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ACOs thwarted by lack of interoperability

January 27, 2016
by Pamela Tabar, Editor-in-Chief
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Accountable Care Organizations (ACOs) are designed to improve care quality and reduce costs by synchronizing the efforts of all players in the care delivery chain and sharing responsibility for quality outcomes. But, according to a new report from Premier and the eHealth Initiative, ACOs still don’t have the one thing they need to succeed: data system interoperability.

In “The Evolving Nature of Accountable Care: Results from the 2015 survey,” published this week, nearly 80 percent of the 68 responding ACOs reported issues integrating data from out-of-network providers, while 70 percent reported problems with getting data from specialists back to the primary care physician. Almost half said they couldn’t achieve data integration with long-term and post-acute care providers, including skilled nursing, palliative care and hospice.

The results aren’t necessarily a surprise, since most data integration incentives have been focused on individual health system networks—and predominantly acute care. “The real challenge is successfully moving and integrating that data across dozens of different systems, and we’ve found that out-of-network practices often lack the proper incentives to make investments in the data sharing agreements and interoperable interfaces necessary for success,” said Jennifer Covich Bordenick, CEO of eHealth Initiative, one of the publishers of the report. “This lack of liquid data is creating dry spots in care delivery, making it difficult for ACOs to proactively intervene with needed care. Until [health IT] systems across the continuum can exchange data freely, we handicap ACOs in their quest to achieve healthcare’s Triple Aim of better health outcomes, quality and costs.”

Interestingly, the No. 1 health information technology used by ACOs is data analytics software. But without chain-of-care data integration, the data analytics will reflect only part of the quality outcomes improvement story—the metaphorical cart before the horse.

“Although ACOs have successfully merged some HIT systems, data access is just the tip of the iceberg,” said Mimi Huizinga, MD, vice president and chief medical officer of Premier’s Population Health Management (PHM) Collaborative, at a press call about the report. “Today, providers are doing the lion’s share of integration work themselves, making it difficult to establish interoperable connections with those that are not part of the ACO. Even when those connections exist, that’s really just the first step in a long process of establishing a technical environment to work with the data, create a full view of the care experience and then digest the results across the care team. We urgently need public policies to require interoperability standards in HIT so that providers can access data from any system and unlock the true potential of coordinated, high-quality, cost-effective healthcare.”

Read the ACO report here.