Wednesday, December 9, 2009

Advice to Beacon Communities

On December 2, David Blumenthal announced the $235 million dollar Beacon Community Program to accelerate and demonstrate the ability of health IT to transform local health care systems.

As we all think about how best to submit our applications (15 communities will be chosen), here are a few guiding principles:

1. This must be a public/private partnership - we need to ensure the "public good" needs of population health reporting, disparities in care reporting, immunization registries, administrative simplification, and biosurveillance are met. We must ensure private practice needs to achieve meaningful use are considered including electronic lab workflow, e-prescribing, and clinical summary exchange. We must include payers, both public and private.

2. We need to leverage the work that has already been done. In the case of Massachusetts we have multiple organization such as

Massachusetts eHealth Collaborative - implements EHRs

New England Healthcare Exchange Network - exchanges healthcare data

Massachusetts Health Data Consortium - develops healthcare IT policy and educates the community

Eastern Massachusetts Healthcare Initiative - provides a guiding coalition of payer and provider CEOs

Massachusetts eHealth Institute - the state organization serving as the distribution point for Federal funds

Massachusetts Health Quality Partners - the quality analysis organization

Boston Public Health Commission - the public health reporting entity

All of these organizations need to work together to create a single Beacon Community application. Having multiple applications from a region purely because of political infighting does not telegraph the kind of collaboration needed to be a beacon for others.

3. The focus must be on quality and efficiency, not IT for the sake of IT. There must be a measurable outcome - better wellness, fewer strokes/cardiac events, less hospitalizations.

4. There must be great governance - a steering committee and a series of working groups that can make tough decisions on detailed issues.

5. The strategy should be easily understood by all i.e. 40% of all clinicians in our community will have certified EHRs that are meaningfully used and exchanging data with other providers, payers, and patients for coordination of care and quality improvement. We will create the foundation for healthcare reform in which organizations are held accountable and rewarded for patient wellness, not delivering more fee for service care.

Thus, gather your stakeholders, creating a collaboration and ensure that IT raises the bar for everyone. Closed and proprietary IT is no longer a strategy, since healthcare is a zero sum game balancing the interests of employers, payers, and providers in the service of the patient.

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