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The Competitive Advantage of Data in a Post-ACA World

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IT leaders must wire the care continuum to connect patients and providers

While reporting on industry reaction to the U.S. Supreme Court ruling to uphold the main parts of the Affordable Care Act (ACA) on June 28, it was clear that many experts believe the landmark event did little to change the IT trajectory of healthcare organizations. What was apparent though was this decision validated and encouraged the initiatives organizations were already taking to digitize healthcare records to provide for better analyses and rein-in climbing healthcare costs.

The passage of the ACA accelerates the need for care transformation given that most organizations are dealing with shifting reimbursement models and tightening budgets, said Christopher Kerns, managing director, research and insights, The Advisory Board Company, a global research, consulting, and technology firm based in Washington, D.C. “Most organizations are very well aware that they are going to have to be building out new abilities to manage patients more affectively across the care continuum in any sort of payment environment,” he added. “This only accelerates that because it validates many of the payment transformation pilots that were baked into the ACA.”
“I think it does inject some stability into the equation, at least for the short-term, and puts some momentum behind sustainability for this approach,” said Mark Van Kooy, M.D., director of informatics at the Pittsburgh, Pa.-based Aspen Advisors, a healthcare consultancy.

As the ACA mandates that the uninsured must purchase healthcare insurance or face a tax, several hospital CEOs that Dave Roberts, vice president, government relations at the Chicago-based Healthcare Information and Management Systems Society (HIMSS), has spoken to are optimistic that this will provide sustainable funding for future IT investments above and beyond meaningful use. “ACOs [accountable care organizations], electronic funds transfer, the whole health information exchange,” said Roberts, “these are some of the key things that can really roll out because of this legislation.”

The need to provide for the seamless information transfer across the entire care continuum to connect providers and patients has been underscored by this ruling, said Kerns. He added that because more patients have accountability for their cost of care, and will look for new ways to pay for their care, they will have more of an impetus to connect with hospitals in meaningful way and “healthcare information is going to have to become a major source of competitive advantage for our providers.”

“Information is going to be a primary means by which patients attach to specific health systems and attach to specific providers, ensuring greater patient lock over the long-term and leverage information in a way that creates competitive advantage is going to be absolutely essential,” added Kerns.

Roberts said that a big piece of post-ACA IT strategy will be to correctly identify patients across the healthcare continuum. He noted there is a taskforce among multiple associations in Washington, D.C., who are working with members of Congress and the U.S. Government Accountability Office (U.S. GAO) to come up with a nationwide strategy for correctly identifying patients.

“We need to build accountability into our systems and for IT professionals that means efficient workflows and access to data that is rock-solid accurate for clinicians to help drive behavior changes that are needed,” concluded Van Kooy.