With January's CMS announcement that another 121 Accountable Care Organizations have been certified, the total now comes to 477 ACOs in 49 states and the District of Columbia. As the new bundled payment, shared savings, and shared risk programs fall into place over time, these ACOs will be looking to coordinate care with the post-acute care community to keep costs under control and hospital 30-day readmissions down. Wise HHAs and Private Duty agencies are turning to technology to give themselves a competitive edge.

What remains to be determined is which post-acute providers these ACOs will select as partners and which will be left to battle with each other over the few remaining Medicare beneficiaries not enrolled in ACOs. In addition to the competition that will be generated among providers for the relatively few ACO partner slots that will be available (early experience indicates that ACOs prefer to partner with no more than five or ten home healthcare agencies), the ACO movement is also certain to generate competition between in-home and institutional healthcare sectors. As proof, "SNF Diversion" programs are already being pitched by in-home care providers to Medicaid officials in a number of states.

TECHNOLOGY  To improve their chances of winning ACO partnerships, some healthcare at home provider agencies are turning to technologies that will supply a competitive edge. In response, inventors and investors are collaborating to create a variety of care coordination tools, seeking to capture a share of a broad market that will span nearly every acute and post-acute healthcare sector.

We examined one of these emerging technologies recently. Whether it will be the one that dominates the market remains to be seen but its concept and goals are representative of the category.

"MedAware Solutions" is a mobile knowledge sharing system designed to securely connect care teams with each other and with patients and their families. It hits the market with an impressive pedigree. MedAware is based on a platform originally designed for the Department of Defense for use by elite Special Operations teams and was customized for use in healthcare with input from and beta testing by Cedars-Sinai Health System in Los Angeles. Product development and launch are being guided by an advisory board that includes former Wisconsin Governor and former HHS Secretary Tommy Thompson, founding Medical Director of Express Scripts Thomas Zink, MD, and Jeff Garibaldi, a CEO with a history that includes startups that accumulated a combined 55 patents.

According to company VP Christian Carlson, "After a highly successful military demonstration of the solution, an innovative technology company known as Coolfire pursued an opportunity to extend its offering into healthcare through an engagement with Cedars-Sinai." 

Carlson continued, "The new solution, launched in 2014, enables patient-centric sharing of critical information via smartphones and tablets to minimize disruptions in workflow that can impact patient care." The concept, he explained, is that when every member of an individual's dispersed, multi-disciplinary care team has fingertip access to a chronological stream of real-time clinical information, benefits accrue to patients, payers, and providers.

Clearly, the list of disciplines that touch a patient, either a person in crisis or someone with one or more chronic conditions, can be lengthy. EMS Teams, Trauma Surgeons, ER Doctors, OR Staff, Radiology, Pharmacy, Hospitalists, Specialists, Skilled Nursing, Home Health nurses and therapists, all typically attempt to collaborate and handoff through telephones, pagers, fax machines and other 20th-century tools. With smart phone or tablet access to real-time patient data stored in the cloud, details such as patient name, imagery, age, vitals, mechanism of injury, risk, ETA, duration of care, location, alerts, conversations, and medication history are shared by all members of a patient's dispersed care team.

MedAware delivers the information to each patient-centric thread in a variety of formats appropriate to each data type, including voice messages, video clips, photographic images, text messages, imaging results, lab tests, and written clinical observations. The data is transmitted via a highly secure, HIPAA compliant platform that enables access from hospitals to homes with complete control over granting specific permissions to each user. 

If MedAware company materials are correct that fully implemented care coordination could save the U.S. Healthcare system $240 billion, expect to see more tools like this one.

Tim Rowan, MA, is the Editor and Publisher of Home Care Technology Report. He has been a student of home care technology since 1993 and a national voice on the subject since 1999. He can be reached at

©2015 by Rowan Consulting Associates, Inc., Colorado Springs, CO. All rights reserved. This article originally appeared in Tim Rowan's Home Care Technology Report. Reprinted by permission. One copy may be printed for personal use; further reproduction by permission only.

By Tim Rowan, Editor, Home Care Tech Report on Saturday, January 23, 2016