Posted by: RedaChouffani
Accountable care organizations, ACO, Health information exchange, HIE, Interoperability and health information exchange
When discussing the subject of Accountable Care Organizations (ACOs), the exchange of health information is most often assumed to be a must have component for the model. Rightfully so, since the intent of an ACO is the coordination of accountable care to reduce costs and improve population health.
But when looking at the infrastructure required to accomplish truly coordinated care, we often find that an HIE platform is a must have in order to succeed.
Clearly most ACO members would need to have an electronic medical record (EMR) system in order to efficiently and electronically communicate and review patients’ health data.It is also part of the ACO requirements to have a certified EHR for CMS.
While the current certification criteria does include some of the components required for the coordination of care (i.e., electronic lab results, exchange of health record, and PHRs), it is still far from being complete without an existence of an HIE, which would facilitate the exchange of the information amongst physician groups and hospital systems. This is especially important when patients seek certain treatments outside of their community, which requires the health data to move in and out beyond the community system boundaries.
Clearly this presents a challenge for ACOs that may form in states where HIE is still new, possibly in the infancy stages.
While having an HIE is ideal, it is not a must have.If the organization has the capital to implement its own private HIE to support its members in exchanging and collaborating on care, and the physician groups are using a certified EHR that has the ability to communicate with an HIE (state, national, or private) then information can flow in and out of these systems without having to wait on a community or state wide initiative.