WASHINGTON – Beacon communities are beginning to turn the corner and report improvements in patient care and population health in their regions based on analytics they have extracted from data collected for measures.
That is in part because these model health IT communities have put an emphasis on the capture of structured data in electronic health records (EHRs) and enhancing data quality so they can share and compare measure results, according to the Office of the National Coordinator for Health IT.
One of those is the Bangor Beacon Community in Maine, which has an intensive care management program using health IT-enabled processes and systems, said Kerri Petrin, project officer of ONC’s Beacon Community Program.
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The Bangor beacon has demonstrated that “in the first six months of enrollment in the program that their group of high-risk, high-cost patients has reduced emergency department visits, hospital admissions and walk-in urgent care visits by as much as 40 percent,” she said at an Aug. 9 data and analytics conference sponsored by the eHealth Initiative, which advocates for health IT to improve health care.
Beacon communities rely on a variety of data sources, including chart abstractions, administrative claims data and data repositories. They are also becoming skilled at collecting community-wide data that may require cleaning up or normalizing to a standard.
The Western New York Beacon Community provides a data quality dashboard that highlights invalid data entries that providers contribute to support core measures and a practice assessment tool deployed to practices, she said. The beacon works with clinic staff and EHR vendors to correct flaws to obtain better quality data so they can target clinical quality improvements.
ONC also has an EHR vendor affinity group project in which representatives of beacon communities and several EHRs are collaborating to achieve interoperability in health information exchange, Petrin said.
For instance, they are tackling issues such as a consistently formatted continuity of care document (CCD) of patient summary data to accommodate existing practice workflows and creating clear documentation to support data extractions for quality measures.
A pilot will start around mid-October for CCD-enabled exchange across 200 clinic locations, representing 3,000 providers, she said.
Beacons are breaking new ground in quality improvement at the community level, bringing data from many organizations into a community-level measurement platform. The Utah Beacon Community has developed a tool that eliminated some of the flaws that came with providers’ EHRs. The analytics software captures quality measures from participating practices directly from their EHR databases, she said.
“Once communities have the data, they need to get it to speak the same language, combine the data in a way that connects key health information for individual patients across multiple sources and develop an infrastructure to store the data to support performance measurement and analytics,” Petrin said.
HealthBridge, the Cincinnati, Ohio-based health information exchange, wanted to build a community-wide platform to support analytics around population health and financial outcomes.
“A lot of hospitals and payers are already doing this, but the data is about patients within their own walls and systems,” said Randy Woodward, director of business intelligence systems at HealthBridge, which also leads the Cincinnati Beacon Community.
HealthBridge is collecting clinical data from all kinds of providers, payers, and lab and radiology units from across the community into a single data warehouse using a data integration engine. Some of the data needs to be normalized and standardized so disparate codes and descriptions can be aggregated, he said. To identify the patients and providers across hospitals and claims, it uses a master patient/provider index. A geographical information system provides population density maps, identifies where patients are located and locates the services that they need.
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The data is loaded into the data warehouse to perform population aggregation and clinical and financial outcomes. All of this is delivered through a common platform, such as SharePoint, to enable access to reports and collaborate on other content.
HealthBridge used this infrastructure to also build an emergency department alert system in Cincinnati for the beacon community. When HealthBridge receives messages from the community hospitals of an encounter, the exchange identifies if it involves one of the patients being monitored for chronic conditions on behalf of the provider organization. If so, it generates an alert to that provider through a variety of formats — directly to EHRs, PDF documents, Direct secure email systems, and then to the practice care coordinator.
“So they know within minutes that their patient has arrived at the emergency department or admitted to the hospital,” Woodward said. That enables follow-up care with that patient or even intervening while the patient is still in the ER to connect ER doctors with the patient’s primary care team so that they can have more information as they are delivering care.
