Perficient Healtchare Solutions Blog


Archive for March, 2011

Protecting Patient Data in an Interconnected Healthcare System

I will respect the privacy of my patients, for their problems are not disclosed to me that the world may know.  (Hippocratic Oath)

I recently read an article titled, “Protect Patient Data from an Inside Job” by Phil Neray of Health Management Technology, which stated, as many news organizations have, that in 2010 healthcare organizations were a  top target of data breaches.  All totaled, 214 healthcare organizations were breached in 2010 with a total of 6.3 million patients impacted by those security breaches. 

Open to the public 24/7, and being the keeper of the most private of all data, healthcare organizations are unlike any other in terms of security challenges.  No one questions the importance of privacy in the practice of medicine.  A doctor cannot expect a patient to openly disclose private information if that patient fears that they may be harmed by that disclosure.  Any information withheld out of fear can have a dramatic impact on the care received.

The Importance of Shared Data in Healthcare

Of course, by its very nature, providing the highest level of care requires sharing confidential information with colleagues.  You know the story if you have ever been a patient.  You may enter the healthcare system through the emergency room, go to the laboratory for testing, then off to radiology for an X-ray.  You then meet with a doctor and get a diagnosis.  The doctor then provides treatment where you may be sent to the operating room for surgery and then released to a rehabilitative services center or referred to your primary care physician for post treatment.   This data can be provided by electronic submission  to support research that can create innovations to further the quality of care.   The medical profession consists of multiple silos of specialized functions necessary to treat you as a patient.  Each department has its own procedures, specialized record keeping, best practices and scheduling. Improving patient care, and providing more efficient care, is the impetus behind the movement towards electronic health records (EHR) and Health Information Exchange (HIE) in the first place. EHR and HIE systems make it possible to rapidly transmit this data to make optimal care in the digital age a reality.   

Protecting Patients in the Modern Age

The issue is that since HIE systems essentially centralize data into data warehouse structures, fending off data breaches can become an even larger issue in the future.  As such, it is important that we effectively balance the importance of sharing patient information with the seemingly opposite, but vitally important, concept of keeping patient data private.   In his article, Neray recommends that the healthcare industry use the financial services industry, that dealt with data security issues under Sarbanes-Oxley and have been enjoying a decline in data breaches, as a model.  Data breaches have declined in the financial sector because financial companies have moved beyond perimeter security and no longer use a firewall as a standalone solution.  A frank discussion with any security administrator in financial services, I’ve enjoyed a few, will inform you that security breaches are most often an inside job.  These companies are actively monitoring sensitive information stored in databases.  Events are created to alert a security team about every small detail in order to prevent unauthorized access by prying eyes both inside and outside of the organization. 

I think that financial services does provide healthcare with a good model to follow.  However, it is important that healthcare organizations take control of data security issues now to prevent further reluctance of EHR and HIE technologies by a worried public.  In the end, both enhanced means for transmitting data, and better security of that data, are both necessary ingredients to enhanced healthcare.

The Future of Social Media in Healthcare

Perficient has created this series, “Responding to Healthcare Consumerism with Social Media” in order to identify the benefits and drawbacks of using social media and collaboration tools in healthcare, explore the doctor and patient communities currently interacting online, outline social media’s impact on the quality of care, and use current innovations to predict the future of social media collaboration in the healthcare industry.

Many have advocated for increased use of social media in the practice of healthcare.  However, healthcare social media advocates have been criticized for the lack of privacy and the partial picture of the patient that online interaction provide.  They argue that such a model would limit the quality of care. 

I agree that not all patient and doctor interaction can occur in traditional social media outlets.  However, new technologies are rapidly filling the current void to extend social media channels into a private, communication-rich online environment where patients and doctors can interact.  Using these advances in technology, I envision a world where traditional social media outlets, such as Twitter and Facebook, become a starting point for healthcare communications that can be fully integrated into care using advances in collaborative technology.  For example, a patient could ask a question in a traditional social forum, which becomes an invitation for further correspondence with a physician.  A doctor at a healthcare facility can reach out and respond by direct message, email, portal, phone call, and potentially an office visit.  The new office visit could be a traditional in-person visit, or a modern interpretation we’ll call the “cyber visit”.

