ACOs held back by poor interoperability

Premier, eHealth Initiative find IT to be both help and hurdle to accountable care
By Mike Miliard
10:54 AM
health IT

Most accountable care organizations have health information technology in place to improve quality and lower costs, but many say difficulties with data exchange are keeping them from reaching their potential.

[See also: ACO start-ups in IT-buying mode]

Of the 62 ACOs polled by Premier healthcare alliance this past summer, 88 percent report "significant obstacles" in integrating data from disparate sources. Also, 83 percent say they have a hard time fitting analytics tools into their workflow. As ACOs grow, gathering data from more and different care settings, these challenges become more accute, according to Premier.

Cost and ROI are also cited as key roadblocks to more effective implementation of health IT, according to 90 percent of respondents.

[See also: Accountable care requires right tools]

Even when ACOs have successfully merged health IT 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," said Keith J. Figlioli, Premier's senior vice president of healthcare informatics, in a press statement announcing the findings.

The numbers reported in the survey suggest interoperability is a "pervasive problem among ACOs, and it could stymie the long-term vision for ACO cost and quality improvements if not addressed," Figlioli added.

The good news is that ACOs are reporting heartening improvements in clinical quality (66 percent), preventive screenings and vaccinations (63 percent), chronic disease management (59 percent) and health outcomes (55 percent). But those percentages could be even higher.

"While accountable care organizations are providing quality care for many patients, even more could be accomplished if interoperability issues were addressed," said Jennifer Covich Bordenick, chief executive officer, eHealth Initiative. "However, the cost of interoperability can be prohibitive for many organizations."

In a Sept. 24 call discussing the report's findings, Bryan Bowles, Premier's vice president for population health solution management, noted that this new era of shifting risk from payers to providers requires a lot of these organizations, necessitating that they manage health at both an indvidual and population level, and make smart use of clinical, claims, financial and administrative data.

Mercifully, "you have to do it all, but you don't have to do it at the same time," said Bowles.

Indeed, ACOs nationwide exist at very different levels of IT maturity, said Tracy Okubu, senior director of HIT stakeholder outreach at eHealth Initiative.

"The majority of the surveyed ACOs have some sort of health information infrastructure that can support quality measurement, population health management and physician payment and contract adjudication," said Okubo.