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Instead, put resources into creating or enhancing a data warehouse system. The goal is to be able to integrate system-wide cost, utilization, and revenue data and stage it for reporting. Hospital IT also needs to acquire or develop advanced analytics capabilities. Look for a system versatile enough to tie clinical outcomes to revenue cycle claims data.
Functionally, the goal of a data warehouse/analytics system is to identify opportunities to reduce waste, reduce spending, and improve operational efficiency.
GOAL #4: INTEGRATE PATIENTS INTO COMMUNICATION
There are a growing number of personal health record (PHR) systems on the market. Most hospitals are looking at ways to use these systems to provide patients with access to their health data. But under accountable care, patient integration is about more than just information access. IT executives need to focus on using PHR systems to build patient engagement and support chronic care.
One priority is technical. Make sure PHR data feeds into key information systems, including the hospital registration system, the acute care EMR, and the ambulatory EMR. The second priority is strategic. CIOs need to guide PHR design based on high-level decisions about what information will be captured and exchanged and how it will be used. The overall driver is strategy. For example, if a hospital is launching its accountable care effort with a clinical integration project for asthma management, the IT department should configure the PHR to allow patients to log their medication use, record lung function measures, and receive seasonal asthma reminders.
GOAL #5: CREATE MANAGED CLINICAL VALUE
Right now, accountable care is being driven by the promise of higher government payments. Before long, however, leading accountable care organizations will work proactively to identify enhanced clinical value and get paid for it.
Here, the most precious commodity is patient medical information. What many hospital leaders struggle with is that an EMR system is not enough. EMR is a tool for capturing and retrieving patient information at the point of service. For CIOs, the core action item is to build a model of system integration that allows for the capture of clinical data within a data repository.
A clinical data repository (also called a patient disease registry) is a database that stores and coordinates clinical information for an entire population of patients. It allows an organization to report off clinical data, which is needed for calculating actual clinical quality outcomes and comparing them against industry benchmarks. By tracking clinical quality outcomes and accurately measuring the cost of care, hospitals will be in a position to identify savings-which will then lead to evidence-based reimbursement opportunities. A clinical data repository also creates an infrastructure for joint clinical decision making about population care. This is essential for achieving clinical improvement across the enterprise to meet performance goals and therefore payment goals.
HOSPITAL STRATEGY IS KEY
The common theme that runs through all these action items is the importance of an integrated IT strategy. The key to designing an effective IT infrastructure is to focus on your hospital's clinical and business goals. In almost every case, strategic goals determine how to configure technology to support accountable care.
Daniel J. Marino is president and CEO of Health Directions, LLC, Oakbrook Terrace, Ill., a national consulting group that provides business solutions for healthcare organizations. He can be reached at (312) 396-5414 or dmarino@healthdirections.com. Healthcare Informatics 2011 September;28(9):24-27
