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Making accountable care organizations work

Since health care reform passed, accountable care organizations, or ACOs — loosely defined as collaborations among numerous institutions, including primary care, ambulatory, inpatient and post-acute care — have garnered attention as a means of improving care coordination. Such a process, it is argued, will reduce the burden of unnecessary and/or duplicate medical tests and appointments, which in turn will reduce the overall cost of care.

Health information exchange (HIE) technology vendor Medicity Inc. supports the accountable care organization model, noting that it shifts the risk from payers and patients to providers while giving those providers a more complete picture of their larger patient populations.

However, there is some concern that physicians may lose their independence in the ACO model, since their affiliations would be limited to the facilities within the organization itself.

Then there’s the matter of incorporating ACO processes into EHR systems. Consultant Paul Roemer cautions organizations against rushing into this. To quickly summarize his point, when inefficient paper workflows become inefficient EHR workflows, they inevitably drag down the ACO’s effectiveness as well.

Preventing this, Roemer says, requires asking what one really needs from an accountable care organization, which “allows you to change the organization and develop systems to support the organization,” he says.

Even then, success remains elusive, he surmises. “[It] requires you to strip functionality away from the organization to make ACO fit. This approach may make it fit, but it will not make it work.”

The better answer, then, may be a sort of virtual accountable care organization — as consultant Charles Hewitt, or “CIO67” in this post on the Health IT Exchange, puts it, a bidirectional HIE that is secure and efficient enough to foment trust among all ACO members. It’s a tall task, but it’s also not very far removed from the federal government’s (admittedly and equally difficult) health information exchange efforts.

As such, improved care coordination may not be a pipe dream after all.

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Making accountable care organizations work https://bit.ly/fzg36J #ACO #HCR #healthreform #healthIT
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