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Accountable Care and Social Media: Can it connect the silo’s?

By Gregg A. Masters, MPH

In an article posted on KevinMD by the always learned and insightful George Lundberg, MD*, the question was posed:

can ACO’s re-invent the American Health Care System?

A rather compelling and timely question given the fragmentation and vertical silo’s characteristic of American health care finance and delivery, and the ‘patient-centric’ enhancements the ‘social media tool set’ seems to afford. Yet, there was a limited and in my view somewhat ‘unbalanced’ response. As someone familiar with the thought leadership ‘gene pool’ of social media, and healthcare social media sub-set in particular, I was struck by the absence of their voices [including yours truly] in the comment section.

Yet, the substance of the question is on point to a Health Information Technology Social Media TweetChat I will moderate this Friday, April 6th, 2012 at 9AM Pacific via the hashtag #HITsm. For the most recent tweets tagged with #HITsm, click here.

The flaws in our imploding house of cards ‘sick-care [non] system’ are recounted seemingly everywhere these days. And the recent preoccupation of the Supreme Court of the United States with the constitutional challenges of the Patient Protection and Affordable Care Act, places the question of what are the best practices to restrain and re-orient an overly paternalistic, too costly, unsafe and increasingly inaccessible industry that many would say has lost it’s way.

While Dr. Lundberg is hopeful:

We can build a new medical world based less upon process, quantity, volume, and lucre, and more on quality, safety, speed, outcomes, and patient-centered efficiency.

That sentiment is not shared by those called to comment on the piece. Some representative thoughts include:

Come on Dr. Lundberg, take the blinders off.

If grand platitudes can save our system, then ACO’s are a surefire success.

The ONE goal of an ACO: to maximize market share.

ACOs represent an enormous step forward in the corporatization (profit motivation) of American medicine.

Where do you come down? Does any of this negativity fanned by considerable skepticism if not sarcasm of ACOs to pull off what many of its predecessors, i.e., HMOs, PPOs, EPOs, DPOs, etc., have not – at least in the aggregate?

Is it wishful thinking? And what role, if any, does technology play in the remediation – or the ‘this time it’s different’ department? Might social media and the democratization of the patient/provider value proposition change the balance of power and thus drive ‘accountability’?

Here are my suggested topics for the #HITsm TweetChat:

  1. What does ‘Accountable Care’ mean to you?
  2. Can ‘social media’ (broadly cast) enable accountable care or ACOs in particular?
  3. Will physician’s ever play ball, and why? Why not?
  4. If you ran the zoo, where would you start? What tools are essential to build the conversation and enable the transformation?

We should have some fun on Friday. If I omitted any questions more on point for this conversation, please list them in the comments section.

* George Lundberg is a MedPage Today Editor-at-Large and former editor of the Journal of the American Medical Association.

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