Joining an accountable care organization (ACO) has its benefits and its risks — financial and otherwise. Part of the challenge: Partnering with other healthcare organizations in the delivery of cost- and-value-conscious patient care requires the sharing of data. What should you do if you don’t share the same EHR with other providers in your ACO?
According to Derek Kosiorek, principal consultant with the Medical Group Management Association’s Healthcare Consulting Group, there are three questions a practice should ask if they’re either looking into joining an ACO or are already involved in an ACO but they’re not on same EHR as the other providers:
What are your internal technical resources to work on interoperability?
As part of their own due diligence, physician practices should consider what type of resources they have to integrate their data systems into a format that can be understood by other organizations involved in the ACO, said Kosiorek.
The fact is, many small and medium-sized physician practices don’t have access to a lot of in-house technical resources to help with interoperability between EHRs, he said.
Interoperability success often comes down to whether the practice has the internal resources to devote to creating and maintaining interfaces between the practice’s EHR and the systems used by other organizations involved in the ACO. “Smaller practices typically don’t have the resources or the technical coding experience to write interfaces themselves. And that can be a deal breaker,” he said.
How much can you lean on the hospital or other larger healthcare entities in terms of interoperability?
Creating and maintaining interfaces between EHRs isn’t for the faint of heart, according to Kosiorek. Physician practices looking into an ACO arrangement with larger healthcare entities should look to larger organizations “take the lead” on mapping out the right approach to interoperability.
Typically, the larger healthcare entities will have a list of preferred systems that work with their EHR, he said.
Should you consider switching your EHR as a result of your ACO involvement?
Kosiorek said practices should really work through how happy they are with their current EHR and consider whether switching to one that’s more compatible with other EHRs in the ACO is a viable option.
Part of that discussion involves determining the quality of the data that’s currently stored in the practice’s EHR —and whether or not that data will transfer.
He pointed specifically to how practices handle receipt of lab data from other providers within the ACO. If physicians are storing lab data simply as text information within the patient’s record, there’s no discrete data format that can later be pulled out and analyzed, Kosiorek said. “That’s useless to the [ACO]. If they can’t pull the information and the quality of the information is questionable, it’s very likely the practice will need to change its EHR.”
What really matters, he said, is what it’s going to take to get the practice from where it is today to the “magic place where [you’re] just transferring data without having to do anything.”