Based on impending reimbursement cuts, proposed bundled payments and enhanced quality expectations emerging from the federal government, providers that have been fearing these changes, but not moving to alter their internal processes, would be wise to heed the words of Allan Quatermain in H. Rider Haggard’s novel. At this week’s annual conference of the Healthcare Information and Management Systems Society (HIMSS) in Orlando, Fla., representatives from a slew of government agencies, including CMS, HHS, ONC, NIST, spoke to the necessity of providers starting to prepare for a change in the U.S. healthcare system, and healthcare practitioners provided examples and guidance for improvement.
The recently popular catchphrase, accountable care organizations (ACOs), was oft referenced this week, but few seemed clear on how these entitites would eventually take shape. It was clear, however, that providers need to prepare for a shift away from the current fee-for-service model.
“Now is the time to start changing,” said Nate Kaufman, during his keynote address of the CIO Forum. “Healthcare’s new leaders must organize doctors into teams; measure their performance not by how much they do but by how their patients fare; deftly apply financial and behavioral incentives; improve processes; and dismantle dysfunctional cultures."
In addition to getting the right people into place along with standardized protocols, truly prepared providers also will require clinical integration supported by the proper IT infrastructure.
However, he realistically suggested that “successful ACOs won’t exist by 2012, as we won’t even know the return on investment at that point.”
As a start, the U.S. government is pushing the more widespread adoption of health IT systems through the potential of meaningful use incentives. At HIMSS11, Farzad Mostashari, MD, U.S. deputy national coordinator for health IT, urged attendees to consider meaningful use as “a jumpstart to what we all are going to have to do in our new healthcare financing ecosystem.”
As Mostashari indicated, getting an EMR in place is just the beginning, and representatives from Sentara Healthcare spoke to the next step, which is to leverage the incoming flood of data in as many ways as possible to derive maximum value from it. However, big providers aren’t the only ones reaping benefits, as a single-provider, nurse practitioner-led diabetes center in New Orleans also leveraged an EMR to become sustainable, following Hurricane Katrina.
Other presentations reviewed how providers are successfully using health IT, such as clinical decision support systems, computerized physician order entry systems or a tele-ICU, to drive down adverse event rates and potentially save money.
However, implementing these systems isn’t the only hurdle to overcome, as hospital executives need the buy-in from the physicians and staff in order to become successful, which many described as the hardest challenge. Again, Haggard’s Allan Quatermain adeptly reminds us of the dichotomous human nature: Man's cleverness is almost indefinite, and stretches like an elastic band, but human nature is like an iron ring.
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