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Ankota: Home Care Next Generation Blog

Health IT, EMRs & EHRs Falling Short in Accountable Care

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We hear it all the time: Electronic Medical Records (EMRs) will solve everything. Patients won't be hurt by mistakes, vast numbers of readmissions will be avoided, and the cost of healthcare will go down.

Uh, yeah...right. 

 Dave Chase EMR quote

The reality is this: EMRs & EHRs are necessary, but they are not sufficient. Why? 

In a FierceHealthIT article Experts Express Different Views of EHR's Future in Accountable Care Health IT expert and former Accenture consultant Dave Chase explains, "The two big problems with today's EHRs is that 1) they were designed for a "do more, bill more" payment system that's on its way out; and 2) they are not nimble enough to cope with a rapidly transforming healthcare environment. In addition, he noted, systems like those of Epic and Cerner 'have their strength in automating internal workflows of hospitals and other clinical settings.' That works fine in acute care, where providers make the decisions, but they are not well-suited to chronic care, which requires a lot of patient engagement, he said."

Eric Coleman Quote

Accountable Care requires a focus on Care Transitions and coordinating providers. Provider "Ecosystems" will rapidly emerge, and will be enabled by technologies like Ankota's Xchange Care Coordination platform. 

"EMRs/EHRs are all about data and billing," says ankota CEO Will Hicklen. "They are a great place to collect and store data so that providers can get paid under the old model. They are even excellent at managing well defined workflows within hospitals." Hicklen adds, "The big limitations of systems like EPIC and Cerner are that they 1) are not well suited to manage chronic conditions, which require a heavy dose of proactive, and community based care, and 2) they never anticipated addressing healthcare delivery models outside of hospitals, on which Accountable Care depends." As more and more care is delivered outside of hospitals, a tremendous need has emerged for systems that can manage these transitions, coordinate many types of providers, and provide oversight and transparency to operations. 

The most effective care transitions initiatives also include behavioral health and even some non-medical services, which presents additional challenges in managing this "ecosystem." For example, the occurance of depression and anxiety has been shown to worsen medical outcomes, yet most patients are never screened or treated for these conditions. By coordinating with medical providers, behavioral health specialists can identify and treat conditions earlier, saving huge amounts of money and helping patients to get healthier faster. The medical community also widely recognizes that certain non-medical care improves medical outcomes. Support services in the home, often called Private Duty Home Care, and even dental services have also been shown to lower healthcare costs and improve outcomes. These models depend on a community of third party providers. These tend to be complex businesses with highly mobile workforces, too. It is important that the providers of these services be well coordinated, and in constant communication with medical providers. "The system has to be transparent, where one hand knows what the other is doing and it's all in a coordinated, deliberate effort," says Hicklen. 

Never before has it been more critical to reduce avoidable readmissions, manage chronic disease, and manage population health. Ankota's Xchange Care Coordination technology is leading the way in enabling Care Transitions programs. 

For more information about Ankota's Care Coordination technology, click this great big orange link 

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Additional Reading:

Dr. Eric Coleman, Care Transitions Program 

FierceHealthIT, Experts Express Different Views of EHRs... 

iHealthBeat Health Systems Spendingn Billions to Prepare for the 'Last War'

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