By Christine Kern, contributing writer
Survey assesses how ACOs are leveraging Health IT and what obstacles still need to be overcome.
While most accountable care organizations (ACOs) stated health IT has had a generally positive impact on their overall performance, a new study reveals they still face significant barriers in implementing health IT universally. Cost and interoperability are cited as the largest obstacles.
The survey, conducted by eHealth Initiative and Premier Inc., reveals the majority of ACOs have not progressed from simply collecting health data electronically to using electronic data for analysis and care coordination. Very 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, the purpose of which was to assess how ACOs in commercial and federal markets are leveraging health IT, were released during an eHealth Initiative webinar.
“ACOs are seeing growing pains when it comes to their health IT infrastructure,” Jon Dimsdale, director of programs and research at the eHealth Initiative, said during the webinar. “Most were able to put in some key health IT building blocks, but they now face barriers [doing more].”
Among the survey’s findings:
- most ACOs offer an electronic health record (86 percent), disease registry (74 percent), data warehouse (68 percent), and clinical decision support system (58 percent)
- few ACOs report using secure messaging (38 percent), referral management tools (36 percent), phone-based telemedicine (34 percent), or video-based telemedicine (26 percent)
- few ACOs report use of revenue cycle management (28 percent) or customer relationship management (26 percent) systems
- 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.
Ninety-five percent of ACOs surveyed reported they were collecting clinical data using their EHRs and receiving post-adjudicated claims data from local insurers, while sixty-three percent reported collecting pre-adjudicated administrative, billing and financial data on patients from insurers.
Less than 40 percent of ACOs are collecting data from public health registries or directly from patients, the survey said. Less than a quarter of ACOs surveyed said they collect data from remote monitoring devices and sensors or from local or state health information exchange organizations.
Less than a third of ACOs surveyed said they had deployed health IT services to increase patient access to care, such as self-serve scheduling or telehealth tools.
ACOs cited technology costs, a lack of interoperability between EHR systems, a lack of provider engagement and privacy and confidentiality concerns as barriers to adopting health IT tools.
In the survey, all of the 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.