Athenahealth's EHR Tools Boost Quality Of Care, Revenue

The insurer has developed a cloud-based "accelerator" program that may help clinicians more accurately report patient data, meet National Committee for Quality Assurance standards, and improve their bottom line.

Nicole Lewis, Contributor

September 1, 2011

3 Min Read

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Athenahealth this week launched the Patient-Centered Medical Home (PCMH) Accelerator Program to help primary care physicians meet Patient-Centered Medical Home (PCMH) standards outlined by the National Committee for Quality Assurance (NCQA), quicker and at a reduced cost.

The NCQA standards call on medical practices to increasingly focus on the PCMH model of care which is supported by the adoption of health IT that meets federal Meaningful Use requirements. The NCQA standards evolve around accurate data reporting requirements that track patients' medical results and contribute to a higher quality of care.

Once primary care practices meet NCQA standards and are PCMH recognized, they are in a better position to receive pay-for-performance opportunities through state agencies, health plans, and regional independent practice associations.

To help these efforts along, the NCQA conducted a corporate review of AthenaClinicals, Athenahealth's cloud-based electronic health record (EHR) system and AthenaCommunicator, another cloud-based service that manages and stores information related to care planning, provider-patient communications, intra-office coordination, and organizing referrals to specialists.

In an interview, NCQA spokesman Andy Reynolds said the review found that by using Athenahealth's solutions for NCQA's PCMH 2011 Standards, "providers will automatically receive 18.5 points toward the 85 points needed to achieve the highest level of NCQA Recognition."

If providers meet these standards, Minna Chan, Athenahealth's senior manager for payer outreach, told InformationWeek Healthcare that health insurance companies could "pay a higher rate to that provider knowing that they deliver a higher patient-centric quality of care."

The PCMH Accelerator Program marks the first time that the NCQA has undergone a corporate review process of a company's cloud-based EHR, and has qualified the system as a service that helps primary care physicians participate in the PCMH incentive model.

Athenahealth EHR customers wishing to apply for NCQA's PCMH recognition program will receive automatic credit in the areas where Athenahealth's solutions have "met or exceeded NCQA's requirements," without having to spend time and money to design a system that meets these requirements, the company said. The NCQA PCMH recognition areas that Athenahealth's suite of services help healthcare organizations meet include:

-- Pre-filtered reporting for NCQA PCMH applications. For example, the system allows physicians to identify the population they want to track, such as patients with diabetes or who have received vaccinations. Once the provider indicates the population it wishes to monitor, the system is alerted and the clinical guidelines associated with that population allow the physician to coordinate their care.

-- Quality management tools to track PCMH measures. These tools track patient interactions with the healthcare system to make sure, for example, that patients have the correct blood tests and that test results meet a certain threshold. If there are concerns, the AthenaCommunicator system will prompt the doctor or his staff to follow up through phone calls or Web alerts.

-- Identifying/pursuing payer programs that can help subsidize the cost of recognition. By aggregating the data collected in the EHR, the system generates reports that can reveal gaps or barriers between providers and health plans that can help them improve their procedures.

In her comments, NCQA president Margaret O'Kane said those who are using Athenahealth's cloud-based EHR stand to benefit from being recognized by her organization.

"We're deeply invested in the PCMH model and believe in its potential to drive better patient care in this country," O'Kane said in a statement. "Practices and providers using the Accelerator will be well positioned to earn PCMH recognition from NCQA. We are thrilled that Athenahealth is helping practices by launching this program."

Find out how health IT leaders are dealing with the industry's pain points, from allowing unfettered patient data access to sharing electronic records. Also in the new, all-digital issue of InformationWeek Healthcare: There needs to be better e-communication between technologists and clinicians. Download the issue now. (Free registration required.)

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