Understanding the Role of Healthcare Information Technology in Accountable Care Organizations: Q&A With Ravi Sharma, CEO of 4Medica

Accountable care organizations are emerging in increasing numbers, as healthcare providers are coming under increased pressure to better coordinate patient care. At the same time, individual organizations that make up ACOs are struggling to implement healthcare information technology that meets meaningful use requirements. Ravi Sharma, CEO of 4Medica, a company that develops integrated medical records, shares some insights into how healthcare information technology fits into the ACO model.

Q: What role does healthcare information technology play in the emergence of ACOs?

Mr. Ravi Sharma: ACOs are playing an important role in the future of healthcare. The whole purpose of ACOs is to create a full continuum of care. ACOs bring providers together, such as the primary care physicians and nursing home care providers, into a network. It's not just to manage quality but also cost of care. The key part of HIT in ACOs is to be able to create clinical integration of data across multiple locations between primary care physicians, hospitals, specialists and everyone in between. I think that's really the heart of HIT.

The reason why HIT is different than before is because most systems were institution-centric, not patient-centric. By institution-centric, I mean a hospital's goal was to create HIT within the four walls of different departments, like a physician's office or an emergency department or pharmacy or laboratory. With ACOs, patient information now has to be patient-centric. All of these departments and organizations need to be connected for inter-operability as well as exchange of clinical data so that everyone knows what's going on with a patient at all times.

Q: What would you say is the biggest challenge for ACOs in implementing HIT?

RS: There is a multitude of information systems that have already been deployed or are already in place. These are systems that do what they're supposed to do for the function for which they were purchased, which is collect information for specific departments for specific care providers. When you bring the data together and apply decision support, then it becomes information that is actionable. That actionable information is key for the success of the ACOs. How do you change all this technology and modify it to create a network of connected information? That's the fundamental problem at this point in time. It's not just like connecting pipes.

Even though a hospital may have laboratory information systems, there are at least different 20 different laboratory information systems in the market that have different ways of collecting information. The same applies to radiology or any other department. When you start compounding this, it becomes a big problem for the country to become a clinically integrated environment.

Q: So what does that mean for the future of healthcare?

RS: A new breed of technology needs to be deployed. What you're going to see is a lot of innovative companies that have web-based applications with existing platforms with existing capabilities coming out with this type of technology. It will be very costly and time-consuming to develop, but web-based technology can be easier and cheaper to deploy in the healthcare setting. It's a market with huge potential. Market awareness is still not as pervasive as it should be, and healthcare is behind in IT implementation and sophistication.

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