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Accountable Care Workgroup Makes 15 Recommendations

July 7, 2014
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Focus on HIE participation, APIs, shared care plans, ADT feeds

There should be greater transparency about health system participation in health information exchanges. And certified EHRs should be required to publish application programming interfaces (APIs) or use a common API to allow increased access to data to support population health management. Those are just two of 15 specific recommendations of the federal Health IT Policy Committee’s Accountable Care Workgroup.

After several months of listening sessions and deliberations, on Tuesday, July 8 the ACO workgroup is scheduled to make its recommendations to the full Health IT Policy Committee regarding how the Office of the National Coordinator and Health & Human Services can advance health IT capabilities in accountable care arrangements.

In documents prepared for the July 8 meeting, the workgroup notes that health IT and data infrastructure to support ACOs extends beyond the core use of EHRs for patient care, and includes information exchange, integration of data across settings, and analytics capabilities. “Investing in the robust IT infrastructure needed to support accountable care arrangements is a continuing challenge for providers, especially smaller organizations,” it says. “HHS must continue to develop and expand strategies, such as the Advance Payment Model, to help providers invest in the infrastructure necessary to support accountable care models.”

About HIE participation, the workgroup suggests that ONC work with CMS to explore public reporting options that would measure the degree to which hospitals and health systems are performing on specific measures around exchange — for instance, reporting of Meaningful Use transitions of care measure results as part of inpatient quality reporting on the Hospital Compare Web site.

On APIs, the workgroup suggests that the health IT certification program should consider a requirement by which vendors would demonstrate that they can easily integrate with other applications. For instance, ONC could implement standards being developed under the Data Access Framework (an S&I Initiative) around a common API for HIT applications that would allow real-time sharing of information between applications.

Another key focus involves shared care planning. The workgroup recommends that HHS and ONC establish pilot projects to understand how clinicians can use electronic shared care planning tools to deliver effective team-based care across settings.Granting agencies such as CMMI, AHRQ, HRSA, and others, should establish new initiatives to pilot, test, and document best practices for using electronic shared care planning tools including HIE-based services, EHR-based modules, and care management software.”

Healthcare Informatics will follow the discussion of the recommendations during the HIT Policy Committee meeting. Below are some other highlights from the list of “actionable” recommendations.

• CMS should leverage innovative service delivery models to encourage hospitals and other institutions to make admission, discharge, and transfer (ADT) feeds available to any appropriate receiving entity across their community.

• Provide additional shared savings incentives to ACOs that include partners who are not eligible for EHR incentives.

• CMS, ONC and other HHS partners should work together to articulate a future strategy around how the government can advance a federated, scalable data infrastructure model to meet the data and reporting needs of providers in accountable care arrangements.

• ONC should coordinate across HHS to expand support for the development of state-level all-payer claims databases (APCDs) to support accountable care arrangements (inclusive of Medicare & Medicaid).

• ONC and HHS should drive progress on standardization and capture of social determinants of health data elements that are most critical to accountable care delivery models.