5 stages of EHR maturity and patient collaboration

By Michelle McNickle
01:27 PM

By now, it’s apparent EHRs need to grow up. But, as patient-centered business models become increasingly popular, the EHR is also shifting into a vital part of the success of these organizations. 

“The new ‘patient team’ business models, like ACOs, will require that EHRs mature into real-time care coordination and collaboration platforms that can help move organizations … from basic independent care into accountable care,” said Shahid Shah, software IT analyst and author of the blog The Healthcare IT Guy.  

“But care coordination and collaboration aren’t just about adding patient messaging and simple health records sharing— in fact, they must become managers of digital biology and digital chemistry and be able to use that new data to help physicians across patient care teams better comprehend what is happening inside the patient so that they can actually improve health outcomes.”

Shah walked us through what he calls the patient collaboration maturity model and outlines the five stages of EHR maturity and patient collaboration. 

1. Independent care. The first stage of Shah’s model, independent care, is where individuals or separate organizations provide much of the patient care. “This is pretty much where most organizations are today,” he said. “There’s nothing wrong with independent care, but the vast majority of the burden of managing patient collaboration is placed on the patient themselves, which means there’s very little real care collaboration going on.”

2. Connected care. Next, in the connected care phase, organizations begin to share enough information to begin basic patient care collaboration, like sharing patient charts electronically or sending messages about patient care between organizations. “Organizations will start by sharing simple records, but they must design their systems to help move from digital paper into digital biology and chemistry sharing,” said Shah. 

3. Coordinated care. Once an organization begins to benefit from connected care, said Shah, they mature into coordinated care, “where enough patient data is connected, [so that] it will allow multiple organizations to coordinate their care between each other through case tracking and management for simple tasks, such as identifying health risks,” he said. Organizations at the coordinated care maturity level, he continued, start to use their systems to start helping their patients manage their care between firms that might not be legally connected other than as HIPAA business associated or providers. “This is the first maturity level where [patients feel] they aren’t leading their care team but are the center of their care team,” he said.

[See also: ACOs and meaningful use to go hand in hand.] 

4. Integrated care. “Further maturity takes us from coordinated care to integrated care,” said Shah, “where multiple organizations share data and resources between each other, almost as fluidly as if they were a single organization without boundaries.” He added this is where population health management and advanced digital biology starts to “pick up steam,” since coordinated care organizations are no longer concerned with basic records management and digitizing paper and instead start to learn more about what’s going on with their patients. “At this maturity level, the patient starts to feel like they have control over their health, [and that] they have a great team behind them to not just fix existing ailments, but [also] help prevent future problems by modifying behavior.”

5. Accountable care. Lastly, in the "most mature organizations,” said Shah, we see accountable care, which is where there is "such a high level of patient collaboration, that groups of firms become accountable for outcomes and costs together as a team." At this stage, he said, full information therapy and customized behavior prescriptions are now tracked, in addition to typical clinical treatments. “Accountable organizations take full responsibility for a patient’s care over time,” said Shah.

Follow Michelle McNickle on Twitter, @Michelle_writes