Tennison Janet, Rajeev Deepthi, Woolsey Sarah, Black Jeff, Oostema Steven J, North Christie
HealthInsight.
EGEMS (Wash DC). 2014 Aug 20;2(3):1100. doi: 10.13063/2327-9214.1100. eCollection 2014.
The Utah Improving Care through Connectivity and Collaboration (IC3) Beacon community (2010-2013) was spearheaded by HealthInsight, a nonprofit, community-based organization. One of the main objectives of IC(3) was to improve health care provided to patients with diabetes in three Utah counties, collaborating with 21 independent smaller clinics and two large health care enterprises. This paper will focus on the use of health information technology (HIT) and practice facilitation to develop and implement new care processes to improve clinic workflow and ultimately improve patients' diabetes outcomes at 21 participating smaller, independent clinics.
Early in the project, we learned that most of the 21 clinics did not have the resources needed to successfully implement quality improvement (QI) initiatives. IC(3) helped clinics effectively use data generated from their electronic health records (EHRs) to design and implement interventions to improve patients' diabetes outcomes. This close coupling of HIT, expert practice facilitation, and Learning Collaboratives was found to be especially valuable in clinics with limited resources.
Through this process we learned that (1) an extensive readiness assessment improved clinic retention, (2) clinic champions were important for a successful collaboration, and (3) current EHR systems have limited functionality to assist in QI initiatives. In general, smaller, independent clinics lack knowledge and experience with QI and have limited HIT experience to improve patient care using electronic clinical data. Additionally, future projects like IC(3) Beacon will be instrumental in changing clinic culture so that QI is integrated into routine workflow.
Our efforts led to significant changes in how practice staff optimized their EHRs to manage and improve diabetes care, while establishing the framework for sustainability. Some of the IC(3) Beacon practices are currently smoothly transitioning to new models of care such as Patient-Centered Medical Homes. Thus, IC(3) Beacon has been instrumental in creating a strong community partnership among various organizations to meet the shared vision of better health and lower costs, and the experience over the last few years has helped the community prepare for the changing health care landscape.
犹他州通过连通性与协作改善医疗（IC3）灯塔社区项目（2010 - 2013年）由非营利性的社区组织健康洞察（HealthInsight）牵头。IC(3)的主要目标之一是在犹他州的三个县改善为糖尿病患者提供的医疗服务，与21家独立的小型诊所和两家大型医疗企业合作。本文将聚焦于利用健康信息技术（HIT）和实践促进来开发并实施新的护理流程，以改善诊所工作流程，并最终改善21家参与项目的小型独立诊所中患者的糖尿病治疗效果。
在项目早期，我们了解到21家诊所中的大多数都没有成功实施质量改进（QI）举措所需的资源。IC(3)帮助诊所有效利用其电子健康记录（EHR）生成的数据来设计和实施干预措施，以改善患者的糖尿病治疗效果。事实证明，在资源有限的诊所中，HIT、专业实践促进和学习协作的这种紧密结合尤其有价值。
通过这个过程我们了解到：（1）广泛的准备情况评估提高了诊所的留存率；（2）诊所倡导者对于成功的合作很重要；（3）当前的电子健康记录系统在协助质量改进举措方面功能有限。总体而言，小型独立诊所缺乏质量改进方面的知识和经验，且利用电子临床数据改善患者护理的健康信息技术经验有限。此外，未来像IC(3)灯塔这样的项目将有助于改变诊所文化，使质量改进融入日常工作流程。
我们的努力导致了实践人员在如何优化其电子健康记录以管理和改善糖尿病护理方面发生了重大变化，同时建立了可持续性框架。IC(3)灯塔项目的一些实践目前正在顺利过渡到新的护理模式，如以患者为中心的医疗之家。因此，IC(3)灯塔项目有助于在各组织之间建立强大的社区伙伴关系，以实现改善健康和降低成本的共同愿景，过去几年的经验帮助社区为不断变化的医疗格局做好准备。
