Healthcare organizations moving into the uncharted territory of accountable care organizations (ACOs) face technological and organizational challenges that could stop their fledgling attempts in their tracks. Many have embraced health IT as the key to establishing successful ACO models.
The CIOs of healthcare systems that are creating accountable care organizations make no bones about it: without health IT to knit together healthcare providers and patients, ACOs will fail.
“Healthcare is an information business,” notes Bruce D. Smith, CIO of Advocate Healthcare in Chicago. “The ability to access that information and move it around is going to be a key factor for ACOs to operate efficiently.”
Fledgling ACOs face some daunting health IT challenges: the inadequate integration of enterprise systems, the need to develop or enhance computerized physician order entry (CPOE) capability, the slow uptake of electronic health records (EHRs) in private practices, a lack of national standards for health information exchange (HIE), and poor communication between inpatient, ambulatory-care, and post-acute care providers.
To cope with these difficulties, healthcare organizations have developed an array of strategies. To move data between hospitals and clinics, for example, they're using everything from physician portals to HIEs to integration software such as Amalga (supplied by Microsoft Corp., Redmond, Wash.) and Carefx (from Carefx Corp., Scottsdale, Ariz.). The healthcare systems we examined are using data warehouses, registries, and claims data from health plans to do population health management and track where patients go for care. But there's a general recognition that all of this is in a very preliminary stage.
Here are four case studies showing how some leading organizations are planning to use health IT in their ACO projects.
NORTON HEALTH CARE
Louisville, Ky.-based Norton Health Care, which is preparing for an ACO pilot with Humana Inc., Louisville, Ky., will employ health IT to find out whether the ACO lowers the cost and improves the quality of patient care. “The one thing that's going to make this successful or a failure is collecting the data and using it to show that the ACO is making a difference,” explains Steve Heilman, M.D., vice president and chief medical officer of Norton.
Norton's ACO will initially cover four of its five hospitals and 300 of its 400 employed physicians. While all of the hospitals have EHRs in different stages, Norton is just beginning to roll out the Verona, Wis.-based Epic ambulatory care EHR to its outpatient clinics.