Crotty engaging patients in new ways from open notes to social media
Cmio nhin
1. NHIN 204 – Beacon Communities:
Spotlight on HIE Success Stories
FACULTY:
Craig Brammer – Deputy Director, Beacon
Communities Program, ONC
MODERATOR:
Aaron Seib
Interim CEO
National eHealth Collaborative
2. NHIN University
National eHealth Collaborative's NHIN University is a series of free webinars intended to
provide stakeholders with knowledge about what the Nationwide Health Information
Network (NHIN) is, how it works, and the vital trust fabric that underpins the safe and
secure exchange of health information over the Internet.
•NHIN 201 - The Importance of the Standards and Interoperability Framework
•NHIN 202 - NHIN Governance Authorities
•NHIN 203 - The Direct Project: Where We Are Today
•NHIN 204 - Beacon Communities: Spotlight on HIE Success Stories
•NHIN 205 - Revisiting the NHIN Value Proposition
Register for NHIN University: www.NationaleHealth.org/NHIN-U
Students may request a Spring Semester Certificate of Completion at
www.NationaleHealth.org/NHIN100certificate.aspx after completing NHIN 101 – 105.
To view recorded classes, go to www.NationaleHealth.org/NHIN-U or the HIMSS eLearning
Academy.
3. Please enter your questions or
comments in the Q&A window at the
bottom right of your screen.
OR…
• Send us an email at info@nationalehealth.org
• Tweet a question using hashtags #NeHC or #NHINU
• Join the conversation on NeHC’s new Facebook page at
http://www.facebook.com/pages/National-eHealth-
Collaborative/153115611367411
4. HITECH in Action:
The Beacon Community Program
Craig Brammer
Office of the National Coordinator for Health
Information Technology
5. Agenda
• Beacon Community Aims and Conceptual Model
• Beacon Logic Models
• Beacon Support Infrastructure
• Exchange Characteristics in 9 Beacon
Communities
6. Beacon Community Aims
• Demonstrate Better Care enabled by HIT
– Show that diverse communities can achieve
quality, affordable, efficient care, healthy
people and communities
• Support Lasting Learning Networks
– Wide range of stakeholders can collaborate,
design, & implement new ideas that improve
health & health care
• Provide lessons & best practices for other
communities
7. HITECH Addresses Barriers to Adoption
Obstacle Intervention Funds Allocated
Market Failure, Need for Medicare and Medicaid EHR Incentive
$27.3 B*
Financial Resources Programs for “Meaningful Use”
Addressing Adoption Regional Extension Centers $643 M
Difficulties Health IT Research/Resource Center $50 M
Workforce Training Workforce Training Programs $84 M
Addressing Technology Strategic Health Information $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
Need for Platform for Health NHIN, Standards and Certification $64.3 M
Information Exchange State Cooperative Agreement Program $548 M
*$27.3 B is high scenario
8. Beacon Community Conceptual Model
Sustainable
Quality & Efficiency
Improvements
Care Delivery Measurement Payment
Innovations & Provider Reform
Feedback
Decision support Quality Accountable care
organizations
Rx management Efficiency
Bundled payments
Care coordination Population
health Advanced medical
Discharge planning
homes
Foundation of Health IT
Electronic health records and information exchange
8
10. 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
HealthBridge Greater Cincinnati, Ohio
Southeast Michigan Health Information Exchange Greater Detroit
10
11. Beacon Community Workplan
Program Goals
Community Beacon “Community Objectives” encompassing
CO
CO CO
CO cost, quality, and population health
Objectives
Measured MO
MO MO
MO MO
MO MO
MO Well-defined measurable improvement goals
Outcomes
Defining risks and barriers and establishing plans to prevent or mitigate them
Defining risks and barriers and establishing plans to prevent or mitigate them
Outputs O
O O
O O
O O
O O
O O
O Operational and process results of core activities
Activities A
A A
A A
A A
A A
A A
A Tasks/interventions leading to outputs
Resources R R R R
R R R R R R R R
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,
Sustainability plan outlining provider reimbursement,
program revenue, and other strategies
program revenue, and other strategies
11
12. Indiana Health Information Exchange
Service area Central Indiana
Population 1,154,294 people in target population
2,700,000 people in geographic service area
Summary of Action Plan HIE-based measurement and provider feedback
P4P, accountable care organizations and payer engagement
Remote telemonitoring
Selected Performance Improvement Goals
Quality Population Health Cost/Efficiency
Increase by 10% the proportion of Increase by 5% the proportion of Reduce by 3% the number of
diabetic patients with controlled patients screened for colorectal and ambulatory care sensitive
blood sugar levels (HbA1c<9.0%) cervical cancer (ACS) hospital admissions
Increase by 10% the proportion of Increase by 5% the rate of adult Reduce by 3% the number of
diabetic patients whose cholesterol immunizations, with an initial ACS emergency visits
is controlled emphasis on the flu
Reduce by 10% the number of
ACS readmissions
Reduce by 10% the number of
redundant radiologic studies
13. Rocky Mountain Health Maintenance Organization
Service area Grand Junction Area, CO
Population 298,028 target population/people in geographic service area
Summary of Action Plan HIE-based performance measurement and feedback
HIE-based care coordination in conjunction with PCMH payment
reform
Technology-enabled patient activation
Selected Performance Improvement Goals
Quality Population Health Cost/Efficiency
Ensure that all identified Increase the number of children Reduce unnecessary
hypertension patients are in the immunized within the 90th percentile emergency department
90th percentile based on national utilization among children
data Increase by 5% the number of
uninsured children who are 5% Medicaid and
Ensure that all identified diabetic immunized at equivalent rates to uninsured, 1% privately
patients are in the 90th percentile other populations uninsured
based on national data
Increase the number of all patients Reduce unnecessary hospital
immunized greater than 5% above readmissions within 90 Days of
the 90th percentile Discharge in Children
2% Medicaid and
uninsured, 0.5 % privately
uninsured
14. Communities of Practice and TA Domains
Activities across the 5 domains will align to enable high quality, cost
efficiencies, patient-focused health care, and population health
through clinical transformation.