A New Model for Delivering Healthcare

It is true that modern medical coding is needed to support new forms of doctor and patient communication, but social media has the power to revolutionize health insurance as well.  Let me introduce you to Hello Health.  Hello Health is a paperless primary care practice based in Brooklyn that uses social media to communicate with patients.  Hello Health touts “healthcare freedom” through the use of web-based patient communication, practice management, and electronic health records.  Instead of using health insurance, Hello Health requires a monthly enrollment fee.  With this fee, you can send an instant message to a doctor via a secure, HIPAA certified messaging tool.  An email response from the doctor is free, and patients are charged an additional fee for a “cyber visit”.  You can also get an appointment to come into the office, or you can pay for an actual house call. 

Hello Health has differentiated itself in the healthcare market as a low cost provider of highly interactive health care.  Collaborative technology is at the core of their plan.  Modern portals, like the ones at Hello Health, are revolutionary vehicles for providing high quality care in a collaborative environment.  Portals can be used to set appointments, view test results, request prescriptions, and facilitate communication with your doctor during “cyber visits”.  These technologies provide convenience and, according to our previous post, Increased Access to Data Increases Patient Satisfaction, increase patient satisfaction because they provide patients with what they are looking for in a modern healthcare provider.

Healthcare in the New Age

Powerful portal solutions fill the “patient information void” that so many healthcare professionals fear when considering these new socially-enabled forms of healthcare.  One example of a modern portal solution is the IBM Patient Empowerment System.  This recently revamped patient portal acts like a social network for participating patients.  The portal provides a platform where physicians and patients can work together toward their combined goals of better health.  The system also cross-checks patient interactions against past medical records to check for important events, such as potential drug interactions. 

Social technologies are also being used to enhance the quality of care for diabetic populations in low income areas.   In a joint effort between Microsoft and the University of Miami, a group of diabetes patients were given computers and trained on the Internet.  They were then able to communicate with doctors and nurse practitioners via portals.  The portal was used not only to transmit data about weight and self-administered blood sugar tests but also as a virtual classroom to learn about nutrition, exercise, and diabetes care.  Patients were enabled with the ability to send instant messages and email to their healthcare providers and to discuss their disease with other diabetes patients via discussion boards.  This technology shows promise for providers and health plans who are interested in managing chronic disease, especially for the uninsured.  I can imagine a similar application doing wonders in rural areas as well.

However, one void still remains.  How would a “cyber visit” accommodate care that must take place in person, such as listening to a patient’s heartbeat?  There’s a recent invention for that too!  I read a blog post from Dr. Joseph Kim  that announced one of the latest inventions in telemedicine, namely a scope-to-scope application by 3M, which gives physicians the ability to hear actual heart and body sounds in real time from any distance, even space.  Using this technology, and similar technologies that are surely on their way, doctors can provide care from across town, deep into rural areas, or even to astronauts at a space station. 

To wind up this series, I’ll provide you with some final thoughts.  Just as many of us use social media in the early stages of the sales consideration cycle, social media is a tool that can be used to engage patients in the early phases of healthcare.  Healthcare organizations can fill the need for high quality healthcare advice online through the creation of content that increases awareness of both better health and the healthcare organization in question.  These healthcare organizations can interact with current and potential patients via traditional social media outlets similar to Palo Alto Medical Foundation.  However, once deeper communications between patients and physicians are needed, innovations in collaborative technology can be used to provide a revolutionary, and cost effective,  new way to respond to healthcare consumers. 

The future of a social media enabled healthcare system is already here and being tested by revolutionary organizations at the cutting edge of science and technology.  By increasing the power of their collaborative networks, healthcare providers of this digital age can reach out  and enable healcare consumers.  They will reap competitive advantage as a result.

