ACOs struggle with advanced IT, interoperability, survey shows

Many accountable care organizations are struggling with advanced IT functions and interoperability, a survey of 62 ACOs conducted in July and August 2014 by Premier and the eHealth Initiative shows.

“Most ACOs are still at the stage of basic care-coordination capabilities,” said Bryan Bowles, Premier's vice president of population health solution management, Wednesday on a call discussing the survey. “The challenges of blending disparate data have hindered uptake of more advanced functions.”

For example, while 86% of respondents have an EHR system and 74% have a disease registry, other important IT capabilities lag. Only 28% of respondents can build a master patient index, for example, while 58% have a clinical-decision support system.

ACOs “can't succeed if they can't identify patients in their population,” Bowles said.

The reasons ACOs gave for their IT shortcomings include cost (95%), lack of funding or return on investment (90%), and interoperability (95%). All respondents said access to external data was a challenge, and 88% identified integration and blending of disparate data from other EHR platforms and other sources as a barrier. As a result, 46% of respondents pull data from between one and 10 other platforms. Capabilities like remote monitoring devices lag behind in adoption (26%).

Indeed, using health IT to deliver care at a distance was, in general, rarely adopted with only 38% of respondents using referral management and 34% phone-based telemedicine. Video-based telemedicine lagged even further behind, at 26%. That lack of adoption is particularly concerning for ACOs with rural or under-resourced members, Tracy Okubo, the eHealth Inititative's senior director of health IT stakeholder outreach, stated.

But ACOs who used health IT generally found positive results. For example, 66% of respondents felt it improved clinical quality (with 7% saying it worsened it), and 55% felt it improved health outcomes, compared with 6% who say it worsened.

Some categories, however, reflected challenges with health IT: more ACOs (35%) felt health IT worsened patient satisfaction than improved it (29%). And a large number of respondents felt it worsened provider satisfaction (22%) and didn't reduce ER visits (27%).

The eHealth Initiative is a not-for-profit that does research and advocacy for healthcare IT. Charlotte, N.C.-based Premier is a company that provides group purchasing and performance services to hospitals

Follow Darius Tahir on Twitter: @dariustahir