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
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
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. Register for NHIN University: www.NationaleHealth.org/NHIN-U
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HITECH in Action: The Beacon Community Program Craig Brammer Office of the National Coordinator for Health Information Technology
Beacon Community Aims and Conceptual Model
Beacon Logic Models
Beacon Support Infrastructure
Exchange Characteristics in 9 Beacon Communities
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
HITECH Addresses Barriers to Adoption Obstacle Intervention Funds Allocated Market Failure, Need for Financial Resources Medicare and Medicaid EHR Incentive Programs for “Meaningful Use” $27.3 B* Addressing Adoption Difficulties Regional Extension Centers Health IT Research/Resource Center $643 M $50 M Workforce Training Workforce Training Programs $84 M Addressing Technology Challenges and Providing Breakthrough Examples Strategic Health Information Technology Advanced Research Projects Beacon Communities Programs $60 M $250 M Privacy and Security Policy Framework New Privacy and Security Policies Addressed across all Programs Need for Platform for Health Information Exchange NHIN, Standards and Certification State Cooperative Agreement Program $64.3 M $548 M *$27.3 B is high scenario
Beacon Community Conceptual Model Foundation of Health IT Electronic health records and information exchange Sustainable Quality & Efficiency Improvements Care Delivery Innovations Decision support Rx management Care coordination Discharge planning Measurement & Provider Feedback Quality Efficiency Population health Payment Reform Accountable care organizations Bundled payments Advanced medical homes
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
Beacon Community Workplan CO Community Objectives MO CO Activities Resources MO MO MO A A A A A A R R R R R R R R R R R Measured Outcomes R Sustainability plan outlining provider reimbursement, program revenue, and other strategies Outputs O O O O O O Well-defined measurable improvement goals Beacon “Community Objectives” encompassing cost, quality, and population health Operational and process results of core activities Defining risks and barriers and establishing plans to prevent or mitigate them Resources needed to support activities and meet stated outcome goals Tasks/interventions leading to outputs Program Goals
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 diabetic patients with controlled blood sugar levels (HbA1c<9.0%) Increase by 10% the proportion of diabetic patients whose cholesterol is controlled Increase by 5% the proportion of patients screened for colorectal and cervical cancer Increase by 5% the rate of adult immunizations, with an initial emphasis on the flu Reduce by 3% the number of ambulatory care sensitive (ACS) hospital admissions Reduce by 3% the number of ACS emergency visits Reduce by 10% the number of ACS readmissions Reduce by 10% the number of redundant radiologic studies
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 hypertension patients are in the 90th percentile based on national data Ensure that all identified diabetic patients are in the 90th percentile based on national data Increase the number of children immunized within the 90th percentile Increase by 5% the number of uninsured children who are immunized at equivalent rates to other populations Increase the number of all patients immunized greater than 5% above the 90th percentile
Reduce unnecessary emergency department utilization among children
5% Medicaid and uninsured, 1% privately uninsured
Reduce unnecessary hospital readmissions within 90 Days of Discharge in Children
2% Medicaid and uninsured, 0.5 % privately uninsured
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.
HIE Maturity HIE Maturity Level Definitions Beacon Communities Mature Exchange Operational, sustainable community-wide exchange capabilities with a history of expansion (e.g., additional data types, stakeholders, services) and measurable results or outcomes.
Central Indiana Beacon Community
Greater Cincinnati Beacon Collaboration
Coordinated Exchange Operational community exchange capabilities or leveraging other operational HIE networks (e.g., at the state level), with exchange occurring among nonaffiliated entities. May be limited in HIE services and connected stakeholders, lack a history of growth, and may be undergoing pilot phases, etc.
Bangor Beacon Community
Beacon Community of Inland Northwest
Colorado Beacon Consortium
Keystone Beacon Community
Rhode Island Beacon Community
Southeastern Minnesota Beacon Community
Western New York Beacon Community
Active Exchange Active exchange occurring in the Community, but in silos. May be leveraging a more mature HIE network (e.g., at the state level).
Greater Tulsa Health Access Network, Inc.
Southeastern Michigan Beacon Community
Formative Exchange Limited to no exchange actively occurring in the Community, where most HIE activity is at the planning or piloting levels. May be leveraging a more mature HIE network (e.g., at the state level).
BLUES Beacon Community Grant
Crescent City Beacon Community
Hawaii Island Beacon Community
San Diego Beacon Community Collaborative
Southern Piedmont Beacon Community
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)
Stakeholders Participating in HIE
Stakeholders Participating in HIE (cont)
Stakeholders Participating in HIE (cont)
Priority Stakeholders Please indicate the five most important stakeholder participants necessary to meet your Beacon Community’s target outcomes.
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.
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.
Priority for Meeting Beacon Aims Please indicate the top five most important HIE architectural components necessary to meet your Beacon Community’s target outcomes.
Data Types Exchanged
Data Types Exchanged (cont)
Data Types Exchanged (cont)
Data Messaging Standards
Data Vocabulary Standards
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.