What We Can Learn from the Beacon Communities on Their First Birthday?
Aaron McKethan | May 13, 2011
A year has passed since 17 diverse communities nationwide were notified by the Office of the National Coordinator for Health Information Technology (ONC) that they would receive Beacon Community awards. These critical resources empowered the Beacon Community Awardees (“the Beacons”) to build and strengthen their local health IT capacity, use health IT in innovative ways to improve the efficiency and quality of care they can provide their patients, and identify and disseminate these innovations and lessons-learned to others.
Over the past year, as we have documented in a recent Health Affairs article and as we will discuss at our upcoming May 17 Brookings Institution “Beacon Birthday” event, the Beacons have focused on clearly defining who their communities are. They have done so using data (such as patterns of where patients seek care), and community engagement activities (including public meetings and direct engagement with hospital leaders, physicians, and consumer organization leaders) to paint a picture of the local “community” on whose behalf the Beacon interventions are being deployed.
This past year has been a busy and productive one for the Beacons. For example, they have established governance structures that give local stakeholders a voice, but also permit the community to make decisions quickly when necessary. They have worked to achieve local consensus on core health and health care improvement objectives, while partnering with local evaluation, health IT, and clinical leaders to identify and establish baselines for relevant measures to track progress on meeting those objectives over time. Beacon leaders have also worked to design and deploy the initial wave of clinical interventions relevant to these objectives, such as changes in processes that hospitals use to discharge patients so they can manage their own health and exchange information with their regular physician. And, they have designed strategies to deploy those interventions in ways that will allow for refinements to be made based on early results. In other words, they have not only put in place innovative strategies for improving care, but also systems that allow them to learn from challenges and obstacles and make the improvements necessary.
Beacon Communities like that in Bangor, ME have used the development of a statewide governance process to ensure that performance improvement goals being pursued through the Bangor Beacon are aligned with overall policy and strategic goals at the state level.
Beacon Communities have also committed considerable time and attention to establishing a focused set of community objectives. The public officials and other health care leaders involved in the Crescent City Beacon Community in New Orleans, LA, for example, have worked hard to identify a core set of community objectives that unite the interests of the entire stakeholder community, including large academic health systems, small health centers, physician practices and, of course, patients. An encouraging aspect of this work is that these objectives are not merely being established to fulfill the requirements of the Beacon grant program, but also to help chart a course for the community over the longer term.
In addition, Beacon Communities have each worked to establish a baseline using performance measurements and data derived from multiple sources, including electronic health records. They have experienced firsthand the challenges of combining data from multiple sources to better understand the “current state” of the community’s performance on key indicators like hospital readmissions, rates of “good” diabetes care, or prevention indicators. The Keystone Beacon Community, for example, has used its baseline data to help track its progress in delivering care management support to patients facing multiple chronic conditions who typically face the highest risk of costly medical complications that can be prevented through careful care coordination and patient support. In fact, even at this early stage in its development, the Keystone Beacon Community has already documented the avoidance of several serious adverse events using its Beacon care managers and health IT systems.
Further, Beacon Communities in Colorado, North Carolina, and Utah have taken the lead in identifying strategies to facilitate providers participating in the program learning from each other about their experiences using technology and data for performance improvement. Just this week, for example, the Colorado Beacon Consortium is holding its second “learning collaborative” that will provide training and an opportunity for participating physicians and their staffs to learn how best to incorporate new technologies in their practices.
The first year of the Beacon Community program laid the ground work for rapid implementation of core interventions moving forward in each community that will support patients and clinicians in achieving better, more efficient outcomes over the next several years. As we now shift gears from program development to large-scale implementation of clinical interventions, we will take a moment to consider what we’ve already learned at this early stage of the Beacon program.
To learn more about just how far the Beacons have come in blazing the trail on innovatively using health IT to improve the health of their patients in ways that can be adopted by others, come join us on May 17 at the Brookings Institution’s Engelberg Center for Health Reform. The National Coordinator for Health Information Technology, Dr. Farzad Mostashari, Aneesh Chopra of the White House Office of Science and Technology, Joe McCannon from the Centers for Medicare and Medicaid Services (CMS), Mark McClellan of the Brookings Institution, several Beacon leaders, and I will discuss how health IT may be best used to improve health care quality and reduce costs with a special emphasis on what we can learn from the experience of the Beacon Communities on their first birthday. We will also hear from Beacon leaders about their perspectives about how health IT-driven health care improvements can be sustained by linking health IT investments to payment reforms that increasingly reward improvements in outcomes.
Please also check out a series of blog posts by individual Beacons to be published by Health Affairs over the next week that will provide yet more detail on the truly innovative work Beacons are doing across the country to realize the potential of health IT to improve health and health care. Finally, please join me on May 18 between 3:00 and 4:00 p.m. ET at #ONCchat for a live twitter chat moderated by Sherry Reynolds (Beacon Board member and consumer advocate engaged with Beacon development in Washington state) when I will be taking your questions about the topics and themes that emerge from the May 17 Brookings event and shared lessons-learned about the Beacons at the one-year mark.