With the release of accountable care rules by the Centers for Medicare and Medicaid Services last month, it’s time to take a look at potential gaps in the IT infrastructure that may hamper the ability to share information among providers. That information is both financial and clinical, according to Jacqueline Dailey, vice president for IT solutions for medical science, research and patient-centered accountable care at the 20-hospital University of Pittsburgh Medical Center (UPMC) health system.
UPMC participates in a program in which it helps affiliate practices that are not part of UPMC to share data. She says that UPMC does not manage the financials for affiliated practices, and she sees a cultural challenge in sharing financial information with practices that are not part of the UPMC organization. “All of us look at that as our business,” she says. “As you become an accountable care organization, you begin to share financials of that ACO, and this is the cultural shift that is so significant.”
A similar potential barrier may exist in sharing clinical information outside the hospital system, Dailey says. Post-care facilities have not been incentivized under meaningful use, and they may not have made investments in IT as hospitals have. Regardless of whether those facilities are owned or affiliates, it is important to make sure patient information accurately moves with the patient who transfers to or from those facilities. It’s important that personnel in the post-care facilities understand the care plan for the patient, medications, and what kinds of things they should be looking for, and have the ability to notify the physician, she says.
In Dailey’s view, although some post-care facilities have been implementing electronic records, they have not been able to keep pace with hospitals that have been incentivized to do so. UPMC makes its electronic health record available to post-care facilities, she says, adding that “moving the electronic record forward is really where they are going to have to go. Patients go to these facilities after a procedure is done to get rehabilitation services, so they are playing an important role in patient recovery.”