It’s hard to argue that without an EMR, Accountable Care Organizations would be somewhat adrift. After all, any structure that demands a high level of coordination between multiple organizations benefits from a shared EMR backbone.
But do EMRs do a good job of managing population health, the other key responsibility of ACO clinicians? Let’s take a look at the criteria suggested by David Nash, MD, MBA, who’s Founding Dean of the Jefferson School of Population Health at Thomas Jefferson University. Dr. Nash notes that primary care physicians in an ACO need the following:
- A registry to monitor and evaluate my patients – not just individually but as a population
- Relevant data on my patients who share a specific diagnosis such as hypertension or asthma
- Information on how my medical management and patient outcomes compare with other local practices
- Information on where my practice stands in comparison with national benchmarks
Let’s see. Do leading EMRS offer a registry to monitor patients as a group? Automatically serve up data on patients who share a specific diagnosis? Offer means of benchmarking outcomes with other local practices or national standards? No, no and no.
I can hear EMR vendors out there saying, “Hey, wait a minute. That stuff is not our problem!” And historically, they’d probably be right. After all, it’s a formidable enough job creating usable, flexible, reliable medical record analogues in digital form.
The truth is, however, that population health measures are central to the medical home, ACOs and the future of medicine generally.
My guess is that for the next few years, hospitals and large medical practices — even those who have launched an ACO — will be preoccupied enough with meeting Meaningful Use measures that they won’t be demanding more extensive population measures soon.
Still, enterprise EMR vendors will need to offer tools that meet broad population health goals eventually, as the large organizations that buy their products will soon be demanding these types of functions. The only question is when.