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The majority of hospitals fall considerably short when it comes to having the I.T. needed to succeed as an accountable care organization. Dave Garets, executive director at The Advisory Board Company, an I.T. consultancy and research firm, made that point during the ACO Symposium at HIMSS. Garets outlined the phases of ACO development, from the fundamental building blocks to more advanced models in which patient health would be managed across population groups.

Even the entry level I.T. needed to be an accountable care organziation, he said, is sophisticated, and would require a provider to be at Stage 6 or 7 on the HIMSS Analytics EHR adoption scale (Garets previously served as CEO of HIMSS Analytics, a subsidiary of the HIMSS association). Three-fourths of hospitals fall below Stage 4, he noted, a level that likely would not even meet Stage 2 meaningful use requirements, let alone uphold an ACO, Garets said.

To meet the entry-level requirements, an organization needs to support the Direct Project protocols, which are physician messaging standards developed by the ONC; it would need to send CCD documents to various entities, and also need a physician portal, Garets added. A patient portal would be needed as a fundamental communications tool with patients, whose compliance with chronic disease management programs are the cornerstone of accountable care. Organizations will also need in-depth business analytics capabilities and be able to push out quality metrics via dashboards.  And that’s just the beginning.

In an ideal environment, a provider would have one system functioning as an all-purpose, integrated infrastructure, encompassing the enterprise EHR, scheduling, billing, and business analytics, all from one vendor. “Organizations are doing everything in their power to reduce the number of vendors in play,” Garets says. “The ACO is beyond the EHR. You need all kinds of other tools. You need to convert data to information.”