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As we prepare to enter the second decade of the 21st century, industry insiders weigh in on the year ahead in healthcare technology.

ACOs, EHR implementation and inte- gration, social media, ICD-10, the cloud, digital image management and meaningful use are just some of the hot-button topics our panel members address as they consider the next 12 months in healthcare IT.

Payment bundling and ACOs require new IT strategies

By Ravi Sharma, president and CEO, 4medica

While the bundling of Medicare payments is several years away, United Healthcare and some regional insurers are starting to experiment with the concept. Moreover, accountable care organizations (ACOs) can start participating in a Medicare shared-savings program in 2012. ACOs, which will be responsible for the cost and quality of care, will expand from payment bundling for an episode of care to taking responsibility for the health of an entire population. Of course, an ACO must be able to coordinate care seamlessly across all care settings. To do that, it must be clinically integrated. This will be easier for healthcare organizations that employ most of their physicians. But at the majority of hospitals, the medical staffs include both employed and private-practice physicians, so hospitals will have to fi nd a way to integrate clinically with those that are not part of their enterprises.


The clinical integration piece depends partly on the intelligent deployment of the best-available information technology. To accept a bundled payment for a procedure

8 January 2011

Editor’s note: Because we received so many responses, the forecasts will be split into two parts and concluded next month.

and a period of post-acute care, for example, a hospital must collaborate closely with physicians, nursing homes, rehab facilities and home health agencies. Physicians must be able to exchange information online with the hospital and other providers about lab results, medications, allergies and patient health status.

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In the best of all possible worlds, the combination of EHRs and HIEs would supply the basis for the exchange of this information. But the fact is that

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the widespread adoption of these tools is still some years away, while ACOs are right around the corner. What is needed right now is an easy-to-deploy method of combining patient data across care settings. While there are several different ways to integrate and exchange clinical information, integrated health record (IHR) applications are gaining popularity thanks to their simple, software-as-a-service (SaaS) platform that sits on top of existing technology. Such a system can be used to seamlessly order tests from any lab, receive results, prescribe electronically, view hospital reports and exchange information among providers. Because it can be quickly deployed to practices of all sizes and types – whether or not they have EHRs – the IHR provides an ideal, low-cost vehicle for hospitals to expand clinical integration, prepare for payment bundling and become ACOs.


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