As the Inland Northwest Health Services (INHS) began establishing its Beacon Community—the Beacon Community of the Inland Northwest (BCIN)–we knew at least one thing: Evidence-based clinical best practices combined with a technology-based care coordination process could help improve patient outcomes.  How did we know?  INHS had already achieved successes for injured workers through its Centers for Occupational Health & Education (COHE).

About the BCIN

The BCIN is a part of INHS’ Center of Innovation and Quality, and represents 14 counties in eastern Washington, north central Washington, and northern Idaho, with large rural and traditionally underserved populations. The main goal of the BCIN is to increase care coordination for patients with diabetes in rural areas and expand the existing health information exchange network to provide a higher level of connectivity throughout the region. More specifically, BCIN aims to:

• Prevent diabetes complications through improved access to routine and timely care
• Increase communication among providers to ensure more consistent care and follow-up
• Reduce costly emergency care
• Track outcomes through better access to data and identify best practices that are associated with better outcomes

To help achieve these goals, the BCIN is expanding on and adapting the COHE model—which uses care coordinators to help injured workers get back to work—to help patients in the region manage their diabetes.

About COHE

The COHE deployed health service coordinators (HSCs) to help improve provider-patient and provider-employer communication and improve patient self-management. For example, the HSCs help track down and address barriers that are keeping a patient from returning to work or recovering from their injury —from monitoring the claim in the computer to calling the involved parties. The COHE web application assists the HSCs in determining which claim to “touch” from priority-based criteria. Employers, patients and providers also have access to the web application to get information they need, when they need it, and in the form they can use it.

COHE began as a pilot project for Washington State’s workers’ compensation agency in 2002 and was made permanent by the state in March 2011. More than 1,000 providers and 27 urban and rural hospital emergency departments are now working together to save the workers’ compensation system direct medical and disability costs thus influencing employer workers’ comp premiums.  But more importantly, the COHE has reduced the incidence and duration of temporary and long-term disability to injured workers. This helps workers get back to their lives—and their livelihood—faster.

University of Washington Study

A study conducted by the University of Washington  found that injured workers who had received care through COHE providers:

• Received benefits faster and lost fewer work days than non-COHE patients
• Received an average of nearly $600 per claim in first-year disability
• Experienced reduced medical costs

In a May 2011 Spokane Journal of Business article about COHE, Suzanne Heeren, a claims assistant at Red Lion Hotels Corporation, commented that injured employees return to work more quickly since the company began participating in the COHE program. She states in the article:

“The COHE system helps everyone stay on the same track—the employer, the worker, the provider, and L&I (state Department of Labor & Industries).”

Karen Gude, a labor stakeholder and advisory member to the COHE program, believes the health services coordinator is a very important part of the best practices put forth by the COHE program. Ms. Gude says:

“I do see the health services coordination role in this particular project as a core component of its success.” In terms of the COHE as a whole, “I support it 100 percent.”

The Washington State Governor, Chris Gregoire, even weighed in about COHE:

“Our occupational health centers help prevent long-term disability by ensuring workers receive the right medical care early. That means employees are back on the job quicker – earning a paycheck to support their families. And it will help reduce the amount of future increases in workers’ comp premiums. Saving businesses money that they can reinvest in the workforce is essential to our economic recovery.”

Building on Success

While BCIN’s goals to help patients manage their type 2 diabetes is significantly different than helping injured employees get back to work, COHE serves as a model of how combining information technology with timely care coordination can improve patient outcomes. BCIN hopes that adapting the COHE model—especially the use of care coordinators—will help improve care outcomes for patients with type 2 diabetes across 34,000 square miles of mostly rural geography in eastern Washington and north Idaho.

Moreover, to connect providers and patients, the BCIN is expanding upon another of INHS’ established programs—the INHS health information network, which helps hospitals and health care facilities securely access patient’s health information using health information technology—including more than 3.5 million electronic health records.

“The COHE program achieved great successes in improving care for injured workers through the combination of health information technology with care coordination and performance outcomes.  For the Beacon Community of the Inland Northwest, we are building on those successes to bring a new level of coordinated care to patients with type 2 diabetes throughout our region.  With a strong health information exchange infrastructure at the core, our team has build robust care coordination, decision support, performance reporting and workflow management that layers over the HIE – all working together to create additional value for providers and improve care for patients.  It is an exciting opportunity to impact chronic disease and make a significant improvement in the health of our region.” – Jac J. Davies, MS, MPH, Director of the Beacon Community of the Inland Northwest

For More Information

• Beacon Community Program
• Beacon Community of the Inland Northwest
• Center for Occupational Health and Education

Also check out a short film about the BCIN.

Dr. Daniel T. Hansen has served as Program Director for the Eastern Washington Center for Occupational Health and Education since 2003. Dr. Hansen also currently serves as Co-team Lead for the Care Coordination Work Group in the Beacon Community of the Inland Northwest. Other notable current projects include Participatory Ergonomics in the Grocery Industry (and related supply chain) with Eastern WA University and a number of Green Belt/Lean Projects at Spokane-area hospitals. From 2001 to 2004, Dr. Hansen practiced in conjunction with the Industrial Rehabilitation Division of St. Luke’s Rehabilitation Institute in Spokane, WA– a multidisciplinary program serving injured workers in three States.