Preparing For The Brave New ACO World

In partnership with CHIME, healthsystemCIO.com has developed a blogger series featuring insights from hospital and health system CIOs and other key IT leaders representing organizations from around the country. The blogs focus on the major issues affecting CIOs, including the health IT workforce shortage, data exchange, mobile device management, and federal regulations.

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Everyone has a lot going on these days. Most of us are working toward meeting Meaningful Use criteria, preparing on all fronts for ICD-10, supporting organizational growth and expansion, supporting key organizational strategic priorities and goals, accelerating informatics and analytics capabilities, going mobile, going social, and going to the cloud.

There’s also ensuring compliance with security and privacy requirements; implementing advanced technology capabilities; fostering innovation; supporting research; ensuring disaster recovery and business continuity; and leveraging  the capabilities of the IT already implemented and harvesting value from those investments by reducing costs, improving efficiency, and improving quality. We all have the same, long (long) list of priorities and “must do’s”. And all of it must be done in the context of increasing demand for new technology and shrinking capital and operating resources.

And because we’re always game for the next challenge as CIOs and business leaders, one of our primary responsibilities is to understand what’s next; what are the opportunities and impacts, and how do we lay the technology foundation and information management capabilities to prepare. It’s often a fascinating exercise in clairvoyance! Even before the industry direction crystallizes, IT leaders need to anticipate what the future will look like and start laying the technology and data infrastructure to ensure we’re ready when our businesses are.

Does anyone know what a typical accountable care organization (ACO) will look like and will need in terms of IT? It’s probably along the lines of, ‘you’ve seen one ACO, you’ve seen one ACO’. ACOs will likely be somewhat unique organizations with local, state, federal, provider, and payer influences, perhaps with specialized business requirements and technology needs driven by unique partnerships and contracts.

But one thing is certain: we absolutely must reduce the cost of health care. Our current model is unsustainable, and continues to lack the streamlined coordination, efficiency and quality of other industrialized nations. Accountable care will likely involve “care coordination” on an entirely new scale, with business partners who don’t share a common organizational umbrella or a common IT infrastructure.

Health Information Exchanges (HIEs) and medical image exchanges will be very important. Case management and care coordination applications that span businesses and sites of care will be necessary tools for effective “clinical navigators.” Chronic care management utilizing telehealth, remote home monitoring devices, biologically embedded devices, personal health records, clinical data integration from internal and external sources, and more fully engaged consumers will become the norm. Analytics and informatics capabilities are required (now) and will quickly evolve as ‘big data’ becomes pervasive in healthcare — with volume, velocity, and variety.

Our ability to protect data, manage data, and govern data definitions and ensure data quality will become increasingly mission-critical. Population management will thematically push us toward more fully understanding the true drivers of cost and quality. Personalized medicine will be increasingly available and integrated with provider-tethered and personally-owned EHRs. We may see new cost accounting and revenue cycle applications as payment reform starts to drive lasting change.

The rate of economic, political, legislative, cultural, and technological change — all operating on different planes and at varying speeds — will continue to challenge the pace at which we evolve. It is our mission to embrace, and invent, the future. It is our responsibility to keep looking ahead, keep innovating, keep creating new opportunities by leveraging current and emerging technologies, and to keep preparing our organizations, and our HIT industry, for the future of healthcare.