We're looking at an idea of having a care navigator that is an extension of the office practice to really be an adjunct to help the patient when something happens that we know could use some additional coordination because in this population that's really the challenge for us. Now we're trying to figure out how we can get involved with the information even before the claim hits."
Monarch CEO Bart Asner, MD, adds, "It's been an enormous amount of work to figure out who the patients are, get information and data on these patients, and figure out ways that will make the information flow smoothly through the system going forward."
In the ACO model, a variety of organizations must find ways to share information—that can be a challenge, says James Canedy, MD, a board member at the Nebraska Medical Center in Omaha, NE, which has partnered with the Methodist Health System to create an accountable care alliance. "We have a lot of different groups coming together: two health systems, an academic practice plan, independent physicians and health system employed population. And it's not hard to believe that they're all on different systems. So we are fortunate we have the Nebraska Health Information Exchange so we can pull data from any health system in the state. Most hospitals are enrolled in this, so we have access to data … but then how do you match that data with the other system data? So there are processes in place but it's a tough expensive, expensive model."
Getting the most out of an organization's information technology backbone is one of the crucial differences between now and previous efforts to manage population health, says Skea.
"Information technology and the willingness to share information among disparate groups will help to integrate care as well as support the ability to measure success and reach consensus on quality goals and metrics," he adds. "Early adopters are well on their way to positioning their organizations for an era of ACOs."
The Bridge to Accountable Care Organizations and other HealthLeaders Media Breakthroughs reports are available online.