Access to external clinical data and clinical data integration stand out as the top challenges facing accountable care organizations, according to results from a recent eHealth Initiative and Premier Inc.survey of 69 ACOs.
More than three-quarters of ACOs surveyed (78%) indicated access to data outside their healthcare organizations or networks as the top challenge, followed by close to two-thirds of ACOs (62%) identifying data integration as the major hindrance. Rounding out the list were change management (55%), cost of new health IT (38%), and obtaining provider commitment to participate (33%).
Health IT interoperability proves to be a costly endeavor for ACOs as well. As many as 25 percent of respondents reported spending more than $1 million on developing ACO interoperability. Half that figure (13%) spent between $500k and $1 million and a slightly larger percentage spent between $100k and $500k.
The high costs are tied to the number of health information systems that ACOs need to integrate in order to function effectively. Almost half of responding ACOs reported having to integrate between 11 and 50 health information systems; 39 percent, 1 to 10; 7 percent, 51 to 100; and 3 percent, more than 100.
As for clinical data integration, respondents indicated integrating data from specialty care as a harder activity than other parts of the care continuum (e.g., public payers, laboratories, primary care). Home health (39%), long-term post-acute care (38%), and behavioral health (36%) also present clinical data integration difficulties for ACOs.
Pertaining to health IT infrastructure, ACOs are leveraging technologies in five areas. Most common to these ACOs is analytics software used by 82 percent of respondents. EHR adoption is also high among the ACOs surveyed, with three-quarters having EHR technology in place. The remaining three technologies are care management software (62%), computerized physician order entry (CPOE)/electronic prescribing (eRX), and data warehouses (56%).
A closer look at data use and analytics by the surveyors reveals claims data (96%) and clinical data (79%) to be the most scrutinized data sources for analysis. These forms of healthcare data analytics aim to identify gaps in care (84%) or outliers in cost/utilization (80%) as their primary goals. Motivations for other healthcare data analytics include comparing clinician performance (77%), measuring or reporting on quality (77%), and proactively identifying risk (68%).
While ACOs are making headway in terms of looking internally at their clinical performance, they continue to experience difficulties when engaging patients. Roughly half of responding ACOs (49%) reported difficulty associated with patient engagement. Only 30 percent have tools in place for capturing patient data via electronic forms, and just 20 percent leverage telemedicine to improve outreach to patients.
That being said, a majority of ACOs are using consumer-facing tools to address patient engagement. The most common are post-discharge/care coaching (66%), patient portals (62%), and patient navigators (57%).
The main takeaway from the survey is the need among ACOs for solutions to clinical data integration and exchange to ensure that all members of a patient’s care team are on the same page.
Date: September 14, 2015