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One CIO’s Journey into Accountable Care: Baystate Health’s Joel Vengco Offers His Insights (Part 2)

September 24, 2015
by Mark Hagland
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Joel Vengco, vice president and CIO of Baystate Health, shares his insights on ACO development work for a six-hospital health system in western Massachusetts

Accountable care organization (ACO) work continues to move forward at the Springfield, Massachusetts-based Baystate Health, a six-hospital health system serving large swaths of western Massachusetts. Anchored by flagship facility Baystate Medical Center in Springfield, the health system encompasses six hospitals, 80 medical groups, and its own health plan, Health New England, which has 200,000 members. Baystate Health serves 900,000 patients across four counties.

Meanwhile, Baystate Health joined the Medicare Shared Savings Program for ACOs in 2012, with its Pioneer Valley Accountable Care organization, or PVAC, which encompasses 90,000 lives. Joel Vengco, vice president and CIO at Baystate Health, spoke recently with HCI Editor-in-Chief Mark Hagland regarding his organization’s experiences to date with accountable care-driven care delivery. In the first part of his two-part interview, Vengco shared his insights on the early phases of ACO development. In this second part, he discussed issues around aligning his organization’s health plan and ACO, and the implications of the learnings taking place at Baystate Health, for CIOs of other organizations.

Do you feel that the ACO and health plan in your enterprise are organizationally aligned?

There's a little bit of a tension there between the objectives of the health plan, which is looking to be efficient and save, and that of the ACO, which is looking for revenue, obviously, but also to achieve shared savings. But ultimately, we have folks from the health plan who sit on the board of the ACO, and vice versa, so there is an aspiration to be aligned. Ultimately, they still have the same goals in mind—the Triple Aim, more efficient care and greater value. So those are the same broad goals overall; they have some different fiscal and financial differences and goals. But in terms of care management, it’s very much aligned.

I often think about how difficult it was to build the Transcontinental Railroad, where people literally had to break rocks and other hard ground to build that important railroad. You’re breaking new ground. In what you’re doing. In that regard, what should CIOs know about this kind of work?

You need to be aware of the relationships around the community. If there is a formal ACO, make sure you know who all the leaders are. They all have different needs and systems. So you need to be aware of who those leaders are and what kinds of levels of technology sophistication each of their groups has. Second, you need to figure out ways to connect these disparate providers to each other, whether through data connection or collaboration. We pushed out a secure texting app, so that clinicians, doctors and nurses, and office staff, can securely text across the region. For example they could text the pulmonologist or orthopod they’ve referred to. And we offer that through our accountable care organization.

And the third thing is having an understanding of what systems you as the CIO—since you have the largest IT footprint—what you as a CIO should be offering to the region to help continue the collaboration. Is there a single system you might have folks converge on for data exchange? Do you want to offer them views of your enterprise EHR or somebody else’s EHR is there a care management program you can converge on? But the care management programs themselves are still nascent, still in their embryonic phase, and really, not even infancy yet! And CIOs need to make sure they keep an eye out for the analytic needs of the ACO, and identify how you can best help provide reports and analytics for managing shared savings, global payments, and so on. And a lot of that is still nascent. A lot of firms will say, we can do this for you. But if you don’t have the data, you can’t manage the analytics.

And the other thing I would say is that we CIOs are in an interesting time in our industry. There are so many innovations there and there are so many learnings and technologies from other industries that we could benefit from. Think of the analytics coming from the stock market. You could use those kinds of algorithms to sift through signal data. And think about technologies like OpenTable and Uber, which could manage populations. OpenTable could help provide better access to scheduling. And new innovations are coming into other industries that we should be open to trying out.

At Baystate, we opened a technology innovation center in November 2014, called TechSpring. It’s really what we call an innovation center that opens its doors to crowdsource innovation in healthcare. It gives technology firms, both startups, and large firms, the ability to have access to real, live healthcare data, and the environment, and experts in that environment. It’s creating a space whether they can incubate their solutions or innovations inside a living organization like Baystate Health. So it allows us to partner with these partners to solve some of the most difficult problems we have in healthcare today.