Both meaningful use (MU) and accountable care organization (ACO) initiatives are about creating value - the use of technology to manufacture healthcare more efficiently is a big part of the overall design and structure. When we look at the data analysis required to manage and report on the two, ACO is "other worldly" at first blush.
If we start with the major process differences, MU is more about transporting data to and from the electronic medical record (EMR) to help gain efficiencies in the manufacturing of healthcare. The ACO model requires the same infrastructure, but is more reliant on analysis of disparate data sources to provide greater visibility and nuance for quality and cost improvements. In the ACO model, being able to monitor the avalanche of data that shared savings requires is a primary driver for much of the technology requirements, after the electronic medical record is implemented. Over time, the sheer volume of ACO data will far exceed that required for meaningful use and, by default, implies that ACO technology will be quite a bit more tricky and disruptive.
In these early days, it is best to think about how an ACO is a business problem first. Much is to be considered about the business structure and relationships needed to provide care and then identifying savings and sharing them across the entity, before thinking about the technology needed.
So far most will agree that the technology required for ACOs has not been well defined when compared to how the ONC and NIST laid the MU technology out with formal tests, demonstrations and recommendations. ACO tech will have to be much more robust. Foreseen challenges include an even greater load on the integration and maintenance of desperate systems holding data, data analytics and getting the data out of warehouses – upwards to 30% of EMR data is not computer usable, according to some estimates. When we begin to reach out to the patient through remote care technology, telehealth and remote monitoring, these processes and data feeds present unforeseen problems for many clinical systems.
What is clear at the moment, and despite what we heard a this year’s HIMSS conference, a growing chorus of highly experienced healthcare technologist say there is no single source vendor for ACO technology within healthcare and there really can’t be due to a growing list of newly minted ACO configurations . A common note from this chorus is that you’ll need to look beyond traditional health IT vendors for your ACO integration solutions.
So, when you do get to the technology part of the discussion, a worthy question to start with is - What technology will help me spot, track, verify and dole out shared savings...the business problem first, then the tech.
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