IT Infrastructure: A Foundation For Accountable Care Organizations

The advent of healthcare reform will require a health information technology infrastructure that integrates all the "moving parts" of an ACO, including hospitals, physicians, labs, outpatient centers, claims and analytics.

In this emerging environment, the need for accessing information and exchanging data is critical to ongoing operations and cost-efficient performance.

The alignment of primary care physicians with specialists, hospitals, health plans and other industry stakeholders, however, poses many challenges to the entire industry. Federally enacted legislation considers an ACO to be a coordinated group of providers – teams of physicians, hospitals and others healthcare suppliers – that agree to manage the quality, cost and overall care of an assigned population of beneficiaries. In fact, the "Shared Savings Program" of the Patient Protection and Affordable Care Act – one of the measures adopted in the new legislation – includes a number of reforms designed to reward these ACOs that lower growth in healthcare costs while meeting quality care standards that put patients first.

If the ACO network can work together to coordinate the delivery of services in medical environments, such as hospitals, doctors' offices or long-term rehabilitation facilities, then the "Shared Savings Program" would reward the providers with reserves from the lowered costs – only if they meet standards of care in five key areas:

• Patient/caregiver care experience
• Care coordination
• Patient safety
• Preventative health
• At-risk population/frail elderly health

An information technology infrastructure that coordinates and embeds electronic safety checks, clinical analytics and data exchange into the patient experience is another key component necessary for ACOs to thrive. Over time, ACOs will need to expand this framework to include an arsenal of ongoing pervasive connectivity, data analytics and predictive modeling that keep (cost of) care down and quality up.