Rectifying System Disparities within ACO Improves Data Capture, Quality Reporting

Thursday, October 30th, 2014
This post was written by Cheryl Miller

Addressing the disparity between data systems was one of the operational and information technology (IT) issues the John C. Lincoln (JCL) Accountable Care Organization (ACO) addressed at the end of its first year as a Medicare Shared Savings Program (MSSP) ACO, says Karen Furbush, business consultant with JCL ACO. Here she explains the steps taken to rectify the situation.

I was brought on board in July 2012 and was given the ‘playbook,’ or answers that John C. Lincoln provided to the Centers for Medicare and Medicaid Services (CMS) on how they would structure their ACO over the next three and a half years. It was my job to figure out from the IT perspective how to address all the new advancements with the Transition Coach program.

My job was to figure out this new EMR EPIC® system that was being installed, and how we were going to get data back out. It took us a while once we got our membership list from CMS to find addresses and do the mailing, which we decided to do. This is not required, but we wanted to get the information out to patients about what an ACO was; that we were now providing their basic primary care physician (PCP) services. And we wanted to communicate that as early as we possibly could.

Along with doing those initial mailings, we determined any additional data we needed from our system in order to respond to CMS reporting requirements for 33 quality measures. We took a two-day workshop in November 2012 and realized that not everyone was on the same EMR at the very beginning.

We have a lot of disparity between systems; not all data comes from one system to the next, due to business decisions. We had to go back and determine what we needed from each different system and how long this was going to take. Then we had to figure out how we would normalize or make sure that this data was specific for reporting back to CMS.

In this two-day workshop, we broke it down measure by measure. There are 15 different categories in which CMS places all of their reporting. We went through each — for example, for the emergency area, the hospital and in the physician practices — and asked ourselves what we were doing for each. Just because you’re on one EMR doesn’t mean the data capture model is the same. But I still needed to account for every time those things occurred; they are discretely reportable. That’s not always easy; even though you’re on one single platform, there are a lot of factors that play into why that’s very difficult to get to.

Source: Beyond the EMR: Mining Population Health Analytics to Elevate Accountable Care

http://hin.3dcartstores.com/Beyond-the-EMR-Mining-Population-Health-Analytics-to-Elevate-Accountable-Care_p_4900.html

Karen Furbush is a business consultant with John C Lincoln (JCL) Accountable Care Organization in Phoenix. She is responsible for coordinating and managing all things related to IT integration, data analysis and reporting for JCL’s CMS MSSP ACO and Employee ACO programs. She has over 20 years of technical program and IT management experience, and has held a wide variety of information technology roles in the healthcare industry.

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