In our first post in this series, we discussed how many healthcare organizations are re-architecting their care delivery infrastructures as they adopt new, value-based payment and delivery models, such as accountable care.
Working with many different types of healthcare organizations in the U.S. and around the world, we have identified several key elements that make up a proven process for accountable care success: Acquisition of data, Aggregation of data, Access to data by all stakeholders in the patient's care, Adoption of the technology by users, Analytics to “zoom out” to the macro level population and Action to “zoom in”, create care plans and effect outcomes for individual patients.
On to the second step – aggregation. Each system contributing data to an ACO speaks its own language, per se. Each one has its particular quirks and characteristics regarding how it formats data, which can even be different in each version of the software. With data coming in from EHRs, labs, health plans and pharmacies, normalizing it all is a complex, but necessary challenge – having a big impact on both individual patient care and overall population health.
To support effective data aggregation, enterprise master patient (eMPI), master provider index and identity management systems are needed to ensure that the right data is associated with all the right entities (i.e. patient, provider, facility, payer, etc.). Other key elements that are essential for this part of the process include:
- Semantic interoperability technology – a way to translate clinical terminology from different systems into normalized codes, such that data can be meaningfully compared and trended against each other.
- A clinical data repository, which serves as the fundamental source of normalized, patient-centric data for access, analytics and action.
One health system that we have recently worked with set up a data exchange among its two dozen disparate EMRs and aggregated all of that data to enable its ACO – which was quite a challenge. Suffice to say, there was a lot going on with the doctors using different EMRs, and not all of them using the technology the same way. They needed to bring every piece of data together so they could facilitate the truly coordinated care they desired for their patients. While it's still a work in progress, the essential step of aggregating the necessary data from the correct entities is taking place.
With this aggregated data, we move on to step three, making sure all stakeholders involved in the patient's care have access to the data in a meaningful and convenient way.