, Strategies, and Tools
1. Quality Improvement Crusaders
2. Payment Reformers
3. Consumer Energizers
4. Health IT Champions
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8. Tribe 1: Quality Improvement Crusaders
Scientific evaluation methods and management techniques to achieve
better patient outcomes
• Data analysis and performance measurement
- Provider feedback processes, evidence-informed guidelines
• Management techniques
- Lean manufacturing, continuous quality improvement
• Learning and “best practices”
- e.g., avoiding complications in the ICU, reducing hospital
readmissions, improving care transitions, reducing infection
and surgical-complication rates, etc.
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9. Tribe 2: Payment Reformers
Alternatives to volume-based payments to support systematic
improvements in care and opportunities for slower spending growth
• Fee-for-service payments drive toward more, not better care
• Misalignment of primary care and technology-intensive services
• Underdevelopment of value-increasing quality improvement and care
coordination improvements
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10. Tribe 3: Consumer Energizers
Better information and appropriate incentives to help consumers
improve their own health, save money, and achieve better outcomes
• Providing better information to make better informed consumers
• Consumer responsiveness to out-of-pocket costs
• New value-based insurance design
• Shared decision making/informed patient choice
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11. Tribe 4: Health IT Champions
Electronic infrastructure to support administrative simplification, error
avoidance, and improved outcomes
• Widespread adoption of electronic health records
• Tools to support physicians in achieving high-value care
- e.g., clinical decision support tools
• Tools to help consumers make optimal health care decisions
– e.g., personal health records
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12. Tribal Approaches to Health System Reform
• Quality improvement activities may be unsustainable due to
volume-based payment methods
• Payment reforms ineffective if unaccompanied by changes in
provider practices and consumer behavior
• Uncoordinated care subjecting even highly engaged and
informed patients to fragmented care
• Higher spending on technology with uncertain benefits
Yet…tribal approaches to health system reform are common
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13. The Beacon Community Program
• Goal: Demonstrate specific ways that communities
can achieve sustainable health improvement and cost
savings through complex health IT-enabled reforms
• 15* demonstration communities that will:
– Build and strengthen their HIT infrastructure and
exchange capabilities and showcase the Meaningful Use
of EHRs
– Provide valuable lessons to guide other communities to
achieve measurable improvement in the quality and
efficiency of health services or public health outcomes
*Two additional communities to be funded in Summer 2010
15. Round 1 Beacon Communities
Lead Organization Location
Community Services Council of Tulsa Tulsa, Oklahoma
Delta Health Alliance Stoneville, Mississippi
Eastern Maine Healthcare System Brewer, Maine
Geisinger Clinic Danville, Pennsylvania
HealthInsight Salt Lake City, Utah
Indiana Health Information Exchange Indianapolis, Indiana
Inland Northwest Health Services Spokane, Washington
Louisiana Public Health Institute New Orleans, Louisiana
Mayo Clinic College of Medicine Rochester, Minnesota
The Regents of the University of California, San Diego San Diego, California
Rhode Island Quality Institute Providence, Rhode Island
Rocky Mountain Health Maintenance Organization Grand Junction, Colorado
Southern Piedmont Community Care Plan, Inc. Concord, North Carolina
University of Hawaii at Hilo Hilo, Hawaii
Western New York Clinical Information Exchange Buffalo, New York
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16. Beacon Community 90-Day Workplan
Program Goals
Community Beacon “Community Objectives” encompassing
Objectives CO CO cost, quality, and population health
Measured MO MO MO MO Well-defined measurable improvement goals
Outcomes
Defining risks and barriers and establishing plans to prevent or mitigate them
Outputs O O O O O O Operational and process results of core activities
Activities A A A A A A Tasks/interventions leading to outputs
Resources R R R R R R R R R R R R Resources needed to support activities and meet
stated outcome goals
Sustainability plan outlining provider reimbursement,
program revenue, and other strategies
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17. Geisinger Clinic (Keystone Beacon Program)
Summary of 1 out of 10 Beacon/Geisinger Community
Program Goals
Objectives (Logic Models)
Community Improve quality and efficiency among targeted patients with Chronic
Objectives CO Obstructive Pulmonary Disease (COPD) and Heart Failure (HF)
Reductions in hospital admissions, avoidable 30-day hospital
Measured MO MO readmissions, and ED visits among target patients; increased access
Outcomes to/utilization of primary care services among same patients
Specific plans to prevent or mitigate implementation risks and barriers
Outputs O O O O Medication reconciliation outputs, hospital discharge counseling,
targeted case management contact, web-based portals, others
Comprehensive HIT-enabled care model includes care process redesign
Activities A A A A and teaming; integration across all systems of care, care protocols;
performance feedback to patients and clinicians, and reminder systems
Specific funding allotments to core activities phased in over new areas
Resources R R R R R R R R and over time; dedicated administrative, IT, and clinical teams
Sustainability plan: integration of accountable care payment model
aligned with health IT-enabled performance improvement goals
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18. Conclusion and Discussion Questions
• What are new innovative tools and applications
that can help “unite the tribes” in these and other
communities?
– Real-time data interfaces (providers and consumers)
– Prizes, challenges
– Data visualizations
• How do we ensure that the lessons learned from
communities participating in Beacon
Communities are shared in a broader and
dynamic learning network environment?