As healthcare organizations begin to explore accountable care models, one thing is clear—technology will play a huge role. Organizations that are leading the way toward ACOs talked about how they'll use technology to reach their goals in the most recent HealthLeaders Media breakthroughs report, The Bridge to Accountable Care Organizations.
In a roundtable event that is part of the multi-media report, leaders talked about electronic medical records and health information exchanges—the foundation for identifying gaps in care and for housing data that will be used to guide physicians.
"Clearly, health IT is the backbone, the enabler to an ACO," says Warren Skea, PhD, director, health industries advisory practice at PricewaterhouseCoopers, which sponsored the report. "There won't be success unless information is free flowing between all entities. What we've heard is that it is critical to have one system within the organization.
Health information exchanges are critical but not every market has one, and I think that's going to be a significant hurdle for many markets. One of the challenges is that patients' cost and their care will be counted regardless of whether they receive in-network or out-of-network care. So if you've got patients who go outside the network to receive care, outside of your IT framework, it will be critical to get that out-of-network information as quickly as possible, making it interoperable and managing it in the most cost effective way and in the most timely manner."
"In a managed care system with referrals we know where the patient is headed before the cost is incurred and that gives our care management infrastructure a chance to help," says Nancy Boerner, chief medical officer at Monarch Healthcare, a 20-hospital system in Irving, CA. "In this system where choice will still be present, waiting for claims information—even if it's timely claims information—is a bit too late.