Accountable care movement depends on clinical analytics
Anceta is moving from pushing data to physicians, "which can feel like they are being judged, to a pull model, in which the physicians get curious about querying the data themselves and find it more useful than just a reporting mechanism," Cuddeback says. Medical groups can do a query to see which medications their physicians are prescribing for glycemic control in any subgroup of patients with diabetes and see comparative data for similar patients of other medical groups participating in the Anceta Collaborative Data Warehouse.
Clinical analytics in a rural setting
ACOs aren't all run by large health systems. The Cumberland Center for Health Innovation (CCHI) was launched in July 2012 with 39 physicians in 26 rural Tennessee practices. Some serve towns of fewer than 1,000 people. The physicians use 14 different EHR systems with no clinical system integration, and no tie to any larger entity such as a hospital system. To make the ACO model work, they needed shared clinical analytics.
"We did an RFP and only one vendor, Clinigence, was able to demonstrate how to extract that data from 14 different EHRs and consolidate it for reporting," says Frank Ross, CCHI's information technology leader. "We are going to push out reports to them about how they are doing with their patients on meeting federal quality measures." The cloud-based offering from Clinigence will allow the doctors to see how they compare with the other physicians on things like 90-day A1c testing for diabetic patients. Ross explains, "It will get them talking about care coordination and process improvements to meet quality standards being set by CMS (Centers for Medicare & Medicaid Services)."
CCHI also wants to better track the patient's route through the healthcare system—from primary care to hospital to nursing home to home care—and study the patterns of care. "Then we can do some predictive modeling on where patients are likely to end up and not repeat the same patterns we have seen, and hopefully get a different result than more hospital readmissions," Ross says. "Until now, these primary care physicians have been operating in something of an information vacuum once the patient leaves their office."