Accountable Care Organizations Can't Survive Without Health IT

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Healthcare organizations that reject the Accountable Care Organization (ACO) model--and who fail to implement the necessary technology and practices to support better patient outcomes and quality across the full continuum of care--risk long-term clinical and financial failure, concludes a new report published by CSC's Global Institute for Emerging Healthcare Practice.

The report, Preparing for Accountable Care: The Role of Health IT in Building Capability, also reiterates what health IT managers and clinicians already know--ACOs will require a plethora of health information technology to operate and support the new ACO model, which is based on pay-for-performance where providers will receive payments for the quality and not the quantity of care they offer.

"Accountable care may be the only element of the health reform legislation that directly addresses the issues of healthcare quality, health status improvements and healthcare cost inflation," Jordan Battani, the report's author, told InformationWeek Healthcare. "As a result, it's here to stay as an organizing principle for healthcare delivery, and for innovations in payment and reimbursement structures."

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The report outlined several areas where significant investments in technology will help ACOs thrive. These include:

-- Clinical information systems and point-of-care automation. These technologies are required to ensure that providers have access to patient information whenever and wherever the data is needed to make medical decisions. Each provider at every stage of care should have access to the patient's overall health history, as well as information about the current episode, diagnostic studies, care summaries, treatments, medications, and procedures that have already been delivered. For chronically ill patients, this access must also include care plans and ongoing care management activity summaries.

-- Enterprise, master data management and integration. ACOs must develop a strategy that taps information from disparate systems that coexist on the continuum of care and can be effectively used at any point, by any provider on the continuum. Data such as member and patient demographics, provider demographics, clinical codes, and administrative and financial information need to be managed and monitored to support accountable practices as well as enable providers to demonstrate that quality, safety and cost management goals are being met.

-- Health Information Exchanges (HIEs). Exchanges that effectively provide the secure transmission of up-to-date patient information between healthcare delivery organizations ensures that providers have immediate access to patient-level clinical information, updates and clinical decision support. HIEs should facilitate the aggregation and integration of data such as computerized physician order entry (CPOE), e-prescribing, and up-to-date alerts and reminders on the latest diagnostic, pharmacy, and treatment information.

According to the report, healthcare organizations that are gearing up for participation in ACOs will have to come to terms with the fundamental changes that will come with this new model of care.

"The bad news is that most health delivery organizations, struggling under the demands of achieving Meaningful Use of EHRs for HITECH Act incentives, meeting ICD-10 deadlines, reducing cost and maximizing reimbursement, have little appetite or bandwidth for new organizational changes, much less additional health IT projects. The good news is that most of the accountable care investments in work process change and in health IT are not new, and they have considerable overlap with what is required for other initiatives," the report states.