ACOs Create World Class Outcomes with Patient Portals

Last week John Moore of Chilmark Research wrote an excellent piece called “Much Ado About Patient Portals”.  This post is a very telling sign of what we are seeing in the healthcare marketplace.  With the buzz around healthcare reform and the emergence of Accountable Care Organizations (ACO) one can understand why the increase interest in patient portal technologies.  

However, most of these initiatives are more around branding of the healthcare organization and the services that are offered versus the real need to connect and empower patients that interact with your healthcare organization.  Patient portals, when engaged with the broader healthcare organization, have the potential and the power to create real and meaningful change in the outcomes of patients and the physicians that deliver that care.  Innovative healthcare organizations realize that being transparent and non-proprietary with their patient relationships and their medical information can and do create more meaningful relationships that can create world class outcomes.  Healthcare providers must engage multiple areas of their health system to create real and important capabilities through the use of patient portal technologies.

 Creating World Class Outcomes

When healthcare organizations utilize Patient portals that not only include branding but empowerment features such as access to medical information results, secure messaging with physicians, self-service features like bill paying and scheduling appointments are just some of the capabilities that provide a more powerful relationship with patients and their physicians.  In addition, progressive patient portals enable healthcare providers to message and engage with patients outside of an individual encounter.  Being able to interact with patients around medical conditions can reduce re-admission and more complex events from occurring.  True medical management can be achieved only when an interactive and bi-directional relationship is occurring between the patient and the healthcare provider.

 Going Beyond Marketing to Impact Accountable Care

With Accountable Care Organizations taking on a more prominent role in healthcare reform, the ability to connect and engage more effectively with patients and physicians is an important relationship to maintain and manage in a more proactive manner.  The use of a Patient portal tool can and should be an important component of modernizing a healthcare provider environment as long as it is viewed beyond the narrow area of just marketing and branding capability.

Providers Use of Telehealth and Social Media [Video]

In the health IT world there is a lot of focus on meaningful use.  Some are concerned that these discussions are diverting attention away from innovation as a result. 

Worry not.  At the HIMSS conference this year, Perficient interviewed Ken Dean, VP and CIO at Chesapeake Regional Medical Center.  Ken agreed that many of the large exhibits at HIMSS focused on meaningful use, but he felt encouraged by visits to smaller booths where he feels most of the innovation happens.  Two key trends he noticed were increased use of telehealth and social media by providers.  

During this interview, Ken outlined telehealth innovation in neurology that has resulted in high quality care and high patient satisfaction.  He also highlighted the Mayo Clinic’s interesting use of social media around patient communication and referrals for the physician base. 

What happens when hospitals do not participate in social media?

Perficient has created this series, “Responding to Healthcare Consumerism with Social Media” in order to identify the benefits and drawbacks of using social media and collaboration tools in healthcare, explore the doctor and patient communities currently interacting online, outline social media’s impact on the quality of care, and use current innovations to predict the future of social media collaboration in the healthcare industry.

Communication among doctors, patients, providers, and health plans are what healthcare networks are built upon.  If you take away this communication, then the network simply does not exist.  Today there are more ways to communicate than ever before.  Collaboration and social media, by way of portals, email, and webcasts, are drastically altering the old way of doing business in healthcare.

These new communication tools present both challenges and opportunities for healthcare organizations.  Two recent examples illustrate different approaches healthcare organizations have with regard to incorporating collaboration into a healthcare organization’s culture.  We will examine them here.

When Hospitals Don’t Participate

Like the majority of healthcare organizations, London Health Sciences Centre in Ontario, one of the most prestigious healthcare organizations in Canada, did not place heavy emphasis on collaboration and social media in their practice of healthcare.  With the lack of instruction on privacy issues surrounding social media in medicine, they stuck with the old way of doing business.  Enter Baby Joseph into the communication network at London Health.  Baby Joseph was a patient with a “severe and progressively deteriorating neurological condition.”  Baby Joseph’s parents were at odds with the hospital on their recommendations for care.  As a result, Baby Joseph’s family turned to social media.  They posted videos that soon went viral.  London Health was quickly in the midst of a PR firestorm as the communication that was occurring in their network, by way of social media channels, did not include their own expertise. 

