Will health IT failings foil accountable care?
Although healthcare is awash in data, getting it into the hands of clinicians so they can provide coordinated, quality care at the bedside remains a huge challenge. Just ask the 32 Pioneer accountable care organizations--including the nine Pioneer ACOs that may opt out of the program altogether.
The Pioneers, who say the success of accountable care organizations hinges on data and technology, were already raising red flags about interoperability and the difficulties of implementing new health IT systems. Then, earlier this year, they threatened to drop out of the program unless the Center for Medicare and Medicaid Innovation revised the quality benchmarks they must meet to qualify for Medicare bonuses. In a letter to CMS, the Pioneer and Medicare Shared Savings Program ACOs complained that 19 of 31 quality measures were set without anchoring methodology, reflecting a lack of data.
Even as the healthcare industry becomes more connected and accountable, the technology needed to integrate clinical, financial and operational data across individual hospitals, health systems or the continuum of care continues to lag, Allen Naidoo, vice president of advanced analytics for Carolinas HealthCare System--a network with 650 care locations in North and South Carolina--told FierceHealthIT in its latest eBook, Data Integration for Quality Care and Service.
"Think of it this way," he said. "Would you be content with an email system that only allowed you to communicate with people working within the four walls of your office, and not colleagues at other company offices or beyond?"
But organizations--including the Pioneer ACOs--are finding you can't create interoperability in a vacuum. Providers, particularly those in rural areas, are coming together in community-based health information exchanges to share costs and knowledge, for example. Even large healthcare systems benefit from cooperating to address data integration issues.
"Instead of investing in and developing multiple, fragmented solutions that address the same problem, we're pooling resources to develop single solutions we all can use," Terry Carroll, senior vice president of transformation and chief information officer for Fairview Health Services, a Minneapolis-based nonprofit healthcare system with seven medical centers, said in a recent announcement about the creation of a data collaborative between four regional health systems.
"This collaborative represents the first time that providers--not just technology manufacturers--are co-developing, testing and sharing data analytics designed by us, for us, in a collaborative format," Naidoo told FierceHealthIT.
What do you think? Is better collaboration the way to achieve better data? What else needs to happen to ensure interoperability and data exchange? And what happens to the ACO model if we can't figure out the answer to those questions?