ACOs Are Built on a Foundation of Electronic Health Records

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Storing patient data in an electronic health record and sharing it across a health information exchange are essential for participating in an accountable care organization.

“People on paper will be fighting for their lives,” said Richard Hom, OD, MPA, FAAO, national optometric director of WellPoint, Inc., about converting from paper-based patient information to electronic health records. “This will be the siren call for all people on paper. If they want to fight for patients in the next 10 years, they’ve got to be electronic.”

Signed in 2009 as part of the stimulus bill, the HITECH (Health Information Technology for Economic and Clinical Health) Act established financial incentives to subsidize and encourage health care providers to implement the use of electronic health records (EHRs). The Federal government has paid and continues paying practitioners who demonstrate the “meaningful use” of these EHRs.

According to the latest CMS figures, since November 2013, a total of 13,469 optometrists have registered for the Medicare EHR incentive program, and the number keeps growing. Although financially rewarding for providers who implement EHRs, these incentives are not the ultimate goal of higher quality health care at a lower cost.

“This is not about the incentive money for attesting to meaningful use; that’s the gravy,” said EyeCare Advice’s Jackson. “It’s about the survival of your practice. ACOs are of no benefit to providers who have not embraced certified EHR technology, like the guy who shows up for a football game but forgot his pads and helmet at home and is not in a position to play ball.”

The ability to meaningfully use electronic health records sets the foundation upon which the basic tenets of health care reform are built, reduced costs and improved patient care, achieved, in the case of EHRs, through electronically storing and sharing information. Once providers have achieved the goals of meaningful use stage 1 (data capture and sharing), stage 2 (advance clinical processes), and stage 3 (improved outcomes), then they are ready to participate in the loftier goals of health care reform, among them the ability to share information via health information exchanges.

“ACOs will be made successful through the transparency and flow of patient data, the ability to access patient records to get as much data as possible,” said Andy Davis, senior vice president, Advantica. “Practitioners have to have as much information as possible for the best treatment possible.”

The Nationwide Health Information Network Exchange, Direct Project, and Connect software solution are three initiatives launched to help expand secure health information exchange efforts.

“One of key things a provider has to do to be on ACOs is to be able to share information,” confirmed Jim Grue, OD, director of health policy integration with OD Excellence. “This is accomplished through approved communications—Direct and Connect. To achieve meaningful use stage 2, electronic health records software has to support Direct messaging. This enables any EHR to share consolidated continuity of care documents with any other EHR via secure communications and then be able to take apart that document to retrieve the information it contains. With one click of the mouse I know exactly what’s wrong with the patient without having to ask the patient.”

It is through health information exchanges being established on the state level through which medical professionals will securely share information.

Storing patient data in an electronic health record and sharing it across a health information exchange are essential for participating in an ACO. Reprinted with permission from the American Optometric Association’s “Accountable Care Guide.”

For example, the Pennsylvania eHealth Partnership Authority, in conjunction with optometrists and ophthalmologists who currently use or are willing to install Direct messaging, is conducting a statewide study in conjunction with primary eyecare providers on the effectiveness of electronically sharing medical records on compliance reporting for diabetic eye exams and glaucoma tests.

Another new health information exchange is OcuHub, powered by AT&T and Covisint and designed specifically for optometrists by the AOA. Recently sold to TearLab Corp., OcuHub was created to enable ECPs to connect electronically to physicians, hospitals and their ancillaries, pharmacies, payers, benefit managers, optical labs, medical labs, imaging and radiology services, employer human resource departments, home care providers, and with patients themselves. “The OcuHub platform will be a competitive advantage for EHR incentive payments, access to insured patients, participation in ACOs and other new payment systems,” said Barry Barresi, OcuHub CEO and former executive director of the AOA. ■