“There was a lot of misinformation that was beginning to circulate in a variety of media, including the social media concepts,” said Mary Gillett, Director of Communications at London Health Sciences Centre.

This firestorm put London Health in a defensive position that they, at first, did not respond to.  They eventually entered the social media conversation in order to put out the flames.  However, given their lack of investment in the technologies necessary to open these new lines of communication, London Health was at a distinct disadvantage.  For purposes of this post, I will tip toe around the political debate surrounding this case and simply posit that healthcare organizations are often at the center of very emotional issues and decisions.  Social media has become a steam valve for issues of this nature.  By adding their voice to the conversation, healthcare organizations can continue to correct misleading information about healthcare issues and the care that they provide. 

When Hospitals Do Participate 

On the opposite end of the spectrum, you have healthcare organizations like Palo Alto Medical Foundation, which is leading the charge in social media.  Palo Alto regularly posts to their Facebook page, YouTube, and Twitter accounts.  They have found that social media is a natural extension to the other communication vehicles they use as a part of their network.  They have successfully used social media to dispense healthcare information and promote events.  Best yet, they have used social media and collaboration to build personal connections with their patients, doctors, and network hospitals.  In one case, a Facebook posting caught the attention of urgent care physician Dr. Enoch Choi at Palo Alto.  A patient of the facility posted that she was having difficulty sleeping and posted her sleep patterns as a graphic.  Dr. Choi immediately responded with “I can help you with that!” This is a great example of extending the lines of communication to grow a healthcare network.

Dr. Enoch Choi has been quoted as saying, “A doctor can show compassion online via social media and can make a difference.”

These two anecdotes symbolize an important movement occurring within the healthcare industry that those utilizing the “old way” of doing business will not realize.  Today’s healthcare consumers value engagement.  They want access to care, and they want open communication enabled by the technologies they use to communicate every day.  I am certain that I am not alone when I say that, in today’s world, I selected my personal physician, and the healthcare organization she is affiliated with, based on the technology she has at her disposal to communicate with me about my care.  By investing in these collaborative technologies, my physician can now count me, and many others, as part of an expanding healthcare network.

Collaboration Integral to Healthcare Reform [Video]

During the HIMSS conference last month, we heard many speak on the importance of Accountable Care Organizations, meaningful use, and healthcare analytics in driving healthcare reform. In this interview with John White, Director of Perficient’s Healthcare Practice, the importance of collaborative tools in healthcare reform were discussed.  John stated that while discussions around the components of healthcare reform are important, if these disparate organizations cannot come together as a single group, then healthcare reform could collapse under its own weight. 

A second trend we witnessed at HIMSS could help this issue.  Many healthcare technology vendors continue to demonstrate the ability to create a collaborative environment around healthcare reform with new technology innovation.  In order to increase the success of healthcare reform measures, physicians, health systems, and patients need to be active participants in the dialogue.   By increasing communication virtually, these parties can connect around the delivery outcomes that generate cost effective,  world class care.  The end result?  A smarter healthcare system.

Increased Access to Data Increases Patient Satisfaction

I recently read that 78% of patients believe EHRs boost care.  What was my reaction to this news?  I immediately thought, “Just wait until patients see what all of the technologies that EHRs enable can do.”

Business intelligence is a perfect example.  Data warehouses and data analytics provide physicians with the tools and technologies they need to enable a remarkable level of care.  Coupled with online portal technology, today’s healthcare consumer is accustomed to interacting with the data provided to them in other industries, and healthcare is no exception.  Having access to this data, and the better clinical results it provides, has increased patient satisfaction as well.  As mentioned by Dr. Paul Grundy, Global Director of Healthcare Transformation for IBM, when patients can access their data through portals and electronic communication, there satisfaction rises “from the 10%s into the 80%’s and 90%s”.

