New study urges healthcare organizations to engage with emerging care delivery models

Released today at the 2011 HIMSS Annual Conference and Exhibition, a new study from HIMSS Analytics^tm, sponsored by NextGen Healthcare Information Systems, Inc., a wholly owned subsidiary of Quality Systems, Inc. (NASDAQ:QSII) stresses the urgency for healthcare organizations to engage with emerging care delivery models, starting with an interoperability strategy. A white paper analyzing the results, "Opportunities for Engagement and Transformation through Emerging Care Delivery Models," is available at NextGen Healthcare's HIMSS11 booth #2163.

Conducted through focus groups with representatives from ambulatory practices and hospitals, the study brings to light a diverse array of methods for data sharing across the continuum of care, with manual processes such as fax, encrypted email, web portals and encrypted patient devices still used often. Respondents face several challenges with these methods, however, including the significant work required to maintain and upgrade a variety of disparate systems for sharing with multiple organizations, as well as a lack of industry standards.

Health Information Exchanges (HIEs) were identified as a means to eliminate many of these issues and arm providers with a complete patient record, as HIEs provide a single platform for positive patient identification and data sharing between healthcare organizations in a local environment.

Participants felt that Patient-Centered Medical Home and Accountable Care Organizations, when done correctly, are vehicles that could result in better coordinated care and a reduction of costs. For these initiatives to be successful, healthcare organizations must be poised to share data through an HIE or other means.

In fact, several study participants are already involved in programs similar to PCMH, such as state Medicaid programs and regional data-sharing initiatives for hospital-employed physicians, while others are engaged in preliminary discussions about forming an ACO. Uncertainty around payment models, the political environment and providers' ability to truly work together in the best interest of the patient, however, raised questions about the long-term viability of these care models. Getting involved in the early development stages of an ACO was cited as critical to gaining a voice at the table to address these concerns.

"If you're a provider and haven't begun developing an interoperability plan, talking about PCMH or engaging in discussions on Accountable Care, the time to start is now," said Scott Decker, president of NextGen Healthcare. "The expertise and educational resources needed to help guide you through these emerging care models are out there. Providers should take advantage of the counsel available from their vendors, industry organizations and peers, and begin to make their voices heard in the development of these initiatives, as they will undoubtedly impact your business in the future."

NextGen Healthcare supports industry-leading Accountable Care Organizations, including the nation's premier ACO pilot, and more than 30 percent of the NCQA-certified Patient-Centered Medical Homes. Southeast Texas Medical Associates, for example, is a Level 3 PCMH and will be honored at HIMSS11 with a Healthcare Informatics Innovator Award for its transformative, patient-centered care.

"Regardless of what form the care-delivery models of tomorrow take, one thing is clear: the ability for providers across the continuum of care to collect and share a patient's data electronically and seamlessly will be a critical success factor. Today, health information exchange technology is in a very nascent stage, but we must nurture and encourage these pioneering efforts if we are to meet the cost and quality challenges facing the industry," said Marc Holland, Vice President of Market Research at HIMSS Analytics.

Key takeaways from the study:

Interoperability: Information sharing between healthcare organizations allows clinicians to have a comprehensive view of their patient's medical history. Organizations need to evaluate not only the technical components required for participating in HIEs and other data sharing agreements, but also understand the workflow and staffing changes required to take full advantage of them.

Patient-Centered Medical Home: Patient-centered medical homes are seen as forming the basis for an ACO. PCMHs allow for the coordination of patient care across the continuum of care and should be considered as part of a healthcare organization's care delivery strategy.

Accountable Care Organizations: Healthcare organizations need to begin conversations about participation in ACOs now. Delaying these discussions could result in a scenario where healthcare organizations are involved in an ACO without having a say in its development.