In 2011, the health care industry went through some interesting changes – from Meaningful Use attestations and delays to ICD-10 – but one of the less publicized milestones was one that may have a deeper and longer lasting effect on how we care for patients and that was the CMS final rule on the Medicare Shared Savings Program (MSSP). I believe that this rule, and the types of new provider risk-bearing models it encourages, will spawn a whole new generation of health information technology. A generation that focuses not just on patients currently seeing doctors and being admitted to hospitals and appearing on a census, but on a much broader spectrum of analytics, clinical transformation tools, wellness/prevention solutions and automated care management systems for comprehensive management of patient populations.
Let’s call this “The New Core,” vs. the basic EMR which will soon be the old core. It’s from these core tools focusing on managing the health of populations that the new age of care will be enabled. Think of more provider-led health plans, consumers who get much more engaged in their care. Think of health systems that follow their patients from different risk categories as they migrate through the health system from pre-hospital/ambulatory settings to inpatient to post-acute and on into the home. Payers will still have an important role as efficient intermediaries and as government-sponsored healthcare expands so will the need to outsource the capabilities to manage the new lives covered. Think of a whole new world for physicians and other more empowered caregivers who get paid to take care of patients the way they were trained instead of being handlers of “care transactions” as in the past.
