Are we standing at the threshold of a major change in the nations healthcare delivery model? With the rules for accountable care organizations (ACOs) finally out, we examine some early models for accountable care organizations in the story on page 18.

The answer to this question will vary across facilities and by scope and function of the CDR. However, there are common denominatorsincluding high-quality, accessible data and, increasingly, scalability.

Patient monitoring is key to excellent patient care. Southeast Alabama Medical Center (SAMC), a 420-bed facility in Dothan, Ala., is an innovator in this space, standing at the forefront of progressive cardiac patient monitoring. Sponsored by an educational grant from Drager.

Swift, effective care and smart economics rest on getting patients through the emergency room as soon as possible. IT that delivers patient flow data plays a major role in maximizing efficiencies within the emergency department (ED).

A familiar saying has been applied to accountable care organizations. Theyre like unicorns: Everybody knows exactly what [ACOs] look like, but no one has ever seen one, says Barry Bershow, MD, of Bershow Consulting, in Chanhassen, Minn.

A revamped image management strategy is becoming a necessity for many organizations, as large files overtax storage infrastructures. With imaging study size and volumes increasing and business models in flux, its not getting any easier, but some organizations are finding a way to manage.

Clinical data repositories have been around a long time, at least 20 years in one form or another. I had the opportunity to participate in an experiment, of sorts, with a CDR used as an ambulatory EHR. We were asked to do a very simple test: To see legacy system scheduling for outpatient care at the University of Michigan, and allow that to be viewed side by side with a new system. We used a web-based app, and a SQL database to store information.

Practice Fusion, a web-based EHR system provider, has developed an iPad EHR tool.