A new consensus report on how to reform the healthcare delivery system has some important implications for health IT. The report, entitled Better to Best: Value Driving Elements of the Patient Centered Medical Home and Accountable Care Organizations, represents a convergence of these two powerful movements in support of joint action to lower the cost and raise the quality of healthcare.
Cosponsored by the Commonwealth Fund, the Dartmouth Institute for Health Policy and Clinical Practice, and the Patient-Centered Primary Care Collaborative, the consensus report -- which grew out of a Sept. 8, 2010 conference of healthcare stakeholders -- includes a section devoted to health IT.
Today's health IT "was developed to support a traditional fee-for-service, visit-based reimbursement model, with the focus on documentation requirements to support a billing function," according to David Nace, MD, a McKesson executive quoted in the report. In his view, vendors will have to create new types of IT that go beyond the visit-based delivery model and support population health management.
"Health IT requires new functional capabilities, such as multiple team member access and permissions, care management workflow support, integrated personal health records, registry functionalities, clinical decision support, measurement of quality and efficiency, and robust reporting. An interconnected health IT network with key capabilities that optimize engagement, coordinate care and support the implementation of value-based payments is required to support PCMH (practice) and ACO (enterprise) practice transformation."
The report recommends the creation of new meaningful use criteria to accelerate this transformation, along with payment reform to ensure that providers adopt and use the technology. Specifically, Nace said, the current requirements do not address "the core principle of comprehensive, team-based and collaborative care among staff within a practice," which is a key goal of the patient-centered medical home.
The report also suggests that upcoming Medicare demonstrations of ACOs and medical homes closely examine the impact of health IT on these types of organizations. Finally, it encourages the organizations that accredit or recognize ACOs and medical homes to align their criteria with those of meaningful use-something that several primary care societies recently called for, as well.
To learn more:
--Read the consensus report
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