EMR Matrix | Accountable Care Organizations and Electronic Medical Records Comparison

Organizations are rapidly working to create and effectively deploy Accountable Care strategies in an effort to create closed systems that moderate costs and increase revenue from allocated ARRA funds.   A critical piece of the Accountable Care continuum is the patient and more specifically how you engage the patient effectively.

Patient engagement is a phrase thrown around in the industry a great deal and has stemmed hundreds of start ups trying to find the “holly grail” of patient engagement and hoping to crack the nut of keeping patients engaged.  Patient connectivity is the technical process of connecting to a patient, which is easy.  What is tough is actually getting connected to the patient and more importantly keeping that patient connected.   No patient wakes up thinking they need to connect with their provider and likewise most providers don’t wake up wishing they could connect to their patients.  Some providers polled even indicated patient communication is actually not what they want as they fear it would distract from patient care delivery.

If you were to ask any patient or general consumer, not a single one has initiated regular communications with their provider leveraging social networking style communication.  However these same patients have hundreds of friends via Facebook, post on Twitter and share on Instagram.   How is it consumers are so incredibly connected over the web but not to their care network?  It comes down to context.

Contextualization is a phrase coined in the eCommerce industry as the ability to deliver the right experience to the right person on the right device at the right moment.   The last modal of this concept, the device, is a newer dimension to engagement and potentially the most effective.

What Does Patient Engagement Mean To An ACO

The Accountable Care Organization concept relies on process and a system that can connect patients and consumers to their providers and the extended care team.  Many of these systems are currently independent systems that rely upon an integration with an existing electronic medical record system or practice management system but regardless these systems must be core to the process.

Principles of Provider to Patient Centric Systems

1.  Make It Actually Work For The Provider

So many times independent systems do not fully integrate or integrate without a focus on a user friendly, seamless integration that is job based (focusing on the clinician being able to finish a task or job easily) simply to check the box.

Creating a fully integrated, usability driven provider to consumer system must start with the job completion aspect in mind and should be driven by usability principles.

2.  Design A System Based Upon Personas

Persona driven design relies upon creating core characters and the jobs they want to complete.   Persona driven design allows software and web development teams build experiences that meet the needs of their end users.   However, most (and I would bet all) clinical system integrations do not use design principles when trying to integrate disparate systems within a health system because most of the systems are “rip and replace” and often times are large, monolithic software stacks that themselves were built purely based upon functions and not based upon job completion.

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3.  A Unified Communication Strategy

In order to create a true patient communication strategy that enables an Accountable Care Organization a unified communication strategy must be designed and implemented.   This UCS strategy overlays patient communication touch points with the technology solutions necessary to reach each patient.  Although this is commonsense, doing this in a way that eliminates a fragmented experience can be challenging.  Moreover, a high priority has now been placed on reaching the patient or consumer where they are at when they need the information so they feel it is contextual, relevant and value added.

Another important element of this UCS is the need to adhere to communication preferences and translate those preferences across each system.

5.  Measurable Analytics

Analytics and outcomes are critical for measuring patient engagement and ensuring meaningful outcomes.  This goes beyond the traditional clinical  outcomes measurements that use PQRI and ARAQ measurements and moves more towards marketing analytics that focus on engagement and conversion.  Conversion in this context means converting a patient to an engaged patient and keeping them loyal to the interactive experience.

A Focus On Acquisition

Acquisition is the word to describe how you either bring existing patients onto your platform or service or proactively recruiting new patients into your system.   This is a concept that is somewhat new to the clinical system as in the past clinicians expected patients to come and find them.  They patients would either find the provider via word of mouth or promote their offices through traditional offline channels.  The new model is far different and potentially far more lucrative.


In order to succeed in this new world of Accountable Care and coordinated care, organizations must think holistically and choose systems that can be seamlessly integrated together focused on user experience and the end job or task in mind.  Systems must adhere to design principles that are just common sense in other industry verticals and adopt concepts like the, “Don’t Make Me Think” usability mantra coined be Jesse James.

Patients have evolved and so must health information technology if it wants to survive in this new era of connected care.



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