Current challenges designing for Accountable Care Organizations (ACOs)

Some 10-15 years ago HIPAA came into play creating a scramble to meet the privacy constraints. Later EMR regulation via CCHIT and other “certification authorities” were born to authorize Electronic Medical Record systems. Compounding this, all medical providers must incorporate Electronic Medical Records into their practice by 2014 or be fined. Over the past year there has been a new mandate for all medical providers and or groups to become Accountable Care Organizations (ACOs). This includes single providers, small practices all the way up through medical centers. This will supposedly allow someone in or outside the org or practice to determine how well the patient population is doing.

One of the interesting spots of concern is that there are currently no interfaces for this “person” to see how well, rate, grade or even view the providers patient population yet alone the patients wellness. I’m also unclear on who should have access to this information. Those are a lot of unknowns that need to be surfaced asap in the form of Standards and Guidelines.

Here are a few of my questions to create an effective UI for ACO users:

1. What information needs to be surfaced? Patient Names, Provider Names, Address, Phone, Age, SSN, Sensor Data, Number of Monitors (fitbit, scales, etc), Wellness Programs they subscribe to, Overall population and individual wellness levels, amounts spent by patients, total amounts spent by ACOs to cover the care, cost of the visit or procedure?

2. Who should be able to see this info, and do we need to set permissions? Providers, Patients, Admins, Insurance agents?

3. How much transparency should Patients have? Should there be a usage log the patient can look at? See who and exactly what was viewed?

4. How much of the record and social networking within the ACO takes place here?

5. What really needs to be in the interface?

6. What APIs need to be in place?

7. Is this the new patient / provider portal? How opaque are the view points? Do we all finally see the same thing so both the provider and patient become accountable?

Who really should be accountable? The ACO is more than just the provider network; its a collective partnership between the patient and the care coordinator / providers office. The ownness of wellness for the past several years has been shifting to the patient, and although its not there yet, this move to ACO management could be the ultimate opportunity to place the responsibility of care on both patient and provider.

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