Electronic Health Records

Adoption & Implementation News

What health IT is necessary to support accountable care?

By Kyle Murphy, PhD

The development and use of a health IT framework for accountable care organizations (ACOs) will help minimize risks associated with forming these risk-based partnerships between healthcare organizations, providers, and payers, according to Certification Commission for Health Information Technology (CCHIT).

“The promise of accountable care is tempered by these concerns and by a lack of experience and knowledge about the HIT infrastructure necessary to optimally support health care transformation,” write the authors of the CCHIT ACO HIT Framework. “While there are more than 400 provider organizations now operating as ACOs, debate continues as to whether they will be successful in meeting their goals as well as the expectations of policy makers who have supported their development.”

As part of its framework, CCHIT has identified the primary health IT requirements for supporting accountable care:

Information sharing: Without the ability to exchange health information efficiently and securely between members of the care team as well as patients and patient representatives, care coordination cannot take place. As result, addressing the first of the four health IT requirements begins with evaluating how information will be exchange:

Evaluate how your organization engages in the sharing of health information, with whom and how. Take into account the degree to which local, regional, or statewide Health Information Exchange (HIE) can be accessed, any data repositories or registries that may store useful data, interfaces between disparate systems, and use of portals. If no HIT roadmap has been established to realize health information exchange among your providers and with patients, developing such a roadmap should be a high priority and may require the cooperation of others.

Data collection, aggregation: Accountable care is about providing healthcare services for a specific patient population. This is made possible through the organization of patient data and its synthesis with other data sources from members of the ACO. Assessing how that data is collected and aggregated is a crucial step:

A high priority is the establishment of a data warehouse that can accept, store, normalize, and integrate data from multiple clinical, operational, financial and patient derived systems. All of the key processes and many of the functions and HIT capabilities listed are dependent on the existence of such a data repository. How your organization performs with respect to its goals will be dependent on a timeline that outlines what data will be incorporated and when. Consider external sources as well, such as your state’s all payer claims database, an HIE’s notification-of-encounter service, or a quality reporting organization collecting and transporting data on behalf of your ACO.

Patient safety monitoring: The adoption and use of health IT systems by healthcare organizations are providers are key to supporting accountable, but they also present threats to patient safety if improperly implemented or misused. All health IT needs to be scrutinized for how it may affect an care team’s overall patient safety program.

Privacy, security protections: HIPAA requires covered entities to assess safeguards responsible for keeping a patient’s protected health information safe from authorized access or abuse. Similar to patient safety, the risks posed to privacy and security by health IT systems must be on regular review.

Read the complete ACO HIT Framework.




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