Over the last several months, this blog has covered topics focusing on various aspects of IT and its impact on long term care. In our Thanksgiving Day blog, we observed how important IT has become to all of us – in how we work, how we communicate, how we entertain, how we educate, how we conduct business; IT is everywhere. Although slow in adopting technology, LTC providers have made significant progress in understanding, valuing, and embracing IT as a powerful tool to meet ever-changing challenges. For example, twice we demonstrated this fact as we momentarily digressed from IT-specific topics to alert readers about changes to billing therapy services to Medicare and avoiding workforce-related lawsuits.

These are trying and potentially dangerous times for the economy in general and long term care in particular. The vital role that IT can play in helping LTC providers survive reminds me of the African gazelle. The gazelle can reach a peak speed of 48-50 mph outpacing many of its predators. However, the cheetah can reach 0 to 60 mph in about 3.3 seconds with a top speed of 70 mph. You do the math. Since gazelles are a favorite meal for cheetahs, the difference between life and death is sustainability vs. spurts of brilliance. Cheetahs can only sustain such high speeds in bursts; gazelles on the other hand can maintain their top speed for miles. They can also make sharper turns and initiate quick changes of direction with minimal reduction in speed. Cheetahs cannot. Although slower, gazelles have the advantage if they are alert, sure-footed, and responsive to threats and opportunities.

Likewise, to survive and thrive, to outpace the “cheetah’s” of poor reputation, burdensome and sometimes conflicting regulation, competition, and reduced reimbursement, LTC providers must be on guard, quick to respond, and nimble. However, they also need vision. To blindly charge day-to-day into the fray without a clear understanding of what is going on around them and within their operations, can be suicidal. Data mining and business intelligence can help providers discover, discern, and act on the data they already have. In real time, digital dashboards can reveal business-critical information (Key Performance Indicators – KPIs) displayed in ways that easy to understand.

In 2011, we also discussed how important protection of your IT assets and data is and why disaster plans must include IT. “After the fact” is too late. Also, IT asset management (ITAM) can help providers to track and protect their IT assets, use, and storage.

Just over the horizon loom major changes in health care, ACOs being one of those changes. The significance of ACOs to IT in long term care can be found in the need for interoperability and IT infrastructure. Whether ACO’s pose a threat or an opportunity will depend on the specific market served and the provider’s willingness and ability to respond. Being uninformed and ill prepared is like a deer facing on-coming headlights. The prospect of becoming health care road kill is not appealing.

Question: IT is here to stay, are you on board? In what ways has IT helped your operation?

I argue that Accountable Care Organizations (ACOs) do not represent a health care delivery revolution, but an evolution. Based on my experience in LTC and what I’ve been reading on the Internet, ACOs appear to be an evolutionary variant of the species known as HMOs. Regardless, ACOs represent a significant change to health care delivery. The ACO model will have a sweeping impact on how health care is planned for, delivered, documented, reported, and paid for. It follows that for an ACO to work, information technology serves as the glue that holds it together; those providers who have successfully worked with HMOs can attest to the critical role IT plays. Participation as ACO members will require providers to carefully evaluate what such participation will have on their respective IT systems.

Let’s explore this in more detail.

An ACO is a group of providers and suppliers of services that cooperatively deliver seamless, high-quality care to Medicare beneficiaries while reducing costs. Therefore, ACO providers must coordinate, deliver, document, monitor, and report patient care not only in terms of the quality of the care delivered, but the costs related to that care. The key word here is “interoperability.” This means the ability of health information systems to work together within and across organizational boundaries in order to advance the cost-effective delivery of healthcare. Interoperability involves seamlessly integrating data and information within each organization and among all providers who participate in an ACO.

More expansively, “interoperability” includes:
• Moving data among all providers
• A consistent data presentation
• A uniform user interface or controls
• Data security and integrity
• Uniform protection of patient confidentiality
• Consistent system service quality

In other words, each provider must at least have a fully-integrated clinical and financial system in place. This system must reliably, securely, and with interoperability communicate with other ACO members’ systems.