Patients have found numerous benefits to this smart use of medical record data.  Two key drivers include:

Increased Quality: By increasing the quality of patient data you increase the quality of care.  Data warehouses and data analytics provide insight into otherwise unwieldy patterns found in data.  Making sense of these data patterns will enable providers to make better quality decisions as a result.

Creation of Value: Analytics have already shown significant results in the healthcare industry in the form of smarter supply chains and enterprise resource planning, which result in cost savings that can be passed along to the consumer of healthcare services.  However, the most significant results will be found when analytics enable cost savings in the clinical setting as well.

Earlier this month, Microsoft CEO Steve Ballmer commented on a grandmother who was enabled to pursue treatment for her yet-to-be-born grandchild from the cardiac unit at Texas Children’s Hospital as a result of hospital communication and a BI platform we supported.  I encourage you to read our previous post “Microsoft CEO Steve Ballmer on Positive Outcomes from #HealthIT” to experience this amazing story in full detail.  It is just one incredible example of how harnessing the power of data enables a level of care unimaginable even a decade ago.  When healthcare organizations incorporate business intelligence capabilities into the practice of medicine, their patients will thank them.

Real or Satire?

Quick-Lube Shop Masters Electronic Record Keeping Six Years Before Medical Industry

KETTERING, OH—A comprehensive digital cataloging system that keeps track of its customers’ car maintenance history, oil-change needs, and past fuel-filter replacements puts Karl’s Lube & Go’s computerized record- keeping an estimated six years ahead of the medical industry’s, sources confirmed Friday…

Alas, it’s from The Onion.

What do ICD-10 and Y2K have in common?

Like many IT professionals, I lived through the onslaught of the Y2K “millennium bug”.  My current life during the push for ICD-10 compliance in healthcare makes it feel like déjà vous all over again.  You may ask, what do ICD-10 and Y2K have in common?  Good question.  Just like during Y2K, we IT professionals are spending many hours analyzing databases.  This time we are looking for all of those places that ICD-9 codes are hiding and determining the impact that changing those databases will have on existing applications and reports.   Business analysts need to dig into business processes and determine key changes brought about by the ICD-10 codes, which include more extensive physician and nursing documentation.  Simply put, the most glaring consistency between ICD-10 and Y2K is that the “fix” is not as simple as it appears.  In Y2K we couldn’t merely shove a “19” in front of the stored year.  With ICD-10 we cannot simply chase down general equivalency mapping of ICD-9 to ICD-10.


What ICD-10 and Y2K have in common is twofold:

  1. Both are a lot of hard work
  2. Both provide an opportunity to examine and improve existing business processes

Fortunately, unlike Y2K, ICD-10 will not be viewed in retrospective as a “non-event.”  At this point, most organizations should be out of the planning stage and well into the ICD-10 remediation effort to meet the October 2013 deadline.  The ICD-10 effort will have to be methodical, orderly and carefully executed.  This careful planning carries the potential to improve the quality of operations and the level of understanding in a complex healthcare business.  Also, unlike Y2K, which felt unrewarding, ICD-10 remediation can save time, money and maximize return in the long run for the U.S. healthcare delivery system.

Given the increased level of diagnostic detail afforded by ICD-10, this remediation effort is a good time to consider re-structuring how a healthcare organization views its service lines for operations and profitability.  The reward for the pain found in analysis, database remediation, database migration and testing is a new detailed capability to examine the profitability and costs by procedure, the costs of specific diagnoses, and potential specific operational savings from best practices.  ICD-10 will introduce a new level of transactional analysis by virtue of the expansion of the sheer number of new codes from ICD-9.

