The Three A's of a Successful Agency

In a time of diminishing resources and ever-changing regulations, today’s providers are entering a new era of care characterized by increased oversight activity and a shift in service delivery from volume-based to value-based, among other changes. Success in the new environment will require more complex methods of documentation, and a new approach to management incorporating a special focus on three A’s: accountability, accessibility and affordability. Providers will need to be accountable to more people and in new ways than ever before. As a result, they will need to promote accessibility (as appropriate) to a large array of data, and be able to obtain this data in a means that is affordable. An electronic data management system is critical to accomplishing these goals.

Accountability is defined as meeting the obligation to report, explain or justify something in a responsible, answerable, explicable way. Administrators, managers, practitioners and staff at all levels of the organization must be aware of the lines of accountability, and determine the best ways to measure it for both external and internal needs. For external requirements these metrics may be predetermined, but for internal ones, metrics need to be developed and used as a tool in agency and outcome management. Data alone is not the key to success, though – you’ll also need the ability to analyze and present it. Raw data may satisfy some of your external needs, but you'll need to link the right pieces of data together to create information that tells a story and helps you make informed clinical and administrative decisions.

Whether examining your accountability to services recipients, families, your board of directors, staff, state or federal government, or other stakeholders, a set of quality useful metrics need to be developed and the data obtained to calculate these metrics. Accessibility is the degree to which you can make your data available to as many relevant people as possible. Questions to ask about your data are: “Is it easily entered? Easily retrieved? Easily understood? Easily used?” It’s critical to know who needs access to your data: direct care workers, senior administration, billers, supervisors, consumers, community members, regulators and others. Then you need to know for each group how they want to access the data: whether on a desktop computer or mobile device, in real time or report-based, and whatever other factors are relevant. Mechanisms and procedures need to be developed that ensure key staff have access to and knowledge of the system so they can review the data on an ongoing basis.

All of this must be accomplished in a manner affordable to the agency. Affordability is based on an assessment of the cost of action versus the cost of inaction. Can your agency find the dollars for an electronic health record (EHR)? In this new climate of health information exchange, the more pressing question is: “Can you afford not to have an EHR?” Investigate the consequences of not having a data management system, and find ways to help defray the costs. Consider state and federal grants, philanthropic opportunities and the potential for increased revenue a quality EHR/data management system can create. Lost accreditation, lost business lines, loss of funding or reduced rates are real possibilities without the ability to provide data to those to whom you are accountable.

Change is here, and it’s happening rapidly. Data interoperability is not just nice – it is mandatory as the nation embraces health information exchange. A functional EHR is critical to applying the three A’s because it will place at your fingertips the information you’ll need not only to sell yourself to funders and system overseers externally, but to provide the wisdom to guide your clinical and operational decisions internally, ensuring success for your agency.