IMPLEMENTING INFORMATION SYSTEMS MANAGEMENT INTO HEALTHCARE PRACTICES TO OPTIMIZE MEDICARE EFFICIENCY

Information systems have become an integral part of organizations seeking to achieve efficiencies and quality in a variety of industries. The healthcare industry is no exception especially as the industry shifts to a... [ view full abstract ]

Information systems have become an integral part of organizations seeking to achieve efficiencies and quality in a variety of industries. The healthcare industry is no exception especially as the industry shifts to a predominately information systems focus for tracking and treating patients. This shift has accelerated with the introduction of the Affordable Care Act. With over 100 sections falling under Title III (Improving Quality and Efficiency of Health Care), the Affordable Care Act (ACA) has impacted the way healthcare professionals track and interact with patients. Healthcare practitioners and administrators must focus on efficiency from the point at which the patient establishes care through the process of filing with insurance. An additional outcome from the ACA has been the establishment of Accountable Care Organization (ACO) for Medicare practices to increase quality and efficiency of care. ACOs are groups of coordinated healthcare providers who agree to be accountable for quality, cost and overall care of Medicare patients. However, the challenge with ACOs is the coordination and execution of these guidelines. The use of information systems management is an essential approach in meeting these requirements. This paper examines how information systems impact the efficiency of healthcare practices, specifically the optimization of Medicare efficiency. The objective of this research is to explore how healthcare providers seek to meet the requirements of the ACA while maximizing efficiency and customer service. Empirical data, a discussion panel, and interviews from a large, private medical physician’s office are used. This research provides insights into the challenges of transitioning physicians’ offices to achieve and maximize efficiencies with the ACO through the use of information technology. An important contribution of this work is to identify and expand on best practices for meeting both ACA requirements and ACO guidelines through the use of information systems that can be implemented into other healthcare practices with the potential to influence quality and efficiency in healthcare.