15. HIE Maturity
HIE Maturity Level Definitions Beacon Communities
Mature Exchange Operational, sustainable community-wide • Central Indiana Beacon Community
exchange capabilities with a history of • Greater Cincinnati Beacon Collaboration
expansion (e.g., additional data types,
stakeholders, services) and measurable
results or outcomes.
Coordinated Exchange Operational community exchange capabilities • Bangor Beacon Community
or leveraging other operational HIE networks • Beacon Community of Inland Northwest
(e.g., at the state level), with exchange • Colorado Beacon Consortium
occurring among nonaffiliated entities. May • IC3
be limited in HIE services and connected • Keystone Beacon Community
stakeholders, lack a history of growth, and • Rhode Island Beacon Community
may be undergoing pilot phases, etc. • Southeastern Minnesota Beacon
Community
• Western New York Beacon Community
Active Exchange Active exchange occurring in the Community, • Greater Tulsa Health Access Network,
but in silos. May be leveraging a more Inc.
mature HIE network (e.g., at the state level). • Southeastern Michigan Beacon
Community
Formative Exchange Limited to no exchange actively occurring in • BLUES Beacon Community Grant
the Community, where most HIE activity is at • Crescent City Beacon Community
the planning or piloting levels. May be
leveraging a more mature HIE network (e.g., • Hawaii Island Beacon Community
at the state level). • San Diego Beacon Community
Collaborative
• Southern Piedmont Beacon Community
16. An HIE Study of 9 Beacons
Beacon Name (Short Name) Icon
Bangor Beacon Community (Bangor)
Beacon Community of Inland Northwest (Inland NW)
Central Indiana Beacon Community (Central Indiana)
Greater Cincinnati Beacon Collaboration (Greater Cincinnati)
Keystone Beacon Community (Keystone)
Rhode Island Beacon Community (Rhode Island)
Southeastern Michigan Beacon Community Collaborative (SEMBCC)
Southeastern Minnesota Beacon Community (SE Minnesota)
Western New York Beacon Community (Western NY)
21. HIE Architectural Components
Please indicate what architectural components are employed currently or will be
in the future to support HIE in your Beacon Community. Please check only one
box in each row and use the additional comments section to specify other
components.
22. HIE Architectural Components (cont)
Please indicate what architectural components are employed currently or will be
in the future to support HIE in your Beacon Community. Please check only one
box in each row and use the additional comments section to specify other
components.
23. Priority for Meeting Beacon Aims
Please indicate the top five most important HIE architectural components
necessary to meet your Beacon Community’s target outcomes.
30. HIE Architectural Components (cont)
Please specify your Beacon Community’s participation in federal HIT/HIE
initiatives and the nature of the participation for each selected answer.
34. Please enter your questions or
comments in the Q&A window at the
bottom right of your screen.
OR…
• Send us an email at info@nationalehealth.org
• Tweet a question using hashtags #NeHC or #NHINU
• Join the conversation on NeHC’s new Facebook page at
http://www.facebook.com/pages/National-eHealth-
Collaborative/153115611367411
35. Questions?
National eHealth Collaborative
818 Connecticut Avenue NW, Suite 500
Washington, DC 20006
(877) 835-6506
info@nationalehealth.org
www.NationaleHealth.org
Register for NHIN University:
www.NationaleHealth.org/NHIN-U