How is your day going? If it appears to be going well, you may not be paying enough attention. Rome is burning, Nero is playing his electric fiddle, and nobody can remember where we left the garden hose.
Here are a few observations just to get the juices flowing:
- The economy has patients postponing care
- Internal cost pressures are tremendous
- Patients are issuing RFPs for their care
- Payers are seeking lowest cost providers
- New care models are being piloted;
- Bundled payments
- Home care
- Value versus volume
- Accountable care organizations
And guess what—none of this works without IT. There are no new care models without the right IT to support them. A lack of resources to fund all of the required IT initiatives needed to address these opportunities is causing additional pressure to consolidate organizations and is driving mergers.
To even think about offering new care options, all of the following systems need to be fully operational, and that is just for starters.
- Electronic health records
- Online results reporting and scheduling
So what else? One big undertaking that seems to be missing from the conversation is the support that new delivery models will require from providers’ financial systems. An accountable care organization is a legal entity, and requires auditable reporting of revenues, profits, and costs.
As far as I know, there is not a single hospital in the country that can tell anyone what a tonsillectomy costs, let alone any of the other services they provide. So, if we do not know what one thing costs, how can we know and report on what everything costs?
If anything can be learned from the last two years, it’s that trying to make EHR interoperability a reality — when viewed from the perspective of linking an acute care facility and ambulatory physicians — has proven to be very difficult. How much more difficult will it be to create “interoperable” financials?