A Health Plan Executive Helps Lead Provider-Payer Collaboration Forward on ACO Development

The business imperative that most CIOs and CMIOs will face is the need to improve their collection and analysis of clinical data. And they should not assume that electronic medical records necessarily give them a major leg up in this area. Electronic medical records are important as records, but you need complementary technology that converts the data into information and the information into actionable information that clinicians can actually use. Second, the CIOs and CMIOs should look very closely at technologies that help convert free-text or unstructured data into structured data. We use a variety of technologies associated with Medicity and other affiliates that help accomplish that conversion.

And you can’t apply a computer very effectively to the art of medicine and have it create the benefits that computerization has created in so many other parts of society. But as you begin to move down this path, you’ll see those sorts of benefits start to apply; and those patient care organizations that first begin to move down this path will see a pretty dramatic competitive advantage.

What are your perspectives on the health information exchange element in payer-provider collaboration?

There are various levels of sophistication in an HIE. The basic level is where the HIE allows you to exchange EMR-based documents, where they can be read by another human being, generally a clinician. Now you’re starting to see the industry become more sophisticated, and they’re adding, beyond a viewing component, a data component to this, and I think you’re going to see a step-wise advancement in that area. For instance, one of our customers had five electronic medical records, and they said, oh, this will be easy for you, because all of our EMRs produce a continuity of care document (CCD), and you can take in a CCD, so this will be easy. But their CCDs failed the federal HIT standard, so that actually made our work almost as difficult as if they didn’t have CCDs.

It’s an area that providers really need to work on?

It’s an area that technology vendors really need to work on, and providers really need to partner carefully with vendors to get the full value out of that element.

Do you have any other advice for our audience?

Even though there’s been significant uptake of the meaningful use funds, still, only about 20 percent of providers have availed themselves of that program. So I think an ongoing emphasis on that program is important; and providers really need to move forward to more tightly bind their clinicians to them, their physicians to them; there are still significant opportunities in that area.