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Strategizing on IT for ACO Development

February 18, 2011
by Mark Hagland
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Premier executives unveil the Continuous Care Capability Maturity Model

Within the past year, member organization leaders and executives at Premier Inc., the Charlotte-based healthcare provider alliance, have been strategizing forward on accountable care organizations (ACOs). Within that broad initiative has been a strong effort to sort through the information technology elements that will be foundational to the development of ACOs on the part of hospitals, medical groups, and health systems nationwide.

As part of that effort, experts from 28 of the nation’s leading health systems have developed an industry standard technology capability model for analyzing accountable care capability. In fact, the members of the Population Health and Data Management Workgroup have just developed a new schematic that lays out the stages and elements of ACO-driven IT capability development. It is called the “Premier Continuous Care Capability Maturity Model”, and its developers consciously modeled its five stages—labeled using the terms (in ascending order of sophistication) “transaction,” “interaction,” “integration,” “collaboration,” and “transformation”—on the very well-known seven-stage schematic for EMR development created several years ago by HIMSS Analytics—but this time applied, of course, to ACO foundational IT.

The announcement on Friday, February 18 of the public unveiling of this effort, and of the schematic, is one that Premier’s volunteer and executive leaders hope will move the healthcare industry forward in this critical, healthcare reform-driven area. In that context, HCI Editor-in-Chief Mark Hagland spoke last week to Keith Figlioli, vice president of health care informatics, and Randy Thomas, vice president, product strategy and planning, at Premier. Below are excerpts from that interview.

Healthcare Informatics: Tell us about the basics of your ACO initiative, and the IT elements involved.

Keith Figlioli: We’ve got a whole workgroup around population health and data management. And the data is the key. The goal here is enhancing the capability to access and use your data, and to move towards greater transparency. At Premier, we have an overall ACO collaborative; and the schematic came out of the Population Health and Data Management Workgroup. And the charge for this group has been, how do we put together this model? And we looked at the HIMSS Analytics EMR schematic, and put the charge to the group to put together to create something similar for ACOs. If you think about meaningful use, everybody’s trying to figure out how to strategize forward.

When it comes to laying the foundation for ACO success, there are really three main layers: baseline infrastructure needs; the transactional layer; and the business intelligence and population analytics side. We put together 17 CIOs, and the schematic emerged from their work.

Things are evolving forward in terms of ACO development, and we’re looking at this as an iterative process. So this schematic really is our baseline that we’re putting out into the marketplace, and we will iterate as we go along here.

Keith Figlioli

HCI: What has the dialogue been like among members of the workgroup?

Figlioli: I think everybody involved in this ACO area is looking for answers. And we think about how long it took just to get the consensus on how to go forward on EMRs. And I think it’s a very similar analogy to what’s happening in the ACO market on all fronts. Specific to the CIO, they’re getting the message from higher-ups that they have to facilitate this work; but they need clarity about what the phenomenon is. We’re talking to some folks who want to move forward on the ACO front but who aren’t even stable yet in terms of EMR development.