I.T. FOR ACOs

As healthcare providers experiment with new ways to deliver care, their IT systems have a hard time keeping up: Traditional systems can’t support coordinated care, they do a poor job of maintaining relationships with patients, and they don’t even supply the basic data needed to manage a contract based on value.

This new report looks at the technological needs of value-based care providers not just today, when care coordination is the primary concern, but tomorrow, when anytime, anyplace becomes the norm and providers work to engage consumers in their own health, and even beyond to a period when data mining and genetic-based predictive modeling bring preventive medicine to new levels of effectiveness. The report includes an assessment of current maturity levels of more than a dozen core technologies.

AN ALTERNATIVE TO THE “BIG SYSTEM” EHR

The simple solution to data integration in an ACO is to force everyone to use the same electronic health record. It enables seamless sharing of data, automated workflows, and seamless connections between clinical and financial data. It would be an ideal approach, except that it is expensive, disruptive, and nearly impossible to achieve in a disseminated organization. For many organizations the next-best approach is a specialized care coordination system (CCS) that sits alongside the ACO participants’ existing EHRs. A CCS can be deployed across the ACO at significantly reduced levels of cost, effort, and commitment, because it keeps existing EHRs while allowing integrated care protocols for the populations managed by the ACO. Truth is the EHR is a central link, but no longer the central technology in a fee-for-value environment. See below for an example of a CCS.

1What is the biggest gap you see in technology for ACOs?

For me, the most worrisome thing about the market is that there isn’t yet a revenue cycle system capable of managing sophisticated payment models such as care coordination payments, pay-for-performance, bundled payments, shared savings, and global payments. Traditional RC programs are all right for simple fee-for-value arrangements, but providers will quickly outgrow them. I know some providers are adding contract management systems designed for payers with decent results, but we need some new products quickly.
2Do you have any advice on “ACO-in-a-box” care coordination systems?

Remember that most of these systems have been cobbled together by acquisitions. The individual components are often at very different maturity levels, and there’s a lot of variation in how completely they are integrated. If you’re interested in that kind of approach, be sure to assess everything: the messaging services and cross-platform electronic workflows; the ability to connect to various EHRs; the patient engagement tools; and the predictive modeling algorithms.
3What should be top of mind for ACOs as they explore new technology?

Remember that the goal is to change behaviors — physician behaviors, staff behaviors, patient behaviors. For example, when you look at a new analytic capability, think of how you want analytics to translate into action: Is the system sending messages directly to the patient’s personal health record? How do you ensure that doctors and nurses take necessary steps? We talk about patient-centered care. We also need to keep the patient in the center of our technology.