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Healthcare Reform

San Diego Beacon: Innovators in Data Sharing

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San Diego Beacon copy

With government funding, more than a dozen towns, counties, cities and metro areas across the country are implementing new ways of collecting and sharing health data. The Office of the National Coordinator in the Department of Health and Human Services currently provides $250 million to 17 such “Beacon Communities” across the country.

“Our goal for this is really to ensure that we can generate a community of collaborative partners who can learn from each other about what is working and what isn’t working, so that we can really deliver healthcare more efficiently,” said Dr. Christopher Chute, of the Southeast Minnesota Beacon Program, in an informational video.

Each community is implementing IT-enabled tools that allow providers like physicians, nurses, pharmacists and medical assistants to proactively identify and follow-up with high-risk patients, and coordinate care between settings. All are trying to better utilize electronic health records and to streamline care and improve community health while lowering costs.

As the Beacon program enters its final phase, some of the best and most successful stories have come out of the San Diego branch, which is in the process of transitioning from federal funding to nonprofit San Diego Regional Healthcare Information Exchange funding, expanding across California and into the future indefinitely.

The new organization will partner with several providers, including Kaiser Permanente, Children’s Primary Care Medical Group, the VA, San Diego Healthcare System and 13 of the 16 regional community clinics, according to executive director Dan Chavez.

San Diego was one of the five locations that were “start-ups,” instituting new infrastructure that hadn’t existed before. They developed and implemented the first Health Information Exchange (HIE), online data networks that connect patients’ electronic health records from different health systems, in Southern California.

“We had to not only create the HIE, but turn it into a sustainable model,” said Dr. Jim Killeen of the University of California San Diego and a technical lead of the Beacon project.

“Our main goals for the Beacon project were improving cardiovascular care in the acute care phase, creating an Emergency Medical Services hub which translates the electronic version of the patient care record from paramedics that can be imported into any EMR in any hospital,” he told HealthBiz Decoded.

“We can send an EKG from wherever it was taken, at home or in the truck, to the hospital so it arrives before the patient,” Killeen said. “That way the cardiologist can hone in on resources, and the computer reads the scan in real time before the patient arrives.”

In some participating hospitals the tool actually reduced false positive activations from 30 percent down to zero percent, a huge improvement, Killeen said. That means fewer unnecessary cardiac catheterizations, which saves money, time and pain for the patient.

“It turned out to be fantastic,” Killeen said. “In fact, EMS agencies are bigger proponents than we are now.”

He and the San Diego Beacon team also worked on leveraging wireless devices at home to reduce unnecessary doctors’ visits, with cardiac patients monitoring their own blood pressure and sending the data to the doctor.

“That decreased readmissions significantly,” he said.

They also worked to integrate the regional immunization registry electronically with local health systems.

“We worked with partners to standardize the messages, leveraging what already existed and mapping it into a form that the public health folks can take in,” Killeen said.

San Diego wasn’t the only Beacon project to have success with innovations, but the other locations focused on chronic disease more than pre-hospital care, Killeen said. Colorado improved the low-density lipoprotein levels of heart disease patients on a population level. The Mississippi Delta Project used clinical decision support tools for diabetes management, like eye camera screenings for diabetic retinopathy. Minnesota instituted asthma management plans in schools.

And in Tulsa, Oklahoma, unnecessary specialty care visits went down by 24 percent, since nearly a quarter of the time specialists were willing to advise the referring physician by communicating online rather than seeing the patient in person.

Though he spearheaded planning for the San Diego Beacon innovations, Killeen said “we try to give the credit to the community, who have so fully embraced them.”

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