The Key to a Successful ACO: Access to Information

An accountable care organization (ACO) is the ultimate balancing act of fiscal responsibility and patient care. According to an announcement on July 9^th by the Center for Medicaid and Medicare, 89 more organizations have taken up the challenge of striking that balance.

But to accomplish this goal, participating organizations need to be able to quickly share clinical and administrative information to other members of the ACO. Otherwise they risk over-utilizing services and creating financial challenges.

By deploying an enterprise content management (ECM) solution in participating organizations, ACOs can have that free-flow of information they need to continue supplying high quality care in a fiscally responsible way.

ECM takes all of your organization’s content, from paper to clinical images to the patient chart, and stores it all in a single, central database. It also integrates with your existing HIT investments to pull and share information between them. This means information is instantly retrievable from any of those applications – making the lives of clinicians and staff much easier by creating a continuity of information across the organization.

But ECM does much more than just capture and retrieval. It also automates the movement of that content to direct it to the right people at the right time, removing redundant tasks like forwarding information. This isn’t confined within the walls of a single organization either, as information and content can be shared between hospitals and other healthcare organizations, making it perfect for keeping information flowing within ACOs. Sharp Healthcare certainly thought so.

Sharp Community Medical Group, Sharp Rees-Stealy Medical Centers and a selected group of Anthem Blue Cross of California PPO members are participating in a commercial ACO pilot in the San Diego area. The goal is for providers to deliver better coordinated care to their patients, with a focus on prevention and chronic care management. The healthcare organizations are currently working through medical management processes, which include physicians receiving authorization for referrals for their PPO member patients from Anthem. Once the solution is in place, Sharp will need to easily exchange case, disease and utilization management information and images with Anthem, explained Cathy Fuhrman, manager of information systems at Sharp HealthCare. The ECM system will take images incoming to Sharp and make them available in the member’s chart through an e-business application.

This allows all of the clinical and administrative patient information to be accessible to all participants in the ACO, eliminating the opportunity for utilization of services.

“If we don’t know that this person has chronic diseases or we don’t have all the images together for that person, we’re not going to meet our financial and clinical goals,” Fuhrman said. “If the patient is managed appropriately, we can get the patient to the right provider.”

That statement describes perfectly the importance of accessibility of participating organization’s content to an ACO’s success.  And ECM is the critical application that makes that exchange of information possible.