Like any sweeping reform initiative and market-driven industry transformation, the effort to leverage technology and implement new standards to improve healthcare delivery and accountability in the U.S. is a complex, controversial undertaking, but it is proceeding behind the scenes, and innovations are reaching more citizens. According to recent analysis from consulting firm Oliver Wyman, more than half of the U.S. population lives in regions now served by Accountable Care Organizations (ACOs).
The growing reach of ACOs is renewing interest in health information exchange (HIE) systems, which have taken shape nationwide to facilitate information flow, a vital component of the new value-based care model that encourages more effective, efficient care by basing payments on outcomes rather than individual procedures performed. HIEs provide a platform that can help ACOs reduce costs, improve workflows and expand access to patient data.
While many ACOs and other healthcare organizations are adopting HIEs to comply with Meaningful Use incentives, HIEs’ potential to fundamentally transform healthcare delivery is greater than is generally acknowledged. Understandably, most medical personnel and healthcare IT professionals are currently focused on completing and fully implementing the foundation components that they can build on to truly realize the potential of universal information exchange.
Although a number of ACOs have made significant progress in this arena, other healthcare systems struggle with overcoming the final obstacle to widespread adoption of HIEs in medical organizations, which is fully integrating it into medical professionals’ daily patient care workflow. When individual physicians and allied health professionals see the value of having actionable aggregated data from multiple health systems, they will be more motivated to use integrated technology tools.
Practice managers have meaningful use incentives to drive behavioral change: Savvy practice management professionals also understand that technology tools that connect care facilities with HIEs must be fully integrated with the practice management technology that doctors and other healthcare professionals currently use to manage patients and records internally. Full integration to streamline the external exchange of records and data is currently underway.
But while the integration of systems to enable external data exchange on the individual patient level will be a huge leap forward in healthcare delivery transformation, another aspect of the initiative is often overlooked: the power of HIEs to provide insights across the continuum of care — insights that can dramatically improve health management for specific populations.
By using HIE technology to access the data generated from individual care delivery, ACOs can not only fulfill healthcare reform requirements, they can make a measurable improvement in their community health initiatives, such as improving outcomes for populations affected by chronic illnesses like diabetes and heart disease. HIEs provide the platform that allows ACOs to meet strategic priorities like productivity improvement, revenue control, referral management and medical home objectives, which is the current focus of most ACOs, but HIEs can do so much more.
When implemented across the continuum of care to facilitate data collection and access, reduce costs, and provide more timely, higher-quality care, HIEs can ultimately help ACOs improve health in entire populations. As healthcare delivery reform moves forward nationwide, the focus will shift from the street level to the view from 10,000 feet, and HIEs will deliver insights that allow ACOs to achieve truly transformative change.
Daniel Newman, MD, is chief medical information officer at MEDfx.