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ACOs need 'more' than an EMR

February 20, 2012 | Richard Pizzi, Contributing Editor

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LAS VEGAS – There's no way around it: Accountable Care Organizations, or ACOs, are the future of healthcare in the United States, and providers had better get on the bus sooner rather than later.

Attendees at the ACO Symposium at HIMSS12 appeared to recognize this, as Monday's pre-conference event was standing room only.

Antonio Linares, MD, medical director at Wellpoint, reassured the audience that "unlike most things you encounter in Las Vegas, there is a win-win relationship for all those involved with ACOs."

[See also: Usability 101 workshoppers conduct research methods for improving EHRs.]

ACOs, as defined in Section 3022 of the Patient Protection and Affordable Care Act, bring together primary care providers, specialists and other providers to manage the full continuum of patient care and assume accountability for the total costs and quality of care for a defined population.

Healthcare information technology is the essential backbone for ACOs, said Joe Damore of Premier, Inc. Damore told attendees that the comprehensive IT needs of ACOs extend beyond an electronic medical record system that links a hospital and physician practice. He said ACOs need an HIE, a population health data management system, a robust business intelligence and predictive analytics platform, and ultimately a consumer health platform or portal.

Linares emphasized the data exchange and reporting function of ACOs. He said IT executives would be asked to focus intently on reporting analytics as ACOs take hold.

"We need to develop real-time information exchange for disease management. ACOs will ultimately require us to transfer data bi-directionally in real-time from provider to health plan."

While the future may be boundless for ACOs, Linares said the current menu of ACO options for providers include the Medicare Shared Savings Program, the Advance Payment ACO Model; and the HHS Pioneer ACO program.

"There's a real opportunity for greater gain sharing in the Pioneer program," Linares said.

Most of the Symposium speakers praised the final ACO rules released late last year by the Department of Health and Human Services. Linares said HHS "really listened to constructive comments from stakeholders" and made positive changes to the proposed rules.

A redesigned healthcare delivery system, of which ACOs are a critical component, will ideally lead to improved population health and better cost control, but should also improve the care experience for patients, Damore said. The process builds directly on the "Triple Aim" designed by former CMS administrator Don Berwick, MD, while he led the Institute for Healthcare Improvement.

"ACOs will help enable patient engagement," Damore said. "That's the direction in which we're moving."

Richard Pizzi
Editorial Director for MedTech Media
Follow Richard on Twitter @HFNeditor
Related Topics:
  • Antonio Linares
  • Joe Damore
  • Las Vegas
  • United States
  • WellPoint
  • Electronic Health Records
  • Policy and Legislation

Reader Comments (1)Login to Post a Comment

frdpan@aol.com says: ACOs Need More than an EMR
February 21, 2012 | 10:01AM GMT

EMRs and HIT are just support systems for ACOs. ACOs if they accomplish what they are suppose to, is a "Patient Care" model that addresses the "Continuum of Patient Care". Episodic care needs to go away, because it doesn't deliver the best clinical outcomes. Hospitals, LTCs, etc. and Physicians working in silos doesn't offer the best patient care. Physicians have always managed hypertension, diabetes, hyperlipidemia, etc. in their office to avoid unnecessary admissions. Hospitals would see that patients that failed treatment, were non-compliant, didn't seek treatment, etc. If we saw a readmission, it was revenue, not, what did we do wrong while the patient was in the hospital or what did we do wrong to bridge to the outpatient side.
Those of us that were talking about ACOs 5 years or more ago and were trying to implement this model with VBP/Bundled Payment/SSP, understood this. We spent money on good financial and clinical information systems and were lead by clinical excellence. Technology is just a support mechanism to generate the metrics needed and to track and trend outcomes and cost of care. Set your ACO model first and then fill in the blanks of needs.

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