6 Steps to Building an ACO's Health IT Capability

For accountable care organizations to be successful, they must provide integrated information access across providers, settings and activities. And in order to integrate, ACOs need health information technology solutions.

Jordan Battani, the managing director of CSC's Global Institute for Emerging Healthcare Practices and author of a white paper discussing the role of health IT in ACOs, shares six steps to building an ACO's information technology capability.

1. Focus on clinical information and point-of-care automation.
Accountable care requires providers to deliver patient care that both responds to immediate circumstances and stays consistent with the care plan and activities that support patient health across the continuum of care. "When we start thinking about accountable care, the notion of cross-continuum access is really important," Ms. Battani says. "What's becoming more and more clear is that healthcare is happening in all the kind of places we think of it as happening, but it's also happening at home and in community settings."

The goal is for each provider in the continuum to have access to the patient's overall health history, as well as information about the current episode, care summaries, treatments, diagnostic studies, medications and any procedures that have already been delivered. For patients with ongoing health conditions, this access will need to include care plans and ongoing care management activity summaries.

To move toward point-of-care automation, Ms. Battani says ACOs will need to advance electronic health record initiatives and support efforts to exchange critical demographic and clinical information with other providers, ones that may not share a common patient record with the ACO.

2. Master data management and integration.
ACOs need an infrastructure that ensures relevant and complete clinical information is readily available to the right provider at all times. Additionally, ACOs need to manage, monitor and report on quality and safety goals and cost of care. Therefore, participants in an ACO must be able to effectively share data and information among and between multiple health records, clinical systems and data repositories Ms. Battani says.

"You have to have a way of uniquely identifying patients, providers and settings of care so when you're looking at information that’s been delivered from another care setting or provider, you can match it with the right patient, the right provider, the right care setting – regardless of how those elements are identified locally," she says. "Master data management takes you right into the guts of governance in these organizations."

As ACOs mature and expand, the possibility of relying on a single, vast integrated EHR is pretty remote, Ms. Battani says. What is required is a strategy to ensure information from multiple electronic systems can still get to the right provider at any point on the continuum.

3. Create effective health information exchanges.
This enables the transmission and exchange of information beyond the boundaries of an enterprise data management system. Ms. Battani calls a health information exchange the "telephone wires" that connect medical records.

"When health information exchange strategies are fully deployed, computerized patient order entry, e-prescribing, and the alerts and reminders delivered to the provider about the patient reflect the latest diagnostic, pharmacy and treatment information,” Ms. Battani says.

Health information exchanges also support the availability of timely and accurate updates and new information. Establishing exchanges is a significant task, one that requires the full engagement of the entire enterprise, she says.

4. Engage patients. ACOs need to consider the improvements patients themselves can make to their own health outcomes. Patients' healthy habits could be an ACO's best friend.

"You could apply all of the care from the outside and you still may not make a dent in savings," Ms. Battani says. But long-term savings may only come when ACOs "can mobilize the patient to take care of themselves and make independent lifestyle behavior changes."

Self-care and self-management tools for patients are improving rapidly, she says, as "other sectors in the healthcare continuum require patient engagement."

Health IT can enable ACOs to ensure that the right patient is engaged with the right information. It can also promote patient and provider communication and increased access to patient self-service capabilities, including scheduling and billing.

Additionally, patient-engaging health IT helps them actually participate as partners in the delivery of accountable care, Ms. Battani says.

5. Improve care management and coordination. Delivering accountable care requires mechanisms that manage and coordinate the efforts of everyone involved in the organization. It's about developing a plan and making sure everyone has the information on all points of the continuum. Care management and coordination tools provide both order and accountability for providers and caregivers, Ms. Battani says.

"Accountable care management and coordination activities have their roots in traditional care management tools and techniques, such as care planning and management, disease management, case management and discharge planning," she says.

At a basic level, ACO health IT plans should cover and engage continuum of care delivery settings, address patients' needs and anticipate, manage and minimize the need for costly care.

6. Utilize performance management tools. This allows ACOs to tackle the overall "accountability agenda," Ms. Battani says. As private payors and CMS link care delivery performance with reimbursements, organizations need a way to meet new performance management demands.

Performance management should include an ACO's clinical, quality, outcomes, administrative and financial performance, Ms. Battani says. Management tools should support retrospective requirements, such as quality and outcomes reporting and revenue cycle information, as well as promote a way of thinking that includes insights, interpretation of data and recommendations for improvements. According to Ms. Battani, the idea is to integrate performance management tools into analytical tools that have the ability to support point-of-care decision-making and care management.

"Historically, there's been long lag from the time a care event happens to the time healthcare organizations are actually looking at performance management information about that event," Ms. Battani says. "In this emerging world of ACOs, the objective is to make performance management information available in real-time."

For accountable care organizations to be successful, they must provide integrated information access across providers, settings and activities. And in order to integrate, ACOs need health information technology solutions.

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