In speaking recently with industry experts and healthcare IT leaders about the topic of strategizing around vendor contracts (my feature article will appear in our June issue—please look for it!)—I had a particularly interesting conversation with Fran Turisco, a Boston-based principal in the Denver-based Aspen Advisors consulting firm, and one of my very favorite industry experts. Fran has been working with some integrated health system clients lately, trying to help them strategize forward to lay the IT foundations for participation in accountable care organizations (ACOs).
And she had an especially intriguing story to tell me about the work she’s been doing with one integrated health system client in particular. That organization is actively establishing an ACO right now, Fran reports, and her work has specifically been with the hospital. To begin with, as she explained to me, it has required a very in-depth, complex process just to identify which activities the ACO would be engaged in, going forward, including quality reporting, performance measurement, incentives and contract management, and so on.
Then, once the key processes that would be taking place had been identified, the hospital leaders were stunned at what happened when it came to reaching out to healthcare IT vendors, as they began assembling their ACO’s IT infrastructure. The key point, Fran says, is this: “We sent out 18 RFPs and got 16 responses back. And of the vendors that had the majority of capabilities needed—patient portal, provider portal, health information exchange, EMPI, rules engine, cross-care management, business analytics, quality reporting, and ACO/back-office accounting/contract management—all of them had to partner to be able to offer all those capabilities; it was unbelievable. One vendor had six partners it needed to provide those offerings.”
What’s happening now, Fran notes, is unprecedented. And so what are those three things you absolutely cannot get wrong about the emerging vendor landscape around accountable care? Here you go…
Number one is that no vendor—and that very much includes the core electronic health record (EHR) vendors whose products are the anchors for integrated health systems’ clinical information systems—has the full range of capabilities needed to support accountable care organization development right now. There are many, complex capabilities required, and at the moment, the “big-box” vendors (as some call the core clinical IT vendors) are having to stitch together constellations of capabilities, through partnerships with smaller, niched vendors. That is simply the reality of healthcare software development at this stage of healthcare system evolution.