Using health information technology to manage a patient population in accountable care organizations.
Purpose - The purpose of this paper is to describe the current landscape of health information technology (HIT) in early accountable care organizations (ACOs), the different strategies ACOs are using to develop HIT-based capabilities, and how ACOs are using these capabilities within their care management processes to advance health outcomes for their patient population. Design/methodology/approach - Mixed methods study pairing data from a cross-sectional National Survey of ACOs with in-depth, semi-structured interviews with leaders from 11 ACOs (both completed in 2013). Findings - Early ACOs vary widely in their electronic health record, data integration, and analytic capabilities. The most common HIT capability was drug-drug and drug-allergy interaction checks, with 53.2 percent of respondents reporting that the ACO possessed the capability to a high degree. Outpatient and inpatient data integration was the least common HIT capability (8.1 percent). In the interviews, ACO leaders commented on different HIT development strategies to gain a more comprehensive picture of patient needs and service utilization. ACOs realize the necessity for robust data analytics, and are exploring a variety of approaches to achieve it. Research limitations/implications - Data are self-reported. The qualitative portion was based on interviews with 11 ACOs, limiting generalizability to the universe of ACOs but allowing for a range of responses. Practical implications - ACOs are challenged with the development of sophisticated HIT infrastructure. They may benefit from targeted assistance and incentives to implement health information exchanges with other providers to promote more coordinated care management for their patient population. Originality/value - Using new empirical data, this study increases understanding of the extent of ACOs' current and developing HIT capabilities to support ongoing care management.
Center for Innovation to Implementation (Ci2i), VA Palo Alto Health Care System, Center for Primary Care and Outcomes Research, Stanford University School of Medicine, Menlo Park, California, USA.
Frances M
FM
Wu
School of Public Health, University of California, Berkeley, Berkeley, California, USA.
Thomas G
TG
Rundall
Center for Healthcare Organizational and Innovation Research (CHOIR), School of Public Health, University of California Berkeley, Berkeley, California, USA.
Stephen M
SM
Shortell
School of Public Health, University of California, Berkeley, Berkeley, California, USA.
Joan R
JR
Bloom
D060866:Accountable Care Organizations; D003430:Cross-Sectional Studies; D057286:Electronic Health Records; D007407:Interviews as Topic; D008490:Medical Informatics; D010346:Patient Care Management; D036301:Qualitative Research; D014481:United States
Accountable care; Delivery of healthcare; Health information technology; Healthcare reform; Medicare