ACO required components that are not typically found in EHR products today include:
Patient Service Tracking
The patient service tools in many EHR products lack adequate management and standards monitoring tools to assure adequate provider response and handling. In some cases, the lack of referential integrity within the EHR makes patient service tracking impossible. For example, a number of EHRs require a patient service item to be recorded in three places: the exam note, the order feature and a message for staff. You cannot verify completion of a patient service item from the exam note and the order frequently is not connected to the exam note.
ACO oriented patient service features track the relationship of all events triggered and derived for the patient visit as well as contextual tools to manage the lifecycle of patient service events.
Collaboration Within the ACO
Effective and efficient collaboration on patient care is a strategic necessity for any ACO. In most cases, CCR transactions and other electronically received information are magically inserted into the EHR without an effective or adequate audit trail of the source transaction or response. Other ACO related exchanges with other providers are typically entered as a miscellaneous message without context or connections to the ACO relationship. Indeed, in many EHRs, the person who receives the information and posts the information to the patient chart is identified as the audit source.
An ACO’s EHR must clearly identify the source of EHR information from ACO partners as well as track the state of such information. For example, the incoming information could be pending an action, completed, or awaiting further activities. As important, links should be maintained to provider activities related to the incoming information. ACO participants will also need effective management tools for exchanges of information as well as the ability to focus on particular ACO related activities or participants. For example, the provider may want to examine the outstanding patient service items sent to a particular ACO provider.