If the patient experience is defined as nothing more than a problem to be solved, then there is already an even bigger problem at hand. The shift toward more sophisticated levels of accountability in patient health outcomes is evidence of a new focus on the experience of the patient.
Many have referred to the shift in the reimbursement model from fee-for-service to outcomes-based as the motivation for accountability in the patient experience. However, physicians have for generations fostered relationships with peers in their community of care that have included accountability for the patient experience.
The shared savings aspect of accountable care organizations (ACO) has proven to be, at least initially, an incentive to build models of coordination within communities around the country. However, regardless of the clinic’s participation in one of several ACO models — from the Pioneer ACO Model and Medicare Shared Savings ACOs to non-Medicare and commercial models — defining expectations for accountability in its process of care is a necessary step in both the patient experience and the ongoing use of EHR systems.
For patients, including those family caregivers or the like acting as their advocates, the term ACO may not have any meaning. With the myriad medical terms in the context of any patient experience, it’s easily an overwhelming task to keep track of so many acronyms and their definitions. What’s more, when you consider the driving force for participating in an ACO being the recognition of shared savings through the coordinated care, it further increases the obscurity from the patient’s point of view.
The benefit for physicians of sharing a patient’s EHR data is one aspect of accountable care that does not have to be linked to an ACO for the patient to benefit in the moment. Whether it’s a referral for some continuity of care or guidance in understanding a complex health condition, this aspect of community is not defined by the acronym ACO or EHR.
As someone who has been acting as a patient advocate for my mother-in-law for over a year, I’ve seen and appreciated all of the data in the EHR. Unfortunately, her patient experience has been defined by vascular cognitive impairment and Alzheimer’s disease. With every encounter, physicians and nurses have been open with that data in the EHR and even helpful if offering their guidance regarding the meaning and implications of that data. The problem is that with this diagnosis the health outcome has resembled a free-fall.
As we’ve navigated this patient experience as a family, those natural relationships among physicians in our community have been invaluable to us, exceeding well beyond the data. Sometimes the greatest value in the drive for the “ideal,” whether it’s a model of accountability or the clinic’s relationship with an EHR vendors, lies in recognizing the value in your own community. Source
