Keith Hepp, chief financial officer of Cincinnati-based HealthBridge, has a favorite quote from Mark Twain: "He said that when the world ends, he wants to be in Cincinnati – because everything happens seven years later there."

Generally, that's "very true," said Hepp. But not in the case of HeathBridge, a pioneering HIE – founded in 1997, operational since 2000 – that became the lynchpin of the Greater Cincinnati Beacon Organization in 2010.

"We bought into the triple aim before the triple aim had a name," he said.

The three-year, $250 million Beacon Community project has now drawn to a close, but the lessons learned by the 17 forward-thinking, ONC-funded initiatives continue to bear fruit.

In a HIMSS14 session on Tuesday, three Beacon Community veterans offered tips and best practices gleaned from their experience – especially when it comes to optimal use of HIE, whose valuable clinical and financial applications can be surprising.


Hepp, for one, said HealthBridge's "meaningful use of health information exchange" has been invaluable for care coordination in the Cincinnati area, especially thanks to notifications and ADT alerts.

Not that there weren't hurdles. Beyond the technology, smart practice redesign was challenging but critical, he said. There were disagreements among stakeholders on population health data. Data extraction from EHRs is "still a challenge." Allowing time for physician buy-in was key. And "initiative fatigue is very real," he said.

Still, there is "true value" in combining clinical and claims data swimming among the Beacon Community's members. "You really need both to be effective," said Hepp.

James Killeen, director of information technology services at UC San Diego, described how San Diego Beacon moved from a federally-funded project to a self-sustaining entity.

"The Beacon Project finished in September. We then transitioned to a non-profit agency, San Diego Health Connect, where we're able to move these operational-ready services and tools," he said.

In doing so, the "innovative opportunities with HIE" explored as part of the Beacon Project continue to drive care improvements and cost reductions across the San Diego region.

The federal funding may have run dry, but many Beacons have seamlessly made the transition to stand-alone entities – with new revenue rolling in.

Asked, for instance, about one initiative similar exchange organizations could get started with that would have the "biggest bang for the buck," the response was unanimous from the three-man panel: ADT alerts.

In Cincinnati, the HealthBridge leverages its data to send 7,000-10,000 of them each month, said Hepp.

"We were able to get 15 hospitals connected in a three month period just doing ADT notifications," he said. "The value is huge for the care managers, and the health plans are coming at us with new potential for funding, because they want their care managers to be able to know what's going on with their patients in real time."