Rob Houston, MBA, MPP and Jim Lloyd, JD, MPPAugust 6, 2015
With rapid advances in health information technology, electronic health records, and the use of “big data,” there has never been more information available to providers about their patient panels. Innovative providers such as the Camden Coalition of Health Care Providers in New Jersey and Hennepin Health in Minneapolis, Minnesota are successfully using health data to create a much more complete picture of patients’ health. In the ideal setting, the traditional Marcus Welby model of high-touch primary care is being integrated with the data-driven, high-tech medicine of today.
Accountable care organizations (ACOs), like many delivery system reform efforts, place more care management responsibility at the provider level, giving providers the incentive to analyze data to target opportunities for improved patient care. Through ACOs, providers are getting unprecedented access to patient data to better understand their patient populations. For example, many primary care providers (PCPs) in ACOs now have access to hospitals’ admission, discharge, and transfer (ADT) data streams as well as lab results and pharmacy prescription data.
Data Overload Keeps Providers from Effectively Using Data
Although access to data is a key ingredient for accountability in ACOs, allowing providers to monitor patients’ health and reduce avoidable costs, data overload is one of the challenges most often noted by ACO providers. The sheer volume of data can become a burden for providers who do not know how, or often simply do not have the time or tools, to process and understand the deluge of data they may receive. For example, providers should be able to use ADT data to answer the question “have you seen the patient shortly after his or her discharge from the hospital?” Yet, PCPs may need guidance on how to extract what they need from complex ADT data feeds.
State Efforts to Help Providers Harness Health Data
States involved in CHCS’ Medicaid ACO Learning Collaborative, an initiative supported by The Commonwealth Fund, are considering strategies to help ACO providers in maximizing the use of health care data:
- Determining which data are most useful for providers. Some states are analyzing which data are most useful for providers in order to reduce the volume of data providers receive. States may identify this information by surveying providers or analyzing data usage statistics.
- Providing targeted or filtered information to providers. The Minnesota Department of Human Services shares streamlined information through monthly patient utilization reports and quarterly total cost of care reports so providers can use this information at the practice level. Over time, the state hopes providers will learn to use this data effectively and develop the capacity to manage more complex datasets themselves.
- Providing analytic and care coordination tools through a data management system. States may provide a tool or contractor to help ACOs manage data. For example, Colorado’s external state data analytics contractor is available to help providers access data and reports about their patients.
- Encouraging providers to dedicate personnel to data management. States can help ACOs build data capacity by encouraging them to employ an on-site data coordinator. Arkansas provides additional payments to providers in its patient-centered medical home program to use the care coordination services of a specified vendor. While this is not an ACO program, the approach could be used by Medicaid ACO programs as well.
The development of health information technology and proliferation of electronic health records have created a tremendous opportunity for ACOs to employ data to better care for their patients. Yet simply providing data without accompanying supports can be overwhelming for busy provider offices. States and ACOs can benefit by working together to effectively manage the data flow with a focus on improving care and reducing avoidable costs.