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Electronic Health Record Vendors Collaborate to Enhance Interoperability in Multi-State Health Information Exchange: Beacon Community

Rationale / Objectives

For the most part, patient information is stored with each provider in systems that are disparate and lack the capability to communicate with each other. An estimated 40% of unnecessary healthcare spending can be attributed to challenges in accessing patient data. In addition, 44% of patient-physician encounters are at risk of resulting in an adverse event due to poor quality clinical documentation. Missing information has also been implicated in delayed care and increased utilization of healthcare services in about 60% of cases. The Office of the National Coordinator for Health Information Technology (ONC) wanted to ease the exchange of patient information (such as baseline labs and images, medication and allergy history) via Health Information Exchange (HIE) in order to reduce duplication of tests and procedures, unnecessary admissions, length of stay, complexity of stay, adverse drug events and the amount of data that needed to be collected. [2]

Project/Program Description & Major Achievements

The ONC established the Beacon Community Program in 2010. The participating communities worked with EHR vendors, and came to an agreement on a minimum data set for sharing clinical data consistently. They built upon the previous work of the Multi-State EHR/HIE Interoperability Workgroup. The collaborative was able to unify 7 disparate vendors representing over 45% of the ambulatory Electronic Health Record (EHR) market in order to enable health information exchange across 17 communities located in different states, leading to a decrease in Emergency Department visits in the majority of participating communities. [3]

Lessons Learned

Programs and applications such as analytics and care coordination were seen as equally valuable as actual infrastructure, necessary but lacking in most areas. To maximize effective use of the EHR, training and retraining was necessary. Return on Investment (ROI) and other profitability ratios were important tools for engaging stakeholders. CFOs should be engaged from the start of the project in order to facilitate financial backing for the project’s initiatives. Health Information Exchange (HIE) initiatives should start from a place of agreement. In Beacon Community’s case, they were able to reach consensus on Meaningful Use as a core feature of the HIE, which helped solidify the collaborative and align goals. Relationship building and leadership was identified as an essential component to success. [4]

Further Description

The collaboration blended together 17 Beacon Communities of roughly 62,000 healthcare providers (serving almost 18.5 million patients) and 7 EHR vendors (who collectively constituted 45% of the ambulatory EHR market share. Funding was provided by the Office of the National Coordinator for Health IT (ONC) in the amount of $250 million over 3 years. The chosen communities were unique in their patient population, and had already made progress in EHR and HIE infrastructure towards the broader goals of sustainability, measurable improvement and innovation. Enhanced HIE infrastructure created possibilities for analytics on a community-wide level. Connectivity was extended to care delivery partners outside of the core, including ambulances and post-acute care providers, in order to maintain the integrity of the continuum. [4]

Major Achievements

Metric Result Additional Detail
Emergency Department visits Decreased Providers at 8 out of 14 Beacon Communities outperformed a matched national comparison group  [3]
Number of communities exchanging data 17 [3]