Population health tools essential to ACO success

Applications for population health management that integrate claims and clinical data can provide the insights essential to the success of accountable care organizations (ACOs), according a new report from IDC Health Insights.

Many healthcare organizations have found that relying on electronic health records systems isn't enough. In addition to pooling claims and clinical data at the point of care to improve decision-making, ACOs need workflow tools to support the creation and management of care plans and a communications channel to fully engage patients in their care.

These other applications might include:

  • Computerized physician order entry
  • Admission, discharge and transfer
  • Billing
  • Practice Management
  • Enrollment
  • Care management

Health information exchange technology is required to integrate heterogeneous data from disparate systems such as EHRs, claims, laboratory and pharmacy and present that data in a standardized way in various applications, the report says.

Key applications for population management include:

  • Analytics for performance measurement, patient identification and stratification.
  • Workflow applications that include the ability to create and manage care plans, track events and scheduling.
  • Patient engagement tools. In the future, these efforts likely will include more than a portal, including other channels such as texting to engage patients.

It urges organizations to spend time to understand their data before making changes based on performance measures and to focus on only a few quality metrics to start.

The importance of change management can't be underestimated, it advises, urging organizations to educate physicians and staff about the importance of proper documentation, for example.

"Meeting the objectives of the Triple Aim requires organizational transformation in addition to new technology. Healthcare organizations engaging in accountable care must acquire new skills, introduce new processes, and fundamentally change the way they deliver care,"  the report concludes. "Critical to meeting accountable care objectives are the workflow tools to create communication and engagement strategies and that provide collaboration among providers, care managers, and patients."

At the start of this year, 123 more ACOs have joined the Medicare Share Savings Program to better coordinate care for an additional 1.5 million Medicare beneficiaries. That brings the total to 360 ACOs involved.

The number of ACOs is expected to double this year from the estimated 500 currently in operation.

To learn more:
- find the report