Learning Health IT from ONC Beacon Communities

Aaron McKethan | December 8, 2010

Core Aims of Beacon Communities

Through the Beacon Communities program, the Office of the National Coordinator for Health Information Technology (ONC) has identified 17 diverse communities—from Maine to Hawaii—that are serving as leaders in health IT. Building on their past successes, these communities have three aims over the next several years:

  • Aim 1: Demonstrate how health IT-enabled quality, cost/efficiency, and population health improvements are possible in diverse parts of the country;
  • Aim 2: Support lasting “innovation networks” in communities through which a wide range of stakeholders can collaborate, design, and implement new technology-enabled ideas that improve health and health care, now and in the future; and
  • Aim 3: Trade lessons, implementation insights, and best practices with each other and with other communities that are just as motivated to improve health, health care, and cost-efficiency.

Creating an Open Innovation Network

In the first six months of the program, we have been busy developing the structure to support Aims 1 and 2, including formalizing the core interventions that will be introduced in each community, starting in 2011. We’re establishing and supporting several “Communities of Practice” comprised of Beacon Community leaders and other experts to support the implementation of, for example, clinical decision support technologies, care transitions programs, or pharmacy interventions in Beacon Communities. As part of this activity, we are also developing a robust performance measurement and reporting capacity that will allow the Beacon Communities to track their own performance and make course corrections along the way. This will make innovation and learning a core part of the Beacon Communities’ journey.

The Beacon Communities will in some cases be scaling up interventions with which they’ve had past success. But let’s be clear:  any effort to achieve large-scale, innovation-driven change necessitates designing and trying new approaches and using data to inform refinements along the way. For example,

  • Among numerous other interventions, the Detroit Beacon Community will be testing the use of communications with Medicaid patients living with diabetes to help them keep their physician appointments, organize their medications, and receive helpful, personalized health reminders. The idea is that engaging patients using simple text messaging technologies that are readily available and already relevant to patients’ lives can be part of a larger strategy for keeping disease under control. Through this particular initiative, we expect to gain new insights about wireless communications and medication adherence among underserved populations. For example, how do people respond to targeted messages and reminders regarding their medicines? What is the right frequency of these communications to best support patients?
  • Similarly, several Beacon Communities will be deploying new telehealth services to remotely monitor the health of patients with chronic disease. This is intended to create an early warning system that can help to avert complications before they arise. Yet the health care literature suggests that the evidence for remote patient monitoring is mixed; some past efforts have been very successful while others have not consistently delivered positive results. Hence, the efforts of these Beacon Communities will be informed by past initiatives; they will seek to learn about the critical factors that can make remote monitoring more consistently successful in avoiding adverse outcomes, such as preventable hospitalizations.

This is a small sample of the kinds of insights we hope to develop as part of this program. We intend to drive  real health and health care improvements, and we are also encouraging the Beacon Communities to be bold in their aspirations, creative in their strategies, and transparent about how these interventions are working so that learning can happen and so that refinements can be made along the way.  This means we are encouraging Beacon Communities to embark on a process of discovery through which they will learn their way toward lasting health care improvement in their communities.

Please Join Our Dialogue

Regarding Aim 3 above, we believe it is important not to establish Beacon Communities as a “closed network” whose insights are only shared with other Beacon awardees. We’ve started by developing brief case summaries and short films that explain the Beacon Community program as a whole, as well as the goals and programs of each individual Beacon Community. In the coming months, we’ll also organize open leadership roundtables, regional meetings, and webinars featuring the experiences of Beacon Communities and others with similar goals. Our aim is to promote open and ongoing learning about how health IT can support needed changes in health care practice that can address some of the important shortcomings in health system performance nationally.

Importantly, we also know that Beacon Community awardees can learn a lot from other efforts around the country, including from the many impressive applicants that did not receive Beacon Community awards.  At present, we are investigating options for making at least some training and technical assistance available next year to help support a broader national network of communities seeking to transform health care using health IT and other tools. If you have ideas or are interested, please email BeaconCommunityGrants@hhs.gov to join a listserv we are creating to update you on these plans as they take shape.

We seek your feedback about how we can best support other communities that want to be leaders in health improvement.  Hence, we strongly encourage you to share your thoughts in a new web forum sponsored by our friends at the Robert Wood Johnson Foundation (RWFJ), “Transformation Has Begun“. This online forum provides a place for health care leaders to share thoughts on how we might coordinate the various regional health care improvement collaboratives to maximize our collective impact and to identify as many practical insights as possible.

We are interested in receiving both your very specific and more general ideas about how a broader national network, that includes but is not limited to Beacon Communities, might support efforts in your community to use health IT and other tools to drive improved outcomes.

We invite you to listen to and share stories, join the dialogue, ask questions, make suggestions, and help light the way to better health care for all.

To learn more, visit http://www.healthit.gov/policy-researchers-implementers/beacon-community-program.