Survey: Accountable care organizations struggling with out-of-network integration, interoperability

Respondents said the more care settings and providers visited by a patient, the less likely the initial provider would receive patient data from those appointments.
By Jessica Davis
11:41 AM
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Although the majority of organizations have made health IT a priority, integration and interoperability are still major hurdles for accountable care organizations, according to a Premier survey released Wednesday.

In fact, 80 percent of ACOs called integrating data from out-of-network providers the biggest health IT challenge they face.

"We don’t live a perfect world," Mimi Huizinga, VP and CCO, Premier Inc., said in conference call. “It would be great if providers or patients could log in and see a complete record.” But there have been many challenges.

"No one system is able to provide universal information – the systems were designed to operate independently. And there's a significant cost to integrate," she added.

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Premier surveyed 68 ACOs of which 79 percent provide care to Medicare patients; 44 percent to commercially-insured patients; 35 percent to Medicare Advantage patients; 35 percent to employer-based patients and 24 percent to Medicaid patients.

Around 70 percent of ACOs reported great difficulty when attempting to integrate data from specialists, especially from those out-of-network. Respondents said the more care settings and providers visited by a patient, the less likely the initial provider would receive patient data from those appointments.

EHRs today aren't seen as the most useable or user-friendly, while we're starting to whittle down the amount of information, it's not easy to get actionable data, Baystate Health Vice President Joel Vengco, said in the call.

Baystate Health is a nonprofit integrated health system in Springfield, Massachusetts that serves more than  750,000 patients through a network of more than 80 medical practices.

"What we're trying to achieve at Baystate Health is to get data from these source systems and out through a data extraction or liberation process, into a platform that transforms that data," Vengco added.

It’s a challenge many health institutions are facing.

About half of the ACO respondents haven't been able to integrate data from long-term and post-acute care providers and more than half have yet to integrate any data from behavioral health providers. Furthermore, 46 percent said there was no integration with palliative and hospice facilities.

While integration is challenging, the ACO respondents are still capturing and using data within their network. 74 percent of respondents have EHRs in their institutions, with 84 percent using analytics software. Ninety-six percent use this data for adjudicating claims, 76 percent for EHRs or other quality measurement systems and another 84 percent use the data to find gaps in care.

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Despite the potential, only 26 percent of ACOs use telemedicine technology and only 29 percent use electronic forms to capture patient data.

"On the population side, we can start thinking about this new way of caring for individuals for more informed, more complete care," Huizinga said. "But the shift can be challenging for institutions."

"It requires thinking about data in a different way and integrating the data to be actionable and meaningful," she added. "We have to cross silos; we all have to come together for this to be a realizable goal."

Twitter: @JessiefDavis