BIDMC's Accountable Care Organization IT Strategy

No one really knows what an Accountable Care Organization is, but many provider organizations want to be one.

As a CIO, I've been asked to create the financial and clinical analytics needed to support high value care (low cost, high quality), population health, and care coordination across the community.  

 

No one really knows what an Accountable Care Organization is, but many provider organizations want to be one.

As a CIO, I've been asked to create the financial and clinical analytics needed to support high value care (low cost, high quality), population health, and care coordination across the community.  

I believe that Accountable Care Organizations will be based on healthcare information exchange and analytics.  BIDMC's approach is accelerate our health information exchange work and continue our existing work on financial and clinical data warehouses.

Here's how it will work.

There are over 1800 clinicians in the Beth Israel Deaconess Physicians Organization (BIDPO).  Some are owned, some are private.  The BIDPO Board of Directors mandated that a certified Electronic Health Record be in use at every BIDPO practice by December 2010 as a condition of participation in payer contracting efforts.  Those payer contracts require "clinical integration" - all clinicians must be knit together by IT.  To accomplish this goal, we implemented a cloud-based EHR which was offered to each practice that did not yet have a certified EHR.  We required all clinicians, owned and private, to send a standardized, structured summary of each visit to a central quality registry.  

As each encounter is completed and signed, eClinicalWorks, Altos Solutions, and webOMR, send a very specific Clinical Document Architecture (CDA) summary containing all the data necessary to compute quality and performance metrics to a statewide Quality Data Center, hosted at the Massachusetts Medical Society and operated by the Massachusetts eHealth Collaborative.

That warehouse is used to generate PQRI measures, the 44 meaningful use measures, and ad hoc reporting via web-based business intelligence tools.

For the financial data warehouse, all private payers claims from BIDPO patients are forwarded to a single financial data warehouse where Extract/Transform/Load tools are used to normalize the data into a single schema.

Data mining and reporting is done by Healthcare Data Services.

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