The rise of various accountable or collaborative care models across the country is already driving new demand for the right technologies to support them. These technologies are especially critical for those aiming to achieve Sustainable Health Communities, where all parties are connected, intelligent and aligned. While hospitals and health networks are already familiar with electronic medical records (EMRs) and health information exchanges (HIEs), they will need to become comfortable with a group of new solutions — some that the payer community has relied on for years and others that will put the data from EMRs and HIEs to the test.
- Population Analytics — Just when hospitals have gotten really good at managing their own patient data, very soon that won’t be enough. They’re going to need technology that evaluates the holistic and ongoing health of a local patient population over time. These systems stratify the population, offer actuarial capabilities to assess risk, and uncover clinical care patterns and disease trends (genetic, environmental or racial). Most importantly, these systems identify incidence of latent diseases like congestive heart failure or diabetes that account for the majority of provider costs. Once the patient population and disease outliers have been well-defined, hospitals are better able to predict costs, budget appropriately, determine capacity/facility needs and offer the services that make the most sense for each area.
- Clinical Transformation — Once the population data is stratified by lines of service, identifying the high priority patients, it’s now necessary to implement new care protocols to help clinicians improve care in under-performing areas, and use performance monitoring and feedback tools to ensure the caregivers are aligning to best practices. These protocols are distributed back through the hospital’s EMR and the caregiver performance analytics sit on top. It’s important that clinicians participate in determining how these tools are used, but it’s also critical that the care improvements align to improvements that meet the Triple Aim goal balancing cost, quality and patient experience.
- Care Management — In any successful collaborative care model, patients need to uphold their end of the bargain and take an active role in their care. And because physicians, hospitals and health systems will be reimbursed based on outcomes, they will have to invest in tools that will improve patient communication and proactively help patients stay healthy. For example, nurses and care managers need to know when to place follow-up calls to make sure patients are following discharge instructions and properly adhering to treatments. They need the tools to best track ongoing patient progress and build in the necessary follow-up visits and check-ups.
As a layer on top of an EMR or HIE, a new breed of “accountable care information management systems” is already starting to emerge. Hospitals and health networks can take cues from the payer market when it comes to many of these technologies, but they will need to customize and adapt them to be provider-friendly and serve as the backbone of any collaborative care model.