Shareable Ink, founded in 2009, offers software to enable physicians to document treatment at the point of care using digital pens on special paper or tablet computers that capture and convert the writing to structured and unstructured data.

That data can be analyzed, and Stephen Hau, co-founder and chief technology officer--who also founded ancillary software vendor PatientKeeper--says that in the accountable care era the data has quickly become valuable to more than just the physicians.

Hau is seeing a chain reaction where a physician practice becomes a customer to collect the data and demonstrate compliance with certain performance metrics being demanded by a hospital during contract negotiations. When the practice wins a contract, the hospital wants to see more reports on an ongoing basis.

In this first phase, data is used to help secure a hospital contract. But Shareable Ink has found that a second phase quickly emerges. A hospital getting regular performance reports from the practice starts to withhold money, say 20 percent, and puts it at risk for improving quality, Hau tells Health Data Management. During a recent customer advisory meeting, some attendees were talking about quality-linked dollars accounting for 20 percent to 60 percent of group compensation. “The economics have to include quality so everyone has skin in the game,” Hau says.

That fostered a third phase where group practices that agree to risk are finding that the personal compensation of the physicians now is becoming subject to risk, with data measuring how often they follow best practices for key performance indicators tied to quality.

Now comes an emerging fourth phase that Hau first noticed in late 2013. It is the most exciting phase, he believes, because this is where data will come back to individual physicians to help them assess how they stand relative to their peers.

Hau knows from personal experience how that data can influence behavior. Training to compete in the Boston Marathon, he was logging five miles a day until a new app informed him that the average runner training for the marathon does nine miles a day. “This is how information systems can give back to spur improvements,” he says.

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