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HIE Acquisitions Represent a Partial Approach to Care Coordination

Alan Gilbert, Vice President of Business Development, AxSys Health
January 3, 2011



Aetna's acquisition of Medicity, Ingenix's acquisition of Axolotl, and the IBM/ActiveHealth Management partnership are three recent indicators of the changing healthcare IT vendor landscape - one that is in the process of consolidating to more sharply focus on the needs of collaborative and coordinated care. These merger and partnership agreements validate the need for an overall technology platform to support the rapid rise of healthcare models like Accountable Care Organizations (ACO) and the revitalization of established approaches such as Patient-Centered Medical Homes (PCMH).

Emerging constructs for care coordination require technology to facilitate data sharing across organizational boundaries - a paradigm shift that will soon characterize healthcare. However, there's one major problem. Despite the industry buzz these company consolidations have created, there have been very few resultant technology platforms that have seen real-world implementation; and even fewer that have demonstrated true cross-organizational, comprehensive care coordination.  

Anticipating the "market of the future," some technology vendors are taking a MacGyver approach: a little bit of twine, a bent paperclip and some chewing gum to create a workable IT solution. By cobbling together various software products, they hope to string together an approach that will permit customers to meet the goals of new models and regulations - and cement their own position in the marketplace.

A superior approach may be found in a cohesive solution that was built from the ground up to specifically serve the needs of a collaborative and coordinated care platform. Some of the key components in this collaborative platform include:
  • Interoperability Layer
  • Enterprise Master Patient Index
  • Semantic Mapping
  • Access Control and Security Framework
  • Team Management and Collaborative Clinical Network Management
  • Clinical Care Process Modeler
  • EMR Framework
  • Data Analytics
  • Alerts and Notification Management
  • Patient Portal/Patient Health Record (PHR)
  • Electronic Prescribing
  • Specialist Clinical Applications
  • Chronic Disease Management
  • Utilization Management
  • Case Management
One has to look across the pond to the United Kingdom for examples of these types of established, collaborative care solutions, many implemented and in use for more than 10 years. Examples include solutions that provide management of gynecological cancer across a region of hospitals and 2.5 million people, management of cleft lip and palate patients, a 20-year care plan that starts at birth managed across the entire country of Scotland, or a regional group that manages chronic obstructive pulmonary disease (COPD) patients.

Without a doubt, healthcare systems and other organizations in the United States are beginning their search for tomorrow's technology in anticipation of catching up with their international colleagues. What should they ask themselves throughout the process?
  • How many vendor solutions are needed to form a complete ACO?
  • If buying products from multiple vendors, are the products integrated or interfaced? If not, when does the vendor plan to offer this?
  • Can the selected solution support widespread care coordination - both within an organization and beyond its walls?
  • Will the solution support data exchange with multidisciplinary care teams and other stakeholders?
  • Can the selected solution accommodate legacy systems so those investments can continue to be leveraged?
  • Can the vendor point to successful implementation of a chosen solution, and users that can provide an assessment of the technology?
  • Does the selected solution have a multi-layered security platform?
There's nothing wrong with looking to tomorrow's technology for today's solutions; but vendors with a history of successful coordinated care solution implementation should be given serious consideration.


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Alan Gilbert is the Vice President of Business Development for AxSys Health, which specializes in the development and implementation of clinical solutions to improve and coordinate the delivery of healthcare.










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