Core ACO Health Information Infrastructure: Analytics

By John W. Loonsk, Chief Medical Officer, CGI

The Accountable Care Organization draft rule is out, and the political, clinical and technical trek to establishing these lynchpins of the Affordable Care Act and health reform is on. Community physicians and hospitals are jockeying for potential shares of the incentives that will be distributed via the ACO program. Health Information Technology has been so frequently cited as being a critical part of making ACOs successful that it is now de rigueur. But if ACO information technology is assumed, it is still not completely defined and certainly not completely available or implemented.

ACOs will need new analytic, clinical workflow, administrative and communication functions if they are to actually reduce costs and improve care. Prevention, decision support, error reduction, revenue cycle optimization and disease management will all be activities successful ACOs aggressively pursue. But not all of these functions or activities are currently performed by existing electronic health records, health information exchange, or traditional hospital IT systems. Where the functions do exist, they are not carried out at the required scale in an integrated fashion across multiple care organizations.

With this article we will begin an exploration of the HIT needs of ACOs. While provider organizations are hashing out the financial distribution, we will start with the second most important influencer – the data. Data for an ACO can be considered as being used for at least three purposes:

1. to analyze and report on trends in clinical and claims data,

2. to support traditional clinical care and administrative recording processes, and in a new category; and

3. to manage shared information across multiple providers such as in ACO-wide managed problem lists, medication lists, care plans, or directories of identity and privacy settings. Here we focus on use for analysis and reporting (#1).

Identifying the analytic data

As HIT goes through the awkward teenage years and heads toward young adulthood, it is clear that a mix of well and poorly structured and maintained clinical data will persist. The first stage of meaningful use did not…. (to read complete article, click here).

John Loonsk, MD, FACMI, is chief medical officer for CGI Federal. From 2006-2009, he was director of interoperability and standards in the Office of the National Coordinator for Health Information Technology.



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