Data Transparency will make or break Accountable Care Organisations

Wikipedia describes the silly season as “the period lasting for a few summer months typified by the emergence of frivolous news stories in the media.”

Through July and August newshounds across the country were on the search for the weirdest and the best that the animal kingdom can throw at us. In recent years for some reason squirrels seem to have dominated, but any number of cats and dogs wait patiently in line to have their day.

Health is not immune to its own silly season of course (“FitFlops: can they really help you lose weight? – The Telegraph 12th August) but at the end of July there emerged a story that for the NHS could prove historic.

On 30th July the ever excellent Health Service Journal broke the story that Northumberland CCG was planning to hand budgets and functions to a provider led Accountable Care Organisation (ACO)1.

Whatever your view of the accountable care experience in the United States, this is a story that is anything but frivolous. As the HSJ highlighted, the move in Northumberland represents a big move away from the current commissioner/provider split.

For many working in healthcare the purchaser/provider modus operandi is all they have known and I would include myself amongst their number. If accountable care is indeed a movement whose day has come then this is going to take a huge cultural shift to deliver the new operating model that is required.

Ultimately this is about people not institutions, and as with all great movements, be they corporate or social, the starting point is an almost messianic desire on behalf of the ‘believers’ to make change happen.

We need more of these people and I wish them every success.

I have described in previous blogs key characteristics that define accountable care organisations. I will not repeat myself here.

What is worth repeating is that if we are to move to a world where we incentivise collaboration – focusing on population wellness as opposed to just fixing illness and where we target outcomes for health and wellness that matter to whole populations – then we need to make transparent as much of the existing health and social care data that is currently at our disposal.

In the world of accountable care the measurement of outcomes across the care continuum requires transparent measurement and monitoring tied to incentives.

With data transparency comes data sharing2. It is accepted of course that we need to find a balance between privacy and the need to share and access data across health and social care providers.

We have yet to achieve that balance.

The delivery of value based healthcare, at the heart of which is the measurement of outcomes that matter to patients, will require data transparency reforms which for many of us working in health analytics appear a world away.

Then again Comet 67P/Churyumov-Gerasimenko was some six billion kilometres distant and we cracked that.

It’s just that when changing the operating model for healthcare we haven’t got 10 years to get there.

1 Exclusive: CCG plans handover to ‘accountable care organisation’

2 Data Sharing blog post by Graham Head