Health IT Services for ACOs: Lessons Learned from the Beacon Community
David E. Kelleher, MS, President and founder, HealthCare Options Inc./Central Indiana
Kent Hiller, Vice President of Data Solutions and Analytics, Indiana Health Information Exchange/Central Indiana Beacon Community
David Lobach, MD, Division Community and Family Medicine, Southern Piedmont Beacon Community
Keith Hepp, CFO and VP of Business Development for Healthbridge/Greater Cincinnati Beacon Community
Beacon Communities from Cincinnati, North Carolina, and Central Indiana highlighted data aggregation, analytics, and information exchange services and capabilities as relevant to accountable care organizations (ACOs).
David Kelleher started the panel discussion with the analysis that the various emerging payment models in healthcare (ACO, PCMH) are beginning to bond together, borrowing elements from each other as they emerge.
Kelleher noted their tendency to build upon existing infrastructure of the communities, where stable health IT infrastructure already existed. Innovations move most readily toward sustainable models where population health can be improved, providing actionable data with visible results.
An overview of 17 communities in the Beacon Community was next presented. Each of the 17 communities worked and continues to work toward improvements in populations dealing with diabetes, heart disease, in measurable ways.
The Beacon Community supports 8 ACOs across the country. Improved care is measured using a report card that is issued before and after quality improvement metrics are instituted.
Kelleher then asked how HIEs are currently supporting ACOs in Beacon communities? Getting natural networks to arise out of existing working relationships and coordinating care across medical neighborhood, were two channels actively being developed.
Kelleher presented a unique visualization of the way that relationships are formed between care providers and patients and how PCMHs build out relationships.
Kent Hiller was then introduced, Vice President of data solutions of the Indiana Health Information Exchange.
The Indiana HIE began work in 2004. Their data volume includes 10.75 million unique patients, originating from 94 hospitals (out of a possible 126 in the state), 37 different hospital systems, 5 payers, 25,000 physicians and an eyebrow-raising 30+ different EMR systems.
The majority of the geography and population of the state of Indiana is covered by the Indiana HIE.
Hiller then presented an overview of how data moves from patients to physicians through a number of different settings into a clinical data repository.
Hiller worked with the 646 Waiver program, a data rich demonstration project which set up an attributed list of beneficiaries and all the requisite clinical and claims data associated with them.
Hiller looked ahead toward combining ADT alerts with clinical data to offer ACOs a broader picture of care episodes outside their ACO network. Population health management support and predictive analytics both stood on the horizon out as near-term future goals for Hiller’s Indiana HIE efforts.
Keith Hepp, Chief Financial Officer at HealthBridge was next introduced. Health Bridge is a HIE in Cincinnati, Ohio operating since 1997. Despite its Midwest location, the area covered comprises the largest percenteage of patient-centered medical homes in the US.
HealthBridge provides HIE services for Greater Cincinnatti and four other HIEs. Hepp reported that HealthBridge HIE is a profitable operation with a sustainable business model, though it does count government grants as revenue.
Hepp next presented the progression of HealthBridge’s HIE development, from a basic HIE (stage one meaningful use), all the way through a fully developed, meaningful use stages 2 and 3. Hepp reflected that his time at the conference was spent listening to what other organizations have been working on as a great deal of the health IT technology development and implementation remains new and that many involved are still “figuring it out.”
Hepp presented an overview of the various capabilities provided within the HealthBridge HIE including: Integration engine, semantic normalization, master patient index, and a clinical data repository.
The HealthBridge HIE is focused understanding how to best use data. Their efforts include creating a customer advisory for clinical claims and analytics, as well as utilizing a data governance committee to maintain the best practices of a working data stewardship policy.
The final keynote panel presentation came from David Lobach, Clinical Informatics Advisor with Southern Piedmont Community Beacon.
Southern Piedmont Community Beacon serves a 370,000+ population in North Carolina. Lobach reported on their efforts to remain focused on using health technology to better serve an population made up on 17% minorities, 17% Medicaid, and 18% uninsured.
The chronic conditions managed by Southern Piedmont include obesity, hypertension, diabetes, asthma, and COPD.
Lobach looked at the challenges on managing their ACO population, understanding what is truly “impactable,” and deploying resources that will be most effective toward that end result. He reported on Southern Piedmont’s efforts to positively impact care at opportunities like hospital discharge and other transitional points of care.
Health IT enhanced care management was next in Lobach’s presentation. This included claims and clinical data across multiple delivery networks, detection of care transitions, detection of gaps in care, and disease/condition registries. Lobach highlighted the efforts of Southern Piedmont to focus on pairing the right intervention with the appropriate need.
Lobach rounded out his presentation reminding the attendees that the more data you have, the more information you can create, and the more appropriate resources can be allocated to impactable individuals and populations.
In closing the keynote session out Kelleher remarked, “In order to acquire data, you have to build trust among competing organizations.”
Questions for the audience were then taken, finishing up the final day of the three-day conference.