IT Interoperability, Cost Huge Burdens for ACOs

A survey of 62 accountable care organizations finds 100 percent of respondents have difficulty achieving data interoperability with disparate partners. And that’s just the tip of the iceberg; the information technology barriers for ACOs remain formidable.

Industry advocacy organization eHealth Initiative and Premier Inc. conducted the online survey in July and August of 2014. Not only do the surveyed ACOs have a tough time sending data to others, but 88 percent reported difficulty integrating data received from disparate sources. In addition, 83 percent are struggling with integrating analytics into workflow.

The cost and return on investments of health information technologies also has become “a crippling concern for more than 90 percent of respondents,” according to survey results, available here.

Most respondents have an IT infrastructure supporting quality measurement, population health management, and physician payment and contract adjudication. Other core components include electronic health records, disease registries, data warehouses and clinical decision support. And most have deployed some patient-facing tools such as web portals and patient reminders.

“However, more advanced capabilities to support patient engagement remain in their infancy,” according to the report. “Few organizations use patient-facing tools that could increase access to care, nor are they well-equipped to use secure messaging, referral management tools, or telemedicine. Even fewer offer patients self-management tools such as remote monitoring devices, untethered personal health records or smartphone apps. Given that many of the new ACOs are forming in rural and/or underserved areas, this is a concerning finding that organizations may be unable to leverage health IT to effectively manage populations in remote geographic areas.”

(See also: Dueling Views on ACO Success)

Other survey results include:

* Analytics are not yet being robustly used. Most ACOs are not getting data from a state or disease registry, health information exchange, or remote monitoring devices and sensors, nor are they accessing patient-reported data or unstructured textual data.

* Because of high concern over IT cost and return on investments, the industry may be entering a slow-down in IT spending over the long term “and inhibit provider efforts to scale systems to additional care settings and platforms,” according to the survey report. Most ACOs have not made significant improvements in their IT capabilities compared with those in a similar 2013 survey.

* Health IT is bringing modest improvements in health outcomes, cost and efficiencies, and quality of care such as chronic disease management and preventive screenings and vaccinations.

The biggest improvements during the past year have been in reduced hospital admissions, readmissions and emergency department visits.


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