The cloud as a health data nexus for ACO
The imminence of accountable care already is beginning to transform the way healthcare is organized. It logically follows that the information technology (IT) necessary to support Accountable Care Organizations (ACOs) is also changing under our feet. The massive shift of patients to the ambulatory sector to achieve lower-cost care, the need for coordinated care among diverse providers and the analytics required to manage population health are all moving the IT dial to a new frequency.
That new frequency is likely to be the cloud.
Although the federal government originated the concept of ACOs as a value-based reimbursement model for Medicare and Medicaid, commercial insurers have also seized upon it as a viable answer to higher quality, more cost-effective care. The goal is to connect hospitals, physician offices, laboratories and other parts of the healthcare continuum to offer preventive, evidence-based medicine that achieves the best clinical outcomes possible. However, connectivity within and among a wide variety of stakeholders is essential before that goal can be reached.
To date, health information exchanges (HIEs) are viewed by many experts as the best way to provide connectivity. While it is true that many public HIEs are struggling to achieve sustainability, commercial HIEs – those spearheaded by healthcare organizations – have gained momentum because they offer direct value to the organization itself. Healthcare organizations are beginning to rely on HIEs not only to deliver the highest quality care, but also to enter into the risk-sharing arrangements with payers that are integral to any accountable care model.
In other words, the ACO is considered an acceptable patient wellness model, and HIEs are its enabler. Indeed, until now HIE connectivity has offered the best model for comprehensive information sharing among those taking ownership of individual and population health.
However, traditional HIEs lack the ability to efficiently and effectively integrate and aggregate all of the data required for analysis in an accountable care world. The problems with which HIEs struggle include trying to efficiently create interoperability among dissimilar technology platforms and disparate data formats in an environment that has few standardized nomenclatures. HIEs have difficulty delivering information where it counts the most: at the point of care.
HIEs are one way to begin linking together the pieces of an ACO, but they are really only stepping stones. They are way stations, not destinations, on the journey to ACO connectivity – which brings us back to the cloud.
Cloud-based services can do more than just integrate unrelated IT systems; they can quickly and efficiently reconcile the semantic differences in the data within those systems to promote useful data analysis. Rather than construct limited point-to-point interfaces among healthcare stakeholders, cloud-based services provide healthcare organizations with an ability to widen the reach of data to wherever patients and providers need it. The cloud has a natural disposition to support healthcare organizations as their traditional walls continue to dissolve operationally.
Take the concept of a Master Patient Index (MPI) as an example. Lots of hospital applications include an MPI that acts much as a local phone book; they can match patients in a limited way. As organizations have grown, MPIs have begun to move from being system-specific to more hospital-centric. They are like a larger phone book. However, ACOs require taking that phone book outside of both individual systems and even the hospital itself; the MPI must become like a global online phone book, with information accessible by all within the healthcare continuum. A cloud-based MPI would not be bound by the department, hospital or even healthcare organization for which it was created.
As this example illustrates, cloud-based integration offers the kind of connectivity demanded for the coordinated, accountable care of populations. It introduces consistency that links not only the apps within a hospital, but the multiple apps within a healthcare organization and beyond. It facilitates the optimization of claims and financial data from payers with clinical and operational data from providers to generate the value required under accountable care.
Simply put: Cloud-based connectivity transcends the limitations of disparate data sources. By allowing all the organizations that make up the healthcare ecosystem to transcend their traditional boundaries, the cloud can offer an efficient information nexus for the ACO.
Gary Palgon is vice president of Healthcare Solutions for Liaison Technologies. This article originally appeared on Government Health IT sister site NHINWatch.
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