The Patient Protection and Affordable Care Act encourages the creation of "accountable care organizations" to promote better care coordination, quality and efficiency. While ACOs are really just an extension of earlier concepts like health plans and capitated payment models, the greater adoption of IT today gives ACOs a fighting chance of succeeding, say John Glaser, CEO of Siemens Healthcare Health Services, and Claudia Salzberg of the Center for Patient Safety Research and Practice at Brigham and Women's Hospital in Boston.

Writing in Hospitals & Health Networks, Glaser and Salzberg say that ACOs essentially require EHRs, PHRs, health information exchange and other forms of data management. "Each of these elements must provide 'traditional' capabilities: For example, EHRs must support the documentation of a patient's problems and e-prescribing, and health information exchanges must enable the transfer of discharge summaries and procedure reports between providers," they say. "Some of these elements also need additional features."

For example, as ACOs encourage patients to take a more active role in their own care, PHRs will gain in prominence, according to Glaser and Salzberg. "These records will need to provide patients with access to their EHR data and work with a range of care management, telehealth and health information tools. A patient may engage in disease and wellness management programs by tracking his vital signs and laboratory results, communicating electronically with his caregivers, accessing trustworthy health information on treatment options, and managing follow-up appointments," they write.

If ACOs serve as the vehicles for moving away from fee-for-service payment models that cause so much inefficiency, the new Center for Medicare and Medicaid Innovation, created by the Affordable Care Act, may be the catalyst. In a story about new CMS Administrator Dr. Donald Berwick, the Boston Globe reports that the innovation center is expected to save CMS $1.3 billion a year over the next 10 years. It's a drop in the bucket compared to the annual CMS budget of $500 billion.

"The innovation center has about 150 employees around the country and will double in size over the next year and a half," said Anthony Rogers, director of the center. Many of its employees will be closely working with local physician groups, experimenting with ways to measure quality and patient outcomes, he added, according to the Globe. This work is supposed to feed off the increased use of IT thanks to the federal EHR subsidy program that begins next year.

To learn more:
- read Glaser's and Salzberg's commentary in Hospitals & Health Networks
- take a look at this Boston Globe article

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