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When IT systems integrate, value-based care can take flight

From the January/February issue of DOTmed HealthCare Business News magazine

By Mark Tomaino

Before the Affordable Care Act, a medical practice management system (PMS) was used by physicians primarily as an office administration tool to capture patient demographic and billing information, schedule appointments, maintain lists of insurance payors, perform billing tasks and generate reports.


The passing of the ACA, which included the HITECH Act’s stimulus, incenting physicians to adopt and make meaningful use of a certified electronic health record (EHR), led to the integration of an EHR with a PMS. This system integration enabled physicians to address both clinical and administrative needs of medical practices, and allowed physicians to see a patient from both a financial and clinical perspective.
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Prior to the integration of a PMS with an EHR, the administration of a medical practice could be compared to the “horse and buggy” era, with manila folders and appointment reminders sent via the U.S. mail. The adoption of EHRs was tantamount to “paving over the cow path” in terms of its basic transformation of paper files to digital information management. The integration of a PMS with an EHR, which enabled clinical information access and exchange in tandem with patient administrative data, was the equivalent of building the healthcare information highway’s “on and off ramps” for sending and receiving digital information and EHR data management.

So where do we go from here? Improving the cost and quality of healthcare for patients will be dependent upon effective care coordination and collaboration between clinicians, their staff and patients armed with the digital information within the EHR and PMS. The transition from fee for service reimbursement of physicians to value-based payments, where quality and outcomes will increasingly take precedence over volumes of procedures and encounters, will demand that clinicians and administers regard their medical practices as patient communication and engagement hubs.

Air traffic controllers and health IT
While ACA provided the catalyst for the digitization of patient encounters and information exchange, outcomes-based healthcare will require medical practitioners to enable their administrative and clinical staff to function more like air traffic controllers than pedestrian crosswalk attendants.

The task of “navigating patients on their journey to satisfactory health outcomes” will require information and communication technologies that resemble the sophisticated systems managing and coordinating preflight, take-off, flight plan, and landing requirements for myriad aircraft representing multiple airlines with different flight plans. The capabilities required by clinicians to care for disparate patient populations representing myriad health conditions dependent upon adherence to multiple care plans delivered across different venues will require a hub-and-spoke network connecting primary care physicians with specialists, and acute care hospitals with post-acute facilities.
  Pages: 1 - 2 - 3 >>

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