Executive Summary Essay Example



Chicago-based Capstone ACO leads the way in health improvements, as it has established a reputation for improving quality and personalization of patient care. However, optimal healthcare benefits are yet to be realized through the Medicare Shared Savings Plans. Currently, ACO members use EMR systems, which make sharing health data limited electronically. Other problems include exposure to human errors, lack of access to medial notes by patients and delays in communication.

This report proposes that patient activation associated with OpenNotes can improve performance metrics and maximize shared savings rewards. The OpenNotes project is expected to improve patient engagement, satisfaction, accurate patient information, and decreased medical cost and patient stay. Indeed, because of increased patient engagement due to OpenNotes, the Medicare Shared Savings payment is expected to be maximized by nearly 20% of $6,500,000.

This consultative report provides a background of the challenges that Capstone ACO has to contend with in its EMR system, and as a result suggests the implementation OpenNotes to replace the present system. It further describes the clinical and financial rewards that can be expected from OpenNotes.

Purpose / Objective:

The purpose of this project is to provide an assessment of the current state of the Capstone ACO, its operations, strengths, weaknesses, and opportunities for improvement. The project identifies OpenNotes as a possible solution to the challenges encountered in using the existing system. The proposed application is supported by evidence-based research of OpenNotes in clinical settings with financial data generated from current healthcare trends within the context of Capstone ACO.

Key Findings and Conclusions

The RSSV survey revealed that EMR systems used at Capstone ACO lead to limited data sharing, delays in transmission of data via fax, delays in communication, and failures in ADT alert system, which compromise the quality of care. These include difficulties in sharing data electronically.


The proposed workflow relating to OpenNotes is designed to enhance current workflow by bridging gaps between clinics and patients. Patients will also have the ability to share their data electronically by means of OpenNotes. It is further expected that as OpenNotes initiative progresses to the advanced phase of implementation, such as remote monitoring of patients, management of chronic medical conditions will improve.


As such, the OpenNotes is not an option for Capstone ACO; it is a requirement. RSSV consultants promote and support any initiative that improves clinical quality and reduces cost of care. We encourage full participation of all stakeholders in this project as it would benefit them on the long run. We recommend phased approach of OpenNotes implementation, as it would create least amount of disruption to current workflow and higher acceptance from providers and patients.


Maximizing the rewards associated with implementing OpenNotes would require employee training. The training plan entails: determining the scope of the training, developing training pre-requisites, coordination or management of the training, and lastly identification and collation of training pre-requisites.

Additionally, with OpenNotes, the patient will be acting as an advocate for own care, empowered with their clinicians various notes. To supplement this approach, an electronic interoperable network should be established. The first phase on the path to ACO enterprise-wide interoperability is engaging the providers and their designees. The second phase entails evaluating the data structure and interoperability exchange capabilities. In the third phase, the IT liaison would need to perform outreach to engage providers.

The implementation of the OpenNotes project is expected to take eighteen months. Although monitoring for success will be continual throughout the implementation process.