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Survey: ACOs Have Not Significantly Progressed With Health IT Adoption

August 15, 2014
by Rajiv Leventhal
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Cost, interoperability present biggest challenges for ACOs

The health IT infrastructure of accountable care organizations (ACOs) has not significantly developed since 2013, and cost and interoperability remain the biggest barriers, according to a new survey conducted by the eHealth Initiative and the Charlotte, N.C.-based Premier Inc.

So far, the data is preliminary— 62 responses have been received, which were released during an Aug. 12 eHealth Initiative webinar.

But the data suggests that ACOs have been unable to effectively scale to health IT needs: cost and return-on-investment are crippling concerns (from 14 percent in 2013 to more than 90 percent of ACOs in 2014); interoperability and workflow integration have grown as a significant challenge (from 50 percent in 2013 to more than 90 percent of ACOs in 2014); and ACOs have been unable to staff appropriately (30 percent reported difficulties with hiring trained staff in 2013; today, it is a barrier for more than 66 percent). Overall though, the surveyed ACOs reported that health IT has generally improved performance.

The survey found that most ACOs continue to utilize basic health IT elements for documentation and coordination of care, with few advanced capabilities (e.g. population health, revenue, or customer relationship management systems). But fewer organizations report capabilities to support risk management and patient engagement. Not surprisingly, larger ACOs have more capabilities and are better staffed.

Additionally, access to and exchange of data have generally remained static. Few ACOs (24 percent) currently participate in health information exchange (HIE) or perceive seamless HIE to be strategically important. And 100 percent of ACOs report access to data from external organizations to be a significant challenge.

Other survey results include:

  • Once ACOs reach 18 months of operation, they report substantially more advanced capabilities, data used for analytics, and performance improvements associated with health IT —but also more acute barriers and challenges.
  • Most ACOs offer an electronic health record (86 percent), disease registry (74 percent), data warehouse (68 percent), and clinical decision support system (58 percent).
  • Few ACOs report using secure messaging (38 percent), referral management tools (36 percent), phone-based telemedicine (34 percent), or video-based telemedicine (26 percent).
  • Few ACOs report use of revenue cycle management (28 percent) or customer relationship management (26 percent) systems.
  • Respondents said that bottlenecks could be reduced at most ACOs with a tethered patient web portal (94 percent), e-prescribing (70 percent), and patient notifications and reminders (61 percent).

“Provider satisfaction is falling….and sustainable, scalable success requires long-term vision and planning around the technology required to achieve key objectives and solve specific problems or challenges,” the survey summarized.

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