They are able to receive and share the right data at the right time
Organizations that manage greater risk use the EMR and data differently compared to those under P4P/upside contracts. As organizations prepare to take on risk, a common pitfall is an overreliance on EMR data. Within the confines of the health system, EMR data is indispensable in meeting P4P/upside requirements. However, it falls short in providing the cost and performance data needed to manage care across the continuum. Successful organizations will pull data from many sources including the ED and hospital admissions, patient diagnoses, medical necessity criteria and expected length of stay. Payer data, including historic claims data and real-time utilization management information, is also critical.
Organizations bearing greater risk also need information from all ancillary providers outside of the EMR, from ambulance services to home health and even care provided by family members. The goal is to ensure the patient receives the right care at the right time while moving through the care process as smoothly as possible. All the data to support that goal sits above the EMR.