Laying the foundation for accountable care

By Charlie Jarvis
08:35 AM

“Accountable” is one of the most popular buzzwords in healthcare today. Whether an organization is striving to become an Accountable Care Organization (ACO) or pursuing a less formal approach to delivering necessary, efficient and effective care, the term frequently comes up in today’s organizational strategy discussions. It’s more than just a buzzword, however. In fact, more than ever, healthcare organizations are holding themselves accountable for the patient care they provide to ensure future solvency. They’re working to retool their processes to become more proactive and ensure care meaningfully improves patient outcomes and the overall health of their patient populations.

Achieving accountable care is not something an organization can just set its mind to and accomplish. It requires healthcare organizations to leverage specific tools, work in tandem with other providers, foster communication and data sharing across the continuum, identify and respond to high-risk patients and support evidence-based care. Fundamentally, the following tools help an organization seamlessly share information for decision-making and improve the quality of care they provide.

Tool #1—The Electronic Health Record
First, organizations need to be fully vested in their electronic health record (EHR) and use it across the enterprise to document and leverage information about patient encounters. Organizations must go beyond thinking of the EHR as merely a repository for notes, but instead look on it as a robust source of information for integrating and coordinating care across an organization. Thanks to the federal government’s HITECH legislation (promoting meaningful use of IT), many organizations are well on their way to solidly interfacing with their EHR. However, improvements can still be made in terms of fostering accessibility, integration and user adoption.

Access to a comprehensive EHR is essential because it gives providers information at their fingertips to deliver the best, most appropriate care. When this tool is used by all providers in an organization, it can support integrated decision making and care that boosts patient outcomes. In addition, aggregating data from the EHR allows an organization to identify and respond to potential trends in care, such as the identification of specific interventions for chronic disease patients.

Tool #2—Health Information Exchange (HIE) Capability
While a fully adopted EHR can facilitate comprehensive data sharing internally, organizations need to have strong health information exchange (HIE) capabilities to support secure data exchange with entities outside the organization. Through a robust HIE tool, an organization can securely share a variety of information across referral networks and communities, including patient demographics, problem lists, allergies, medications, labs and radiology documents. Referring physicians and other outside practitioners can send information back through the HIE, resulting in a more complete patient record, smoother care transitions, enhanced care coordination and ultimately reduced readmission rates because all providers are on the same page about a patient’s current condition and care needs.

Tool #3—Clinical Decision Support
An organization seeking to deliver accountable care must also have good tools for clinical decision support that enhance decision-making across the clinical workflow. Depending on the organization, these tools could include computerized alerts and reminders; evidence-based guidelines; condition-specific order sets; diagnostic support and contextually relevant reference information. Such tools can offer key information to providers at critical times, thus elevating the quality of care, mitigating the potential for error, improving efficiency and ultimately improving the patient experience.

Seamlessly integrating decision support tools within clinical workflow is essential to realize their full benefits. For example, when such tools are organically integrated with the EHR, they can streamline workflow and enhance decision making without requiring the clinician to stop patient care to access information. Conversely, if the tools are cumbersome to access or disrupt workflow, they will not be used consistently, severely limiting their potential.

Tool #4—Population Health Technology
Finally, technology that facilitates population health management is key to supporting accountable care. This technology helps an organization look across its entire patient population and identify gaps in care that represent risk. For example, HIT software can work seamlessly with an organization’s EHR to pinpoint patients who have chronic conditions or other comorbidities who don’t regularly see their physician. The software can then proactively transition these patients into care, allowing the healthcare organization to address the patients’ health risks and avoid negative outcomes. This not only enhances the quality of care for these patients but also elevates the health of the patient population as a whole.

While each of the aforementioned tools are beneficial on their own, when used together they lay the foundation for accountable care. Regardless of whether your organization is working toward becoming an ACO or taking a less formal approach, having strong, integrated technology underpins the effort that can ensure your practice effectively leverages patient information to provide targeted, efficient and accountable care.