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Do You Need An EMR To Make ACOs Work?

Posted on February 28, 2011 I Written By

Katherine Rourke is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

Right now, as things stand, only a small percentage of medical practices have fully implemented EMRs (about 15 percent), research suggests.  But the trend toward integrating physicians in Accountable Care Organizations is moving much faster.

I don’t have stats to hand, but everything I’ve read and heard suggests that the provider community is a lot more comfortable with the ACO concept than EMR adoption.

The thing is, can ACOs advance without higher EMR adoption rates?  I don’t think so.  To my mind, if you want to integrate medical practices and hospitals — with the goal of managing quality jointly — a shared EMR seems virtually indispensable.

During the first wave of ACO adoption, we’re seeing tie-ups between mid-sized to large practices and large health systems.  Those large practices are reasonably likely to have EMR systems in place, and just as importantly, an IT department to support them.

But if ACOs models are to work, they’ll eventually have to embrace smaller practices, which make up the vast majority of U.S. medical groups overall. And if those groups are either EMR-less or just getting started, it’s going to be pretty tough to share value-based payments, coordinate across episodes of care and track quality jointly.

Yes, hospitals can give doctors access to their own, industrial-grade EMRs — and some do — but ultimately, EMR use will have to be part of the smaller practices’ culture for ACOs to work.

And while medical practices will understand ACOs, particularly if they’ve been through lots of fashionable hospital-practice partnership models, EMRs will still be tough to swallow.

So, ACO backers, do you think you can move ahead if your physician partners aren’t EMR-connected and savvy?  Or are we looking at a big problem here?

The Impact of Healthcare Reform on Medicine

Posted on December 1, 2010 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

I must admit that I don’t post that often about healthcare reform and the changing doctors practice. Not to mention things like the Accountable Care Organizations (ACO) and other trends in healthcare. Although, I do watch them peripherally and in many cases these changes are important in relation to EMR since they impact what the future of EMR might look like.

So, I was pretty interested in a post by Barbara Duck about the impact of Healthcare Reform on medicine as we know it today. Barbara has a quote which describes the change:

“Healthcare reform will usher in a new era of medicine in which physicians will largely cease to operate as full-time, independent, private practitioners accepting third party payments.”

Then, she quotes a study which describes how medicine will change and the four possible courses that physicians will take amidst all this change.
• Work as employees of increasingly larger medical groups or hospital systems
• Establish cash-only practices that eliminate third party payers
• Reduce their clinical roles by working part-time
• Opt out of medicine altogether by accepting non-clinical positions or by retiring.

This information isn’t all that new. I also have read many people who just see this as the same cycle that we’ve seen before. I think that’s probably true, but it’s still a cycle that should be considered going forward.

Assuming the above assumptions are correct, does that spell the end of the small practice EMR software? Essentially it would leave only EMR software that supports larger medical groups or hospital systems and EMR software that handles cash only practices (something every EMR vendor would probably love to do).

Personally I don’t see it as the end of small practice EMR software. Although, it definitely will see a shrinking of the market for that software. At least temporarily.