While the Cincinnati Beacon Community project has shown results in improved care, it didn't achieve all of its aims, according to an article published this month in Health Affairs. And the process wasn't always smooth.
The project began with a $13.7 million federal grant to build a shared health IT infrastructure to support quality improvement, including care for adults with diabetes and children with asthma.
The plan was to build communitywide data exchange, registries and alerts so that primary care physicians would be notified when patients went to the emergency room. (The Indiana Health Information Exchange found value in a similar ED-alert program, as FierceHealthIT previously reported.)
During the program, 19 practices that focus on diabetes improvement were recognized as patient-centered medical homes, and the leaders interviewed for the research said the effort transformed care in sustainable ways.
But the project hit some bumps along the way, including difficulty in importing and exporting data in electronic health record systems and adapting technology to support quality improvement. The ambitious agenda required more time for planning, training and implementation than the team expected.
And although hospital executives said they supported community-wide data sharing when the grant was written, privacy officers ultimately threw up red flags, taking 10 months--a third of the project's timeline--to get everyone on board.
Some of the biggest challenges stemmed from limitations of EHR technology. The project had to abandon plans for a communitywide summary patient record. Providers also complained of the difficulty of extracting data from EHRs for population management.
However, an analysis of publicly reported data midway through the project showed that a diabetes composite measure score had improved by 32 percent for practices in the Beacon Community, compared to an 11 percent improvement for non-participating practices.
The article points to two lessons leaders learned from the experience:
- Delays happen, and project timelines should build account for that.
- Integrating technology into quality improvement also required appropriate protocols, tool kits and coaching to support practices.
To learn more:
- here's the abstract