Even groups of providers without an electronic health record system could access enough clinical data to function as accountable care organizations, according to a report cowritten by Elliot Fisher, MD, who coined the term ACO, in the Journal of the American Medical Association.
For example, groups without EHRs can initially start with claims data from payors, wrote Dr. Fischer, director of the Dartmouth Institute for Health Policy and Clinical Practice, and Stephen Shortell, PhD, dean of the School of Public Health at the University of California at Berkeley.
The authors envision three levels of electronic sophistication for ACOs, graduating to a wider set of capabilities:
Level 1: No EHR or well-established patient registries. This group could at first rely on measures gleaned from claims data, such as cancer screening, and then progress to health outcomes, such as blood-pressure control, patient-reported care experiences and total costs of care.
Level 2: Site-specific EHRs and registries. This group could add advanced measures, such as patient-reported outcomes.
Level 3: EHRs across all sites of care. This group could measure informed patient choice and outcomes for a wide group of conditions.
The authors also suggest creating a common framework to evaluate the range of delivery and payment reform initiatives in the healthcare reform law to determine which ACO characteristics are critical to success.
Read the JAMA report on accountable care organizations.
Read more coverage on accountable care organizations:
- 10 Recommendations on ACO Regulations From Premier's Collaborative
- Accrediting Body Issues Proposed Standards for ACOs, Asks for Comment
- 5 Key Questions on How ACOs Will Function: From Robert Betka at Catalyst Management Advisors
For example, groups without EHRs can initially start with claims data from payors, wrote Dr. Fischer, director of the Dartmouth Institute for Health Policy and Clinical Practice, and Stephen Shortell, PhD, dean of the School of Public Health at the University of California at Berkeley.
The authors envision three levels of electronic sophistication for ACOs, graduating to a wider set of capabilities:
Level 1: No EHR or well-established patient registries. This group could at first rely on measures gleaned from claims data, such as cancer screening, and then progress to health outcomes, such as blood-pressure control, patient-reported care experiences and total costs of care.
Level 2: Site-specific EHRs and registries. This group could add advanced measures, such as patient-reported outcomes.
Level 3: EHRs across all sites of care. This group could measure informed patient choice and outcomes for a wide group of conditions.
The authors also suggest creating a common framework to evaluate the range of delivery and payment reform initiatives in the healthcare reform law to determine which ACO characteristics are critical to success.
Read the JAMA report on accountable care organizations.
Read more coverage on accountable care organizations:
- 10 Recommendations on ACO Regulations From Premier's Collaborative
- Accrediting Body Issues Proposed Standards for ACOs, Asks for Comment
- 5 Key Questions on How ACOs Will Function: From Robert Betka at Catalyst Management Advisors