Healthcare Technology Has a Long Way to Go Before We Can Begin Serious Conversations About ACOs

Dr. Akram Boutros

Healthcare reform was ignited by ARRA, which became the catalyst for much of the changes currently taking place in the health IT landscape, and though meaningful use is profoundly changing the way data is collected, according to some we’re a very long way away from actually being able to do something specific and positive with it.

Everyone in the healthcare community is focusing on regulation and meeting the mandates of the reform, from a healthcare technology perspective. Things get a little lopsided when the discussion turns to how the information gathered in meaningful use relates to clinical outcomes.

According to Dr. Akram Boutrous, who leads the consultancy BusinessFirst Healthcare Solutions, right now there is simply no way of collecting all of the data available in the healthcare community on a global level.

As far as he and others are concerned, under the current healthcare reform model there’s too much attention being placed on healthcare technology, including electronic health records, when there is still a mighty void between the tools used to gather the data and the tools (which don’t yet exist, he says) used to analyze the data.

“There are still many tools required to predict what is most likely going to happen in a given scenario and the best course of action to take,” Boutrous said.

He describes the current health IT landscape like an iPad without apps to use on it. “You can look at it, but you can’t do anything with it.”

This means we’re back where we have always been – in a land of silos where the information they contain stays contained without any real chance of it going anywhere to do any good.

Without interoperable systems that can communicate on a much larger scale, there’s certainly no room for even discussing the advancement of the ACO concept. “I’m pessimistic that ACOs as defined [in health IT] will provide meaningful change in healthcare,” he said.

The catalyst for change, he thinks, is the payer community and non-government organizations. Even though the federal government set the foundation for health reform, it won’t be able to maintain a successful program, and innovation will fall by the wayside.

“The non-government side of the world has taken the bull by the horns and made some very innovative advancements,” he said, while the public sector sought clarification of the reform mandates through court and legislative actions.

Until better tools can be implemented and adopted, and a culture change embraced, we’re simply not going to see models like ACOs develop according to the timeline many industry “experts” claim.

Until there are actual tools that provide meaningful support to the community and allow for some sort of global analyzing of specific populations and data sets in real time, healthcare will remain a production-based market where accountable care remains nothing more than an idea.

The market needs more than static components and databases, and health IT needs to evolve and incorporate more capabilities to that make possible, and engage in information exchange before we can begin to move to an accountable care model.


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