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AHIMA White Paper Addresses Managing Health Information in ACOs

Just as the housing market brought unprecedented change in how lending institutions do business, accountable care is commanding change within the healthcare industry to provide high-quality patient care and accurate HIM in more efficient and effective ways. The American Health Information Management Association addresses this issue in a white paper  titled, “Accountable Care: Implications for Managing Health Information,” that was released recently.

Every since the Department of Health and Human Services Centers for Medicare & Medicaid Services released proposed new rules on March 31, 2011—to help doctors, hospitals, and other providers better coordinate care for Medicare individuals through accountable care organizations (ACOs)—the primary focus has been placed upon the IT that will be necessary to operate an ACO. However, the need for the information itself is being understated even though HIM serves as the foundation to provide coordinated care for individuals as well as support the financial viability of the ACO.

“Much has been made about the health IT infrastructure that will be necessary to support accountable care,” says AHIMA Director of Practice Leadership Lydia Washington, MS, RHIA, CPHIMS. “Less attention has been paid to the necessity to create, use, and manage high-quality clinical and business information that will provide the foundation upon which accountable care must be built. It is important to start planning for this now.”

Accountable Care: Implications for Managing Health Information explains how information has always been the lifeblood of the healthcare delivery system, but now new approaches to the management of health information are central and necessary to the success of accountable care. This requires a reconfiguration of the HIM framework to provide optimal support for the essential features of accountable care.

“Accountable care is a game-changer in the way health information is captured, stored, and used.  There are tools available to support this transition to continue enabling the practices needed for maintaining high-quality patient care and accurate health information,” says AHIMA Director of Federal Relations Allison Viola, MBA, RHIA. “Accountable care is an opportunity to innovate the way health information is used for patient care and re-define it with the tools available.”

Healthcare organizations must develop an infrastructure of information tools to support and leverage health information that is accurate, timely, protected, and accessible.  This white paper provides five key tools and processes that institutions can use to perform analyses of health information:

  1. Patient Registries—Data bases of confidential patient information that can be used to understand and compare the outcomes and safety of health care.
  2. Predictive Modeling—Users can create sample scenarios or automated forecasting probabilities and trends.
  3. EHR Integration—A growing trend that is being driven by the need for interoperable EHRs.
  4. Models of EHR Integration—Include patient/provider portals, health-enabling information exchange, and integrated administrative and clinical databases.
  5. Episode of Care Analytics—A mechanism that analyzes resources during an episode of care and their variances for a patient.
Accountable care changes the way healthcare is delivered; and the way health information is created and managed will play a critical key role in this transition.

Source: AHIMA