The proposed government regulations on accountable care organizations create a host of new opportunities and challenges for health IT vendors and professionals.
First and foremost, health IT will be a "core competency" of ACOs, according to Dr. Donald Berwick, Administrator of the Centers for Medicare and Medicaid Services (CMS), writing in the New England Journal of Medicine. That means that every healthcare system or physician group that sets out to form an ACO will need to have a high-functioning electronic health record as well as the ability to exchange information online with other providers.
Second, care coordination will be another core function of ACOs, as the CMS fact sheet and a consensus report by the leaders of the ACO and medical home movements point out. Manual care coordination of care at this level is too cumbersome, difficult and expensive for ACOs to undertake. So a variety of health IT tools -- including registries, care management software, and automated outreach applications -- will be required to coordinate care effectively.
Third, the Medicare shared savings program will require 50 percent of primary care doctors participating in ACOs to be meaningful users of EHRs. Since that program starts in 2012, this means that would-be ACO participants will have to meet the stage 1 criteria for meaningful use in the near future.
And fourth, the shared savings program requires ACOs to report a wide range of quality data. According to Brian Ahler, a health IT executive at Mid-Columbia Medical Center in the Dalles, Ore., the government will update the online reporting tool that some providers use to supply data for the Physician Quality Reporting Initiative (PQRI) so that ACOs can use it, as well.
The regulations have other implications for health IT. For example, data privacy and security will have to be beefed up as health information exchange becomes commonplace. Also, vendors will undoubtedly focus more on post-acute care as ACOs move to improve coordination across the spectrum of care.
To learn more:
Accountable care organizations: Draft rules and guidance released by CMS, IRS, OIG, FTC
Accountable care will require fierce communications strategies
Consensus report uniting ACOs and medical homes has health IT implications