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November 24, 2014

The Role of HIE in Building and Realizing the Potential of ACOs Discussed at Massachusetts Health Data Consortium Meeting

The Massachusetts Health Data Consortium hosted a symposium last month on the effective use of technology in the development of risk bearing organizations, or accountable care organizations (ACOs). The main speaker was John Tempesco, chief marketing officer at ICA, a health information exchange company based in Nashville, TN. ICA’s initial technology was developed at Vanderbilt University Medical Center.

The theme of Mr. Tempesco’s presentation was that, while numerous forms of organizational structures have attempted to create value from health data exchange, including Community Health Information Organizations and Regional Health Information Organizations, ACOs may in fact be the model that will finally cause the financial need for clinical data exchange that has eluded healthcare delivery for decades. The key to its success, however, will be patient centered HIE technology that enables true communication at critical hand offs, collaboration across the continuum of care and analytics to determine best practices to reduce costs while improving quality.

Mr. Tempesco asserts that healthcare has been decisively moving away from a transaction-based care model based on activity, to a value-based care model based on outcomes. This transformation shows an increasing recognition of quality as one of the key criteria of healthcare and represents a fundamental shift in values. The transition has been occurring over decades, but has gained momentum in the past few years as advances in technology increasingly enable the standard exchange of clinical data. Secure, standards-based data exchange will ensure the care coordination often lacking in most healthcare facilities. Shifting the payment paradigm to a provider-centric risk assumption model may ironically result in “empty hospital beds” being the key to enhanced revenue for these organizations.

This quality-driven care model requires a broad and expanded computational capability that works across all care settings and is able to deliver patient information to these multiple settings at the point-of-care in a way that changes practice patterns. One of the key differences in the current approach to health information technology is that prior attempts had stopped at “automating”, leaving the “exchange” and distribution of the clinical information out of the picture. Other industries have led the way in not only automating, but coordinating information in order to make their business models more efficient and improve quality. Healthcare is now in the process of both automating and then using the resultant information to rapidly improve efficiency, effectiveness and quality for care.

“The missing link to care coordination through automation has been a combination of both data portability and patient centric approaches to exchanging information in the healthcare sector,” said Mr. Tempesco. “HIE provides the portability of patient records and the ability to put the patient at the center of the healthcare process. Patient portability enables patient information to be transferred securely; patient centricity requires that available patient data is aggregated and accessible in real-time and that providers can collaborate on a patient’s course of treatment. The patient centric approach is the ultimate goal of HIE because it is the only solution that offers comprehensive care coordination for patients.”

“Mr. Tempesco gave an engaging talk to one of the largest audiences we have had at a forum of this kind. His personable approach brought the key concepts of HIE back to a human level through anecdote and example and provided a lively and down-to-earth presentation that the audience responded to very well,” said Craig Schneider, Director of Healthcare Policy at the Massachusetts Health Data Consortium.

ICA has numerous clients across the United States where this complete coordination is occurring, including Vanguard Health System’s three hospitals in Massachusetts: MetroWest Medical Center in Natick and Framingham and Saint Vincent Hospital in Worcester. Other key clients include the Kansas Health Information Network which covers most of the state of Kansas and parts of Missouri, and MidSouth eHealth Alliance and Middle Tennessee eHealth Connect which cover the major metropolitan areas of Memphis and Nashville, TN, respectively.