BQA is now deploying an exchange based on Covisint health data exchange technology. Couch says "the connection process is going on right now" and the ACO aims to connect the majority of the EHRs by December 2013.
Podesta estimates that OneCare Vermont will need to integrate EHRs from 15 to 20 different vendors. The ACO is now working with Vermont Information Technology Leaders, which operates the statewide Vermont Health Information Exchange. Podesta says a sizable portion of the ACO network is already hooked to the HIE, adding that OneCare Vermont is working with VITL to get the rest of the ACO's participants connected.
Dr. Gary Wainer, president of the Chicago Health System ACO, says the organization is exploring HIEs. He noted that some EHR vendors asks for large sums-ranging from $20,000 to $30,000-to build interfaces between their systems and the ACO's ICLOPS registry, a clinical database.
"We recognize that [HIE] is probably the solution," Wainer says, rather than trying to make one-on-one connectivity happen between multiple EHRs and the ACO's registry.
Challenge No. 3: Healthcare Big Data Analytics
ACOs will acquire large volumes of patient data as they develop. The real trick is to turn that data into information that can help providers improve individual care plans and boost the health of specific patient populations. Data warehouses and associated analytics tools are expected to contribute here.
Digital health records and data exchanges will help populate the data warehouses. HIEs will collect clinical data from EHR systems that can then be fed into big data analytics systems. CMS represents another important source of data, as the agency will provide Medicare claims data to the shared-savings focused ACOs.
Podesta said OneCare Vermont plans to combine HIE and CMS data in its IBM Netezza data warehouse. The ACO received its claims data from CMS in May and is now in the process of moving the data into the warehouse. The organization will use IBM Cognos business intelligence tools to analyze the data.
BQA, for its part, purchased Humedica's MinedShare population analytics platform. Crouch says the ACO is populating that system with data from several sources: The employed physicians' EHR, employed physicians' billing data, payer claims data, hospital inpatient EHRs and independent physicians' EHRs. For the latter group, the ACO will extract a more limited set of information from the EHRs and bring that data to the analytics platform over the HIE.
ACOs will use analytics tools to identify at-risk patients, identify health trends across a patient population and benchmark care programs. The objective is to acquire insights that can help shape treatment programs and establish best practices.
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