John Halamka, MD, chief information officer at Beth Israel Deaconess Medical Center (BIDMC), and its ACO, called Beth Israel Deaconess Physicians Organization (BIDPO), says their approach is to speed up health information exchange and continue their existing work on financial and clinical data warehouses.
BIDPO consists of more than 1,800 clinicians, including hospital-based specialists, clinicians who work in BIDMC-owned primary care practices, and other community-based private practices.
The BIDPO Board of Directors mandated that every BIDPO practice have a certified electronic health record system in use by December 2010 as a condition of participation in payer contracting efforts. Those payer contracts require "clinical integration"; in other words, all clinicians must be knit together by IT, Halamka said.
To accomplish this goal, Halamka said that BIDPO offered a cloud-based EHR to each practice that didn't yet have a certified EHR. It requires all practices, whether owned or private, to send a standardized, structured summary of each visit to a central quality registry.
On a broader note, Halamka listed the following as IT essentials for those planning an ACO:
-- universal adoption of EHRs;
-- healthcare information exchanges;
-- business intelligence and analytics;
-- universal availability of personal health records; and
-- decision support services.
The biggest challenge, said Halamka, is defining the care management rules--the conditions, wellness measures, home care interventions, best practices, and evidence that should be incorporated into the point of care and analytic systems. The BIDMC Clinical IT Governance Committee agreed to charter a working group of experts to set those priorities so that their care management strategy is well planned and not a random collection of individual projects, driven by individuals with specific niche requirements.