Tag: ACOs

Nov 30
2012

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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Aug 8
2012

Patient Engagement Requires More than Speaking Their Language

Patient engagement will continue to become more popular as consumers take greater ownership of their care and begin to discover that their health information should actually be easier to access because of electronic health records and patient portals. However, patients must have reason to engage for this trend to become less of a trickle and more of a flood.

Healthcare technology is meant to allow more access to, and increase the availability of, patient’s health information. At least that’s one of the desired outcomes of the push (meaningful use and federal incentives) to lure physicians to adapt the systems.

Sterling Lanier, CEO of Tonic Health, succinctly sums up lack of patient engagement in a recent editorial published by For the Record magazine.

In it, he states that healthcare, like government, is filled with vernacular and jargon – HIEs, EHRs, ACOs, HIT, et al. – and the more these terms continue to be used, the less likely patient consumers are going to interact and engage with the healthcare community, and to take ownership of their own care outcomes.

As Lanier notes, and as I have often thought, to bring patients into the conversation, they have to be treated like consumers and they must have a reason to “buy” into the system. In this case, consumers must “buy” the information given to them. If they buy and own it, they’ll want more of it, or so goes the prevailing thought.

But simply speaking in terms the natives will understand isn’t enough. Consumers need to better understand how the technology they encounter at the doctor’s office helps produce better care outcomes. They may need some education and certainly they need some engagement once the systems are in place and being used during the visit.

Though patients will interact with the EHR less frequently than other technology they encounter, such as the patient portal (which they can actually use and interact with on their own), that doesn’t mean the EHR should be ignored during the interaction or treated as a foreign concept. In most cases, let’s remember, healthcare is actually behind many other consumer markets so consumers are actually more versed in the use and capabilities of similar systems outside their doctor’s office. Besides, we’re like children with devices and must test drive things like smart phones, televisions and computers as we learn to use them; we like to get our hands on the technology to try it out to satisfy our child-like need to see with our hands.

Even though patients can’t “touch” their EHRs, we can watch the information we provide our doctors being entered into the system; we can speak with our caregivers as they toggle and tab; and we can engage clinicians as they review our profiles and medical records. As a patient of a doctor with an EHR, I ask questions about the system: what it does, who makes it, why it was chosen and if it layout closely resembles the clinics’ past paper charts. I feel better about the little details and doing so makes me feel as though my doctor is listening to me during the visit.

Asking me these questions engages me more in my healthcare, and more than likely, engages my doctor in my care and outcomes.

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