IT Interoperability, Cost Remain Burdensome For ACOs

By Christine Kern, contributing writer

A recent survey finds formidable barriers stand in the way of successfully bringing IT to ACOs.

A recent survey of 62 ACOs found every one of them reported experiencing difficulty achieving data interoperability with disparate partners, and the information technology barriers for ACOs remain formidable.

The survey, conducted by industry advocacy organization eHealth Initiative and Premier Inc., discovered that not only do the surveyed ACOs have a tough time sending data to others, 88 percent of them reported difficulty integrating data received from disparate sources. An additional 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.

Because ACO partnerships often integrate providers, specialists, and systems across disparate settings into a unified network, they must effectively coordinate care to manage health and risk both at an individual and population level. To do so, they need a robust health information technology (health IT) infrastructure, which allows ACOs to derive actionable value out of information collected from various data sources to build a complete, secure and up-to-date record of a patient’s health and medical history that is easily accessible, shared, and updated over time. The survey demonstrates ACOs are struggling to do that.

ACOs are taking a variety of approaches to developing, deploying, and expanding health IT capabilities. It is therefore important to understand the health IT assets that are needed to improve coordination and convenience. The online survey of ACOs was designed to determine the current capabilities and challenges of health IT implementation across the country. The preliminary data were released during a webinar hosted by eHI.

Overall, the data show that, although most ACOs use basic health IT for documentation and coordination of care, 76 percent of respondents do not take part in health information exchange at any level. Specifically, the data show that, of ACOs reporting:

• 86 percent have an electronic health record system;
• 74 percent have a disease registry;
• 68 percent have a data warehouse; and
• 58 percent have a clinical decision support system.

However, few ACOs reported using:

• Customer relationship management systems, 26 percent;
• Secure messaging, 38 percent;
• Referral management tools, 36 percent;
• Revenue cycle management tools, 28 percent;
• Phone-based telemedicine, 34 percent; and
• Video-based telemedicine, 26 percent.

Survey respondents reported several challenges to greater health IT adoption, with:

• 100 percent saying access to health data from external facilities is a significant obstacle;
• 90 percent saying interoperability and workflow integration are significant obstacles, up from 50 percent in 2013; and
• 66 percent saying that appropriate staffing is a major challenge, compared with 33% in 2013.

In addition, the percentage of ACOs that expressed concerns about cost and return on investment rose from 14 percent in 2013 to more than 90 percent.

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