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Healthcare's accountable care organizations face daunting IT task, deadlines

John Moore | June 4, 2013
Outlined in the Affordable Care Act, the ACO model aims to link hospitals, physician networks, acute care facilities and other organizations in an effort to provide more coordinated care that in turn reduces costs. But ACOs must address four key IT challenges before a strict government deadlines impose financial penalties.

As they build in-house warehouses, ACOs also contribute data to regional and national resources that will let the organizations tap into a larger data set.

OneCare Vermont, for example, is moving its data to the Northern New England Accountable Care Collaborative, which aims to combine data from participating health systems in Maine, New Hampshire and Vermont.

Podesta says those systems will be able to access each other's de-identified patient data. Instead of deriving best practices based on an analysis of 5,000 diabetes patients, for example, an ACO would be able to draw conclusions from a much larger group, he explains.

Similarly, BQA plans to work with Anceta's data warehouse. Anceta, a subsidiary of the American Medical Group Association, maintains a warehouse with data on more than 25 million patients. "We'll contribute to that and we'll, in turn, benchmark our care against a huge universe of patients," Couch says.

Challenge No. 4: Patient Portals and Care Management
ACOs aim to increase patient engagement, and patient portals are one method to boost communication between patients and providers. Portals offer features such as secure messaging, the capability to schedule appointments and access to test and lab results.

The portal component tends to be the last of the four technology pillars that ACOs pursue. Couch says BQA plans to pursue a patient portal, following its work on EHRs, HIE and analytics. HealthTexas already employs a patient portal, but, he notes, the ACO would need portal technology with the ability to cover the entire organization. BQA has not yet defined the solution.

Fletcher Allen, for its part, uses Epic Systems EHR software and its MyChart patient portal, which the medical center has branded MyHealthOnline. Podesta says the ACO will look to deploy a more generic portal ACO-wide but adds that no decision has been made on what product to use.

Care management is another ACO-related technology that seeks to improve communication. Chicago Health System ACO in May adopted Care Team Connect care management software, which links hospitals, providers, family members and patients. The system lets ACOs share a patient care plan among those groups.

Wainer anticipates that, over time, acute care and post-acute care facilities, physicians and case managers will be able to view-and have input into-care plans via Care Team Connect. (The Chicago Health System ACO is part of Vanguard Health Systems, Chicago Market, a multi-hospital system.) Care Team Connect CEO Ben Albert says ACOs "need to engage the various communities."

Dr. Robert Wah, global chief medical officer for Computer Science Corp. ( CSC), says ACOs must deal with the cultural challenge of bringing together entities that don't naturally collaborate.


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