So, what’s the impact on a provider’s IT infrastructure? In general, the IT infrastructure will need to include:

So, if ACO’s are in your organization’s future, will you be ready?
• Do you know where IT is today and what you will need?
• How much will it cost to get IT up and running quickly, securely, and affordably? With outsourcing* - sooner than you think and with little to no capital.
• How much will it cost to maintain it? It’s less expensive than you may think.

If ACOs are not in your future, is the IT infrastructure checklist relevant? We’ve found that if you think it is, you’re ahead of the curve. However, if you think not; we urge you to think again.

*Cloud-based managed hosting infrastructure, services, and solutions have helped LTC providers leverage any and all such opportunities, such as ACOs offer, quickly and affordably.

Questions:
Are ACO’s in your future?
What impact do you think ACOs will have on IT?

How the Cloud can help you meet today’s opportunities more rapidly

OK. So what is “the cloud?” In general, cloud computing refers to anything that involves delivering hosted services over the Internet. Because the cloud symbol has been used for a long time in flowcharts and diagrams to represent the Internet, the use of the term, “cloud computing,” is logical. So what’s the recent buzz about cloud computing - especially for health care providers?

To the point, virtualization, distributed computing, and improved access to high-speed Internet have accelerated interest in cloud computing. Indeed, but what’s the benefit?

Cloud computing technologies enable companies to access and pay for only the needed capacity and increase capacity as soon as required. This means that cloud computing is efficient, flexible, and scalable. Because cloud computing usually is a subscription-based model that extends a company’s IT capacity, it’s very affordable. Companies who leverage the cloud can increase their IT infrastructure and computing capacity without having to invest in new infrastructure, e.g. the hardware; hiring, training, and retaining new personnel; administrative overhead; and licensing issues.

How the Cloud can help you meet today’s challenges and opportunities

The path of cloud computing is probably the most direct route for any company to reach its IT goals to empower growth and to stay competitive. It avoids the roadblocks and difficult-to-surmount obstacles of:

• Capital investment, including purchasing, maintaining, upgrading, and replacing hardware, such as servers,
• Additional IT staffing,
• Burdensome administrative overhead, and
• Potential risks to on-premise resources are exposed by offering redundancy, high availability, and disaster recovery provided at a significantly lower cost. 

Cloud computing can be deployed rapidly and frees up a company’s internal resources to focus on strategic issues while leaving the day-to-day IT operations to service providers who have superior technology, experience, support, expertise, best practices (including security with UTM and VDOM technologies), interoperability, and economies of scale.

Example: Health care, ACOs, and the Cloud

Let’s look at health care and ACOs, for example. ACOs (Accountable Care Organizations) can represent an opportunity, a threat, or something to be ignored. If you are a health care provider, I will assume you understand ACOs and what they mean to your organization. The real question is, if you view ACOs as an opportunity, are you ready to work together with other providers to coordinate patient care and share in the savings and risks of doing so? For ACOs to succeed, they need IT across the entire continuum of their membership. At a minimum, your organization must be ready to:

• Identify the patients/residents you care for
• Be able to measure, analyze, and assign costs to the care you deliver
• Input, store, retrieve, and compile the data into useful information for all members of the ACO and CMS
• Produce periodic aggregated reports
• Conduct patient/resident satisfaction surveys
• Have EHR in place
• Alter the way you deliver the care to improve outcomes while reducing costs
• Be able to monitor all of the above in real time.

This takes information automation to a new level of IT capacity and functionality which many providers do not posses and cannot see how to afford let alone implement quickly.

Conclusion

The “cloud” can help businesses acquire the IT infrastructure and tools in a relatively short period of time. As an ACO member, health care providers can focus their internal resources on identifying ways to reduce costs and improve quality as the cloud works behind the scenes to retrieve, protect, deliver, and report the metrics needed.

My questions for you:

Is your organization entertaining the idea of participating as a member of an ACO?

What IT challenges is your organization facing and how are you planning to meet those challenges?