20 Dec 2011

Sample Essay: The Role of Health IT in Accountable Care Organizations and Patient-Centered Medical Homes

Health IT plays a very important role in the Accountable Care Organizations and the Patient-Centered Medical Homes. In most cases, little attention is given to the delivery-system that is required to improve the coordination and quality of the health care and lower the spending rates. Accountable Care Organization and the Patient-Centered Medical Home are two models that are mainly discussed for delivery system reform. They also offer opportunity to enlarge the efficiency of the care coordination. Care coordination helps to improve the appropriateness, efficiency, timeline and the quality of clinical decisions and care, in that way, the quality and efficiency of the health care is improved. The main goals involved in care coordination include: the transfer of medical information such as medication lists, medical history and test results properly from one participant to another in patient care. These can only be efficient when the health information technology is involved and very well utilized.

According to some physicians, PCMH is the model of care that gives the patient’s needs the first priority. Gerlach (2010) says that it provides the most efficient and effective care to the patients by including the use of health information technology, behavioral health services, health maintenance, patient education, and providing preventive services through health promotion. Medical homes are responsible for providing the patient’s health care needs or it takes the responsibility of arranging care with other professionals who are well qualified (Shortell & Gillies 2010). Provider members of ACOs work collectively across the specialties in order to develop delivery of care programs that focus on coordinating care and outcomes. The ACOs encourage most hospitals and physicians to incorporate care by holding them responsible for both cost and quality.

PCMH and ACO models play a role in improving the quality of health care and reduce the costs. For instance, one of their major objectives is to deliver high value products and good quality services. These can be achieved by coordinating care, consolidating multiple level of care to the patients, being accountable for the quality of care, efficient delivery and having a brawny primary care foundation. Health information technology therefore, helps to ensure that all these are well achieved.

PCMC’s and ACO’s try to provide a solution to control the costs of Medicare by ensuring that the country avoids spending or paying for wasteful procedures, and authorizing nurses and doctors to offer more efficient and high quality care. Some of the rules that are used in the models include; providing equal care among populations, providing care in the right setting, supporting the well being of all individuals, providing timely, convenient, responsive services, efficient services, and should easily access to appropriate care and information when required. Other principles include identifying measurable outcomes and availability of information that helps in providing and planning for the patients effectively. In order to make the two models, PCMH and ACOs successful, it is very necessary to use the HIT (Health Information Technology). HIT should integrate across the health care system from one care site to the other (Gerlach 2010). The modern information technology commonly used includes computers, servers, and database management systems. Technology is capable of supporting the rural access to health care which is very critical when it comes to caring for all the patients.

The implementation of the ACOs and PCMH has various challenges that mainly concern the direct control of the primary care practice. First, the model, PCMH, doesn’t provide direct incentives to the other providers collaboratively with the primary care providers in order to optimize health outcomes even though it calls for practices of primary care to take the task for coordinating and providing care across the health care continuum (Shortell & Gillies 2010). Another challenge is that most primary care practices have no financial arrangements that enable them to share the savings.

The information technology helps in the implementation, processing and even the storage of some important data on health care. Meaningful use of IT is actually intended to enable the significant improvements in the health of the population via a transformed health care delivery system. Currently, in the year 2011, NCQA instituted more stringent certification standards. NCQA has also built on various standards with increased accent on patient-centeredness that actually includes a stronger focus on the integration of behavioral health. In addition, it helps in the management of chronic disease and therefore improving the quality of patients with the use of patient surveys. All the activities in improving the patient’s conditions are more efficient with the use of IT. It is therefore important to note that IT also plays a major role in the two model’s well performance.

The two models of the delivery-system reform tend to redirect the delivery system towards the improved quality and the reduced cost mainly with the use of health IT. ACOs need a stable primary care core in order to succeed and provide the effective delivery-system infrastructure beyond the primary care practice to enable the realization of the PCMH model. The combination of both the models and the use of HIT are all essential for the implementation and success. Due to the information above, it is clear that health information is very much involved in the current rules related to the ACOs and the PCMH. It is therefore necessary for you to incorporate it in the planning in order to improve the quality and accessibility of healthcare information and facilities.

References

Gerlach L. (2010). Meaningful Use, PCMH, ACO: One Escalator, Three Destinations. Retrieved on  November 15, 2011 from http://www.nwrpca.org/health-center-news/150-meaningful-use-pcmh-acone-escalator-three-destintations.html

Shortell SM, Gillies R, Wu F (2010). United States Innovations in Healthcare Delivery. Public Health Reviews

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