Accountable care organizations are designed to be the technologically nimble vanguard of the low cost/high quality shift in healthcare, but data access and integration still are formidable challenges to their success, according to a new survey.

The survey of 68 ACOs—Medicare and commercial—by the eHealth Initiative and Premier Inc. finds that obtaining outside data and integrating data in their networks represent the biggest hurdles.

According to the survey, 79 percent of respondents indicated that obtaining and accessing data from outside the ACO network, especially from specialty care settings, was their most formidable challenge, because of the complexity of developing data sharing agreements and technological interfaces.

In addition, 64 percent reported that integrating data within their networks was another major hurdle, with in-network specialty care settings being the most significant pain point.

“Because ACOs need to integrate specialist systems across all these disparate providers, they must really work to coordinate and manage the care at the individual and population level,” said Mimi Huizinga, MD, vice president and chief medical officer of Premier’s population health management collaborative.

In the survey, 69 percent of ACOs said they have a harder time integrating specialty care data—almost double the number for any other care setting—and more than half (53 percent) revealed that they have not integrated data from behavioral health providers.

At the same time, 48 percent haven’t integrated data from long-term and post-acute care settings, and 46 percent haven’t integrated data from palliative care and hospice. Of all care settings, ACOs said they would most like to have greater interoperability with behavioral health (67 percent) and long-term/post-acute care (67 percent) to support operations.

“We have to manage across our silos of data and start actually integrating. Acute care, ambulatory care, and pharmacy care all has to come together for this to be a realizable goal for our hospitals and our healthcare systems,” added Huizinga.

However, Alex Kontur, manager of research and projects at the eHealth Initiative, says that integrating data is an expensive undertaking, with more than a quarter of ACOs surveyed spending more than $1 million on tackling the problem of interoperability.

Toward that end, 39 percent of ACOs have integrated data from one to 10 health information systems; 44 percent integrated data from 11 to 50 health information systems; and 11 percent integrated data from more than 50 health information systems.

“We think that ACOs are starting to get a handle on some of their internal interoperability issues—that is, connecting systems within their own network. But connecting with systems, providers, and organizations outside of the ACO remains a particularly poignant challenge,” concludes Kontur.

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