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Explorys Cloud Services Power Accountable Care Organizations

Explorys uses combination of big data and specific patient data to improve care, lower costs.

show them how they can manage this much more effectively by us managing their data."

Explorys also reconciles the quality measures its clients gather with the inconsistent reporting requirements of different payers, or even different parts of the federal government. "Explorys helps with that mess because they keep a library of measures, and they're paying attention when the measures change," Whitlock said. "It's a heck of a lot less effort than if we were trying to maintain something this big by ourselves."

Cleveland Clinic itself is not currently operating an ACO, although it is involved in other, similar value-driven initiatives such as the Patient Centered Medical Home program promoting better primary care and care coordination, according to CIO Martin Harris. Harris is an MD who says early in his career, "I thought I was going to be an academic researcher using large data sets to answer research questions." The problem was the data he had to work with came primarily out of billing systems, "and when looked at clinically, the data did not make any sense," he said.

Given his lifelong search for a better answer, he was receptive to supporting the creation of Explorys, as well as other analytic applications. "I feel like I've been on this long journey, and we're beginning to see the other end of it at this point," Harris said. What excites him is not just big data, where the goal is to aggregate as much information as you can, but what he calls "applied analytics," he said. "That's where you've not only derived information from this pile of data but figured out how to deliver it to the point of care in such a way that decision making can be improved."

Despite everything Catholic Health Partners does to standardize on Epic, it doesn't have all the data it needs to run an ACO in the EHR. One of the important elements of the Explorys service is to combine both clinical and claims data, Whitlock said. "There are a whole bunch of things going on outside our network, and he only way we'll know about them is if we have the claims data. Mrs. Jones may not appear in the EHR to be that sick, but actually her risk is pretty high." Some of the important care coordination tasks are more basic, like reminding patients of missed follow-up appointments. To really excel, however, requires identifying "rising risk" patients and taking preventative steps before they wind up in intensive care, he said.

Epic is making its own investments in analytics, and it's possible some of the functions currently performed in Explorys apps will migrate into the EHR -- particularly where it would be beneficial for them to be displayed within the patient record, Whitlock said. However, because Explorys is a small, focused startup, there tend to be "more innovative things that we can do quicker with Explorys," he said. Achieving tighter integration, with a single sign-on experience between the two environments, will be important if the Explorys data is to play a bigger clinical role, he said.

Meanwhile, the Explorys risk dashboards are primarily accessed not by doctors but by care coordinators -- staff members specifically assigned to eliminate gaps in care and minimize the risk that a patient will experience a health crisis.

Though the online exchange of medical records is central to the government's Meaningful Use program, the effort to make such transactions routine has just begun. Also in the Barriers to Health Information Exchange issue of InformationWeek Healthcare: why cloud startups favor Direct Protocol as a simpler alternative to centralized HIEs. (Free registration required.)

David F. Carr oversees InformationWeek's coverage of government and healthcare IT. He previously led coverage of social business and education technologies and continues to contribute in those areas. He is the editor of Social Collaboration for Dummies (Wiley, Oct. 2013) and ... View Full Bio

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David F. Carr
David F. Carr,
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4/11/2014 | 1:44:49 PM
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