Accountable Care Organizations Struggling with Health Information Technology Interoperability

By: McKenzie Livingston

A recent survey by Premier, Inc. and the eHealth Initiative shows that while most Accountable Care Organizations (ACOs) report having core health information technology (HIT) in place, a lack of interoperability across systems and providers is still a barrier to accomplishing successful health care coordination.

Of the 62 ACOs surveyed, 86% used an electronic health record, 74% a disease registry, 68% a data warehouse, and 58% a clinical-decision support system. In addition, 94% reported using tethered patient web portals, 70% have e-scribing capabilities, and 61% have electronic patient reminders. Clearly, a majority of ACOs have the HIT infrastructure to support quality measurement, population health management, and physician payment and contract adjudication, and they also utilize some form of patient-facing tools to improve efficiency and streamline the administrative process. Furthermore, at least half to two-thirds of the surveyed ACOs reported improvements in clinical quality (66%), preventive screenings and vaccinations (63%), chronic disease management (59%) and health outcomes (55%) through their use of technology.

However, difficulties with data exchange are preventing many ACOs from reaching their full potential. Eighty-eight percent of the surveyed ACOs face significant obstacles in integrating data from disparate sources and 83% percent reported facing challenges integrating technology analytics into workflow. Interoperability of disparate systems is a significant challenge for 95% of organizations using HIT, and could be limiting the abilities of ACOs to exchange data. One hundred percent of the surveyed ACOs reported that accessing data from external organizations was a challenge.

As ACOs grow and collect more data from more sources, these challenges become more serious. They report lower abilities to leverage their HIT infrastructure to support care coordination, patient engagement, physician payment and contract adjudication, population health management and quality measurement. The costs and return-on-investment of HIT are cited by 90% of the surveyed ACOs as a central barrier to further implementations.

As Keith J. Figlioli, Premier’s senior vice president of healthcare informatics and member of the Office of the National Coordinator’s Health IT Standards Committee, explained: “Even when ACOs have successfully adopted and merged HIT systems, they aren’t able to effectively leverage data and analytics to derive value out of their investments given the pervasive issues with data quality, liquidity and access, as well as issues with integrating data from disparate sources.” Unfortunately, “[t]he survey proves this is a pervasive problem among ACOs, and it could stymie the long-term vision for ACO cost and quality improvements if not addressed.”

To access the survey, please click here.

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