Hospitalists often take the lead in the refinement of electronic health records, but many are still struggling to find their place when it comes to accountable care organizations, according to data from the Society of Hospital Medicine.

Accountable care organizations, which are aimed at coordinating care across inpatient and outpatient settings, are becoming more common across the country. More than one-third of adult hospital medicine groups and nearly half of pediatric hospital medicine groups reported that one or more of the hospitals they work in were actively involved in or considering involvement in an ACO, according to an SHM survey conducted from January through March 2014.

But about half the time, hospitalists said that they either didn’t know what their role was with the ACO, or there was no clearly defined role for the hospitalist within the ACO structure. That’s a “concerning finding,” said Leslie Flores, a partner in Nelson Flores Hospital Medicine Consultants.

“That represents an opportunity for hospitalist groups, I think, to get more involved in the ACOs in those places where they have them,” Ms. Flores said during an SHM webinar on the 2014 State of Hospital Medicine report .

Some hospitalists are taking on a larger role in ACOs. The survey found that in about 13% of adult hospital medicine groups, one or more hospitalists was playing a leadership role in the development of the ACO. In nearly 9% of adult hospital medicine groups that responded to the survey, either the group or the individual hospitalists shared in financial risk under the ACO arrangement.

This is the first time SHM has surveyed hospitalists about their involvement in innovations such as ACOs and electronic health records (EHRs).

On the EHR side, the roles are more defined. About a third of adult hospital medicine groups and more than 45% of pediatric hospital medicine groups reported that hospitalists participated in the development of order sets, decision support tools, and protocols for their hospitals’ EHR systems.

On Twitter @maryellenny


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