When faced with re-working all of the existing analytic reports built around ICD-9 codes, an organization can examine the bigger picture of how their business intelligence, decision support and analytics should perform.  The remediation of the databases for ICD-10 will lead to new opportunities for building more comprehensive data marts and stronger operational reporting including digital operations dashboards.   For the more progressive IT teams, ICD-10 remediation could be an opportunity to move to more of a self-service model for reporting that capitalizes on the new generation of business intelligence tools.

My best advice to healthcare organizations watching the ICD-10 time clock: Don’t treat ICD-10 as just another compliance issue.  Instead, use this as an opportunity to examine and improve your healthcare business.  Your bottom line will thank you.

Microsoft CEO Steve Ballmer on Positive Outcomes from #HealthIT

It’s always heart-warming when we can see the results of our work and the human impact – when healthcare analytics and reported outcomes drive to a better patient experience and positive outcomes.

Microsoft CEO Steve Ballmer recently referenced good systems being able to generate outcomes information at Texas Children’s Hospital in a speech he gave at the Houston Technology Forum on March 10th. The system and outcomes work was supported by Perficient, Microsoft’s Healthcare Provider Partner of the Year leveraging Microsoft technologies including SQL Server, SharePoint and ASP.NET.

Here’s what Mr Ballmer had to say

“One of our guys was telling me a story which I thought was fantastic that happened here locally, so I’ll share it with you. Lady in Kansas, a grandmother actually, finds out that her not-yet-born grandchild has some kind of fetal heart problem and says, what am I going to do about this? Starts searching around, and the only hospital that actually had both good systems to allow her to find them, and actually could demonstrate what their outcomes had been with in utero fetal heart surgery, was the Texas Children’s Hospital. They captured that information, they published it. They had it in a place where this grandmother in Kansas, doing her research on the Internet, using information published by TCH, she was able not only to tell her child, look I found these people, but it looks like they actually get very good outcomes. They did an in utero procedure on this mom here in Houston, and the success story of course is there, the baby is fine, has lived in a way that you just can’t imagine in a generation prior to information technology.

TCH is now getting referrals for these kinds of procedures based upon real outcomes. Very few healthcare institutions can actually prove to you, by the way, they have real outcomes. They don’t have the data and systems to support it. And yet TCH does. And hopefully we get a chance, that’s as dramatic a story as I frankly have ever heard about the use of our technology, but hope we get the chance to work with many of you on important stories for you.”

What is your story of the human side of Health IT? Please comment & share.

The Movement of Patients and Physicians into Social Media

Perficient has created this series, “Responding to Healthcare Consumerism with Social Media” in order to identify the benefits and drawbacks of using social media and collaboration tools in healthcare, explore the doctor and patient communities currently interacting online, outline social media’s impact on the quality of care, and use current innovations to predict the future of social media collaboration in the healthcare industry.

While I don’t know many physicians that are still making house calls these days, I would venture to say that social media and collaborative technology tools have the power to bring patients and doctors together in a fashion similar to those old fashioned house calls.  All of the mechanisms are in place to drive a fresh collaborative healthcare environment.  As will be detailed in a future post, creating a high technology social environment where patients and physicians can interact can revolutionize the delivery of healthcare. 

However, the current reality is much different than the sunny future I see ahead.  Patients are online.  Physicians are online.  However, these two groups are running in different social circles.  While many often get caught up in the “frivolity” of online and social media, this presents a true medical problem.

Approximately one-third of adults in the US are using social media to collect health information.  According to a recent Health Dialog survey, only 25% of individuals searching for health information online verified the source.  Scarier yet, 58% of individuals surveyed assume a diagnosis based on the information they gathered online. 

Welcoming physicians into this conversation would definitely help this issue, but many rightly believe that physicians, and healthcare organizations in general, have been slow to adopt social media into the practice of medicine.  Based on the benefits and drawbacks highlighted in our earlier post in this series, I can understand why.  However, the emergence of physicians navigating social media is progressing.  It is my belief that the direction of this momentum could naturally progress into a new model for delivering healthcare. 

