Prepping for Accountable Care

Not just any electronic health record will do for health care providers participating in an accountable care organization, a new consultant's report says.

"Financing an accountable care delivery system requires expanding payment for activities beyond fees for the services rendered for a discrete episode to include compensation for the effort and the value delivered from collaboration, coordination and integration across the continuum of settings and provider," according to "Preparing for Accountable Care: The Role of Health IT in Building Capability." CSC, a technology consulting firm, prepared the report.

To support accountable care, CSC says, EHRs must enable or allow:

• Clinical information and point-of-care automation, with integrated ambulatory and inpatient records and a central repository for clinical data.
• Enterprise master data management and integration, with a population management repository, a master person index and a master provider index.
• Tools to enable participation in a health information exchange.
• Patient engagement tools, including secure messaging, e-visits and tele-visits, social media, patient portals and mobile health applications.
• Care management and coordination tools, including referral and request tracking, provider-to-provider communication, medication reconciliation and case- and disease-management applications.
• Performance management tools, including integrated business and clinical intelligence and analytics.

Organizations delivering accountable care "must be able to manage, monitor and report on the efficacy of their accountable practices, demonstrating that quality and safety goals are met at the patient and population level, and that cost management and financial targets are achieved," says the report, which was written by Jordan Battani, a principal researcher in CSC's Global Institute for Emerging Healthcare Practices.

The report highlights four EHR starter points:

• Member and patient demographics and identifiers.
• Provider demographics and identifiers.
• Clinical codes (for services, settings and diagnoses).
• Administrative and financial information; especially coverage, benefits and eligibility.

"Information exchange strategies, information management strategies, and interoperability standards are doomed to failure if they are not supported by rigorous, disciplined data management and integration strategies that ensure that the right patient, the right provider, the right demographic, financial and health coverage information are invoked at each step in the care delivery, recordkeeping and reporting process," the report concludes.