title: A case study of pediatric asthma alerts from the beacon community program in cincinnati: technology is just the first step.
abstract: BACKGROUND
  The Beacon Community in Cincinnati, Ohio was an innovative, community-wide initiative to use technology to transform care. One important feature was the development of regional alerts to notify practices when patients were hospitalized or seen in the emergency department. The purpose of this paper is to describe the way in which technology engages the improvement process, and to describe the early stages of learning how to use technology to enhance quality improvement.
  
  
  METHODS
  We interviewed key Beacon leaders as well as providers and office staff in selected practices. We also collected preliminary data from practices that reflected handling of alerts, including the number of asthma related alerts received and followed up.
  
  
  RESULTS
  Regional alerts, supplied by the community-wide health information exchange, were a significant addition to the quality improvement effort in that they enabled practices to identify and follow up with additional children at risk. An important finding was the substantial effort at the practice level to integrate technology into ongoing patient care.
  
  
  CONCLUSIONS
  Developing the technology for community wide alerts represented a significant endeavor in the Cincinnati Beacon Community. However, the technology was just the first step. Despite extra effort and time required on the part of individual practices, they reported that the value of having alerts was high. Hospital and ED visits represent some of the most costly aspects of care, and an efficient process for intervening with children using these costly services was seen as of significant value.
authors.affiliation: Altarum Institute.
authors.forename: Tara
authors.initials: T
authors.lastname: Trudnak
authors.affiliation: Cincinnati Children's Hospital Medical Center ; University of Cincinnati College of Medicine.
authors.forename: Mona
authors.initials: M
authors.lastname: Mansour
authors.affiliation: Cincinnati Children's Hospital Medical Center ; University of Cincinnati College of Medicine.
authors.forename: Keith
authors.initials: K
authors.lastname: Mandel
authors.affiliation: Cincinnati Children's Hospital Medical Center.
authors.forename: Hadley
authors.initials: H
authors.lastname: Sauers
authors.affiliation: Cincinnati Children's Hospital Medical Center.
authors.forename: Gerry
authors.initials: G
authors.lastname: Pandzik
authors.affiliation: Cincinnati Children's Hospital Medical Center.
authors.forename: Carl
authors.initials: C
authors.lastname: Donisi
authors.affiliation: AcademyHealth.
authors.forename: Gerry
authors.initials: G
authors.lastname: Fairbrother
keywords: Data Use and Quality; Health Information Technology; Quality Improvement
references.citation: Pediatrics. 2009 Jul;124(1):159-69
references.pmid: 19564296
references.citation: Pediatrics. 2010 Apr;125(4):e770-7
references.pmid: 20231191
references.citation: J Am Med Inform Assoc. 2009 Jan-Feb;16(1):40-6
references.pmid: 18952941
references.citation: N Engl J Med. 2010 Feb 4;362(5):382-5
references.pmid: 20042745
references.citation: J Am Med Inform Assoc. 2009 Jul-Aug;16(4):531-8
references.pmid: 19390110
references.citation: Med Care. 2002 Dec;40(12):1161-71
references.pmid: 12458299
references.citation: Proc AMIA Annu Fall Symp. 1996;:704-8
references.pmid: 8947756
references.citation: Health Aff (Millwood). 2011 Apr;30(4):782-8
references.pmid: 21471501
references.citation: BMC Med Inform Decis Mak. 2013 Jul 01;13:69
references.pmid: 23816138
references.citation: J Paediatr Child Health. 2013 Apr;49(4):325-9
references.pmid: 23517187
references.citation: Am J Manag Care. 2010 Dec;16(12 Suppl HIT):SP13-8
references.pmid: 21314214