ACOs Struggle with Health IT Capabilities, Survey Finds

Although accountable care organizations report that health information technology has generally improved their overall performance, they face significant barriers in implementing health IT--cost and interoperability being the biggest hurdles.

A new survey, conducted by eHealth Initiative and Premier Inc., reveals that few ACOs currently participate in health information exchange or perceive seamless HIE to be strategically important.

Preliminary results of the national 2014 survey of ACOs--to date 62 responses have been received--were released during an Aug. 12 eHealth Initiative webinar. The purpose of the survey was to assess how ACOs in commercial and federal markets are leveraging health IT.  Among the survey’s findings:

*Most ACOs offer an electronic health record (86%), disease registry (74%), data warehouse (68%), and clinical decision support system (58%);

*Few ACOs report using secure messaging (38%), referral management tools (36%), phone-based telemedicine (34%), or video-based telemedicine (26%);

*Few ACOs report use of revenue cycle management (28%) or customer relationship management (26%) systems; and

*Most ACOs continue to utilize basic health IT elements for documentation and coordination of care, with few advanced capabilities (e.g. population health, revenue, or customer relationship management systems).

In addition, while the majority of ACOs in the survey have a health IT infrastructure that can support activities related to quality measurement, population health management, physician payment and contract adjudication, fewer organizations report capabilities to support risk management and patient engagement.

Preliminary data also indicates that the health IT infrastructure of ACOs does not appear to have significantly progressed since the last survey in 2013, with access to and exchange of data having generally remained static. In particular, interoperability and workflow integration have grown as a significant challenge from 50% in 2013 to more than 90% of ACOs in 2014.

In the survey, 100% of ACOs report access to data from external organizations continues to be a significant challenge. And, most ACOs have yet to incorporate data beyond immediate clinical or claims-based records. The good news is that once ACOs reach 18 months of operation, they report substantially more advanced capabilities, data used for analytics, and performance improvements associated with health IT--but also more acute barriers and challenges--according to the survey results.