Manhattan Research reported that 60% of physicians actively use social networks or are interested in social media.  To date, there are 1327 physicians listed as doctors on Twitter using  However, the real growth is being fueled by physician-only social networking sites like Sermo, Ozmosis, and SocialMD.  The truth is that most doctors work in small practices, are overworked, and geographically dispersed.  As a result, it is difficult for physicians to collaborate with other medical professionals.  These physician-only social networking sites have offered a welcome refuge for learning and collaboration that help physicians filter through the overflow of health information they receive.  Doctors are able to share favorite journal articles and research and participate in online forums.  Many social media communities are now including education portals with CME courses and webinars.  As these physicians collaborate in social networks, medical knowledge spreads more quickly, which results in faster adoption of the very best clinical practices.  This results in better patient outcomes.

Sermo’s CEO, Daniel Palastrant, has been quoted as saying, “Physicians are actually turning to these mediums to better diagnose their patients and provide better care.”

Many brave MDs are now venturing out into the blogsphere and dispensing medical advice based on their experience and research.  This is a great start.  In the next post of the series, we will discuss how adding collaborative technologies to this existing social infrastructure, where patients are seeking more information and physicians are optimizing the care they deliver, can combine to impact the overall quality of care.

How HIE and Collaboration Lead to ACO Success

I listened to an H&HN Daily podcast yesterday titled ACOs Need to Focus on Clinical Care, Too.  Institute for Healthcare Improvement (IHI) CEO Maureen Bisognano was interviewed, and there were two themes that struck me in particular:

  1. Fragmentation of the patient experience leads to increased cost and decreased patient experience:  Bisognano points out that many healthcare executives believe that engaging patients in the design of care increases costs.  However, they found that organizations had better clinical outcomes at lower cost when 1) data is integrated in such a way that design of care can travel across an entire patient episode and 2) patients were engaged in the design of their care.
  2. Many ACOs are focused on legal and financial structure and not on the redesign of clinical care:  This mimics sentiments that I read in the Healthcare Finance News article Payers, Providers Agree – and Disagree – on ACOs.  Bisognano is concerned that ACOs will never live up to their full potential with such a narrow focus.  Her data actually shows that communities that achieved the lowest costs placed the highest emphasis on the entire healthcare system that patients used to receive care.  In some communities competition was rampant, but the leaders that were competing against each other for market share and talent came together to discuss the total burden of illness in the community they served and designed care and services accordingly.  By incorporating the critical components of clinical care into executive decisions, these executives better realized quality outcomes and became market leaders with lower cost structures as a result. 

Bisagnano ended with a query on how to create an IT system that effectively ties these themes together.  Here are my thoughts:

  • Increased Data Exchange in Health Communities: I agree wholeheartedly that fragmented data across communities leads to increased cost and decreased patient experience.  The ability to exchange clinical information will be critical to ACO success.  Beyond the important aspects of delivering quality care, there are real business drivers that favor an environment where clinical and cost information are combined into a comprehensive system delivery model.  Health Information Exchange (HIE) is important in establishing this partnership with patients and the healthcare systems within their community.  The Enterprise HIE eco-system is one approach that innovative healthcare systems are using to enable them to connect patients and physicians together in a more collaborative environment. 
  • Increased Collaboration Among Patients, Physicians, and Healthcare Communities:   There are many smart options available to invite patients, physicians and communities into decisions related to the design of clinical care.  Healthcare portals can be used to empower patients by providing meaningful access to their care and connect a patient to the entire health system that impacts their care.  Similarly, community portals can be created to connect patients to those with similar disease states for information sharing, support, and advice.  This empowers patients to work with ACOs in creating cost saving, and patient centric, clinical care.  Organizations can also use physician portals to connect physicians to the critical components of clinical care which can then be incorporated into executive decisions.  This would enable stakeholders of a healthcare system to come together to create better services and relationships within the community that they serve, and, according to sentiments from Bisagnano and many others, increase an ACO’s success as a result.

What do you think?  How would you create an IT system to enable the redesign of clinical care?