Ok I thought I might get called on this one, but the reality here is a data and health IT system well done and in a closed system. See what progress is made when not having to integrate and aggregate multiple systems can produce? We have too many of them out there and this is the issue we have to deal with today and why the job is getting so expensive. There’s even times when it’s time to migrate, and ouch, the data folks cringe at that alternative, but it can be done but data integrity and processes to take on massive transfers are not like the old days used to be. 
Migration though if a system is that old and antiquated can still be the ultimate though to bring some scalability into the picture. Back to Kaiser, they started their home work a bit ahead of many too and I remember when they wrote their own and spent millions and canned it to bring in Epic. It’s a huge job and they had to bring a lot under one roof though too, but perhaps they did not have the vast numbers of vendors clawing at the door and they had to migrate data to Epic from their own internally written program.
Kaiser Permanente also has their innovation and learning center that has been around for a while that is also a model for others. The work on both high tech and low solutions here. I learned a lot about what they do when I spoke with them last year. Good stuff.
Innovation and Learning at Kaiser Permanente – Interview With Chris McCarthy
Here’s a group with a big bounty carrot hanging out there for some good algorithms.
Heritage Providers Continues to Promote $3 Million Dollar Prize to Create An Algorithm To Predict and Prevent Hospitalizations
We also have technology with the new left curve everyday that we have to look at and see if emerging technologies need to be incorporated into the growth process. Some will and some will not. There has to be one big burial ground on medical code somewhere around this earth and it’s big, and you know we still have Junker code being written. Now like technology and used to write code myself, but darn when everyone comes out with an application that does one thing and throws it out on the market, it’s over load. If those one thing developers would get together and bring some “6 thing” products to market and collaborate like everyone talks about we could save some time here, and some room on this blog for that matter. 
This is where the “hands on” folks come into play. Your average consumer has not clue on the code behind what makes those screens look so cool, and they shouldn’t have to either, but smart scrutinizing IT folks, well the first thing they usually think of is how does this integrate? Do we need middleware and is this “one thing” going to change the world? 99% of the time it does not. Even Pharma is getting smart out there and dumping a lot of this type of software. We’ve passed that stage of the cool screens and movements as they all have it now. Pharma is also looking for that 6 thing or better software application.
Pfizer, J&J & Merck Remove Health IPhone Apps-Realization of the Need for “Meaningful Mobile Apps” in Healthcare And Little Value With Apps that Only Do “One Thing”
Pharma Invests in Mobile-Phone Apps on One Hand and On the Other Hand Pharma Companies Dump a Ton of Their Apps Too
Long and short, for ACOs, you need the right algorithms to make it all work along with some predictive business intelligence numbers to get started in the right direction so before decisions are made, simulations can take place and hopefully keep the “unintended consequences” down to a minimum as there will always be some, but cutting out the potential obvious is a help. When we look at numbers to help us make decisions too let us not forget we have this side that functions out there among us too, good book to read. BD
“Proofiness–The Dark Side of Mathematical Deception”–Created by Those Algorithms
"When I think of HIT systems that have the capability currently to cross the continuum of care, Kaiser Permanente is one of the only systems that come to mind, and even Kaiser's systems have some limitations," says Marion Jenkins, CEO at QSE Technologies, an Englewood, Colo.-based systems integrator with more than 150 ambulatory I.T. implementations.
A reality check: As of January 2011, only 55 hospitals across the nation have achieved Stage 7, the highest level under the HIMSS Analytics scale of health I.T. capabilities, and 35 are Kaiser hospitals. Jim Adams, managing director at the Advisory Board Company consultancy and a former leader of HIMSS Analytics, says even Stage 7 hospitals aren't ready for ACOs.
Consequently, Jenkins warns providers to beware of I.T. vendors touting their products as fully capable today of supporting ACOs. "There's a lot of Kool-Aid getting served up."
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