ACOs Report Access to Out-of-Network Provider Data is

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News Desk 2018
ACOs Report Access to Out-of-Network Provider Data is Biggest HIT Challenge, Premier, Inc. and eHealth Initiative Survey Finds

CHARLOTTE, N.C. & WASHINGTON, D.C., Jan. 20, 2016 (GLOBE NEWSWIRE) -- Despite steep investments in health information technology (HIT), accountable care organizations (ACOs) still face interoperability challenges that make it difficult to integrate data across the healthcare continuum, according to survey results published today by Premier, Inc . (NASDAQ: PINC ) and eHealth Initiative (eHI).

The survey, which included responses from 68 ACOs, found that integrating data from out-of-network providers was the top HIT challenge for ACOs, cited by nearly 80 percent of respondents. Nearly 70 percent reported high levels of difficulty integrating data from specialists, particularly those that are out-of-network. In addition, the more settings of care and number of providers a patient sees, the less likely it was that their data was sent back to the primary care team responsible for coordinating care. More than half of surveyed ACOs report they have not yet been able to integrate any data from behavioral health providers. In addition, 48 percent reported no integration with long-term and post-acute care settings, followed by palliative and hospice facilities (46 percent).

“These results are not surprising. We know that it’s relatively simple for providers within the same organization using the same systems to share information about their patients. 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. This lack of liquid data is creating dry spots in care delivery, making it difficult for ACOs to proactively intervene with needed care. Until HIT 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,” said Jennifer Covich Bordenick, CEO of eHI.

Despite the hurdles, many ACOs have been able to start capturing and using data from sources within their networks. Nearly 85 percent of respondents report they have in place advanced analytics software to analyze disparate data sets. The most commonly used data sources include adjudicated claims data (96 percent), followed by clinical data from electronic health records or other quality measurement systems (76 percent). Less common data sets include administrative data (52 percent), disease registry data (39 percent) and patient reported data (38 percent). ACOs report using the data to identify gaps in care (84 percent), spot outliers in cost/utilization (80 percent), compare clinician performance (77 percent), measure/report on quality (77 percent) and identify areas of potential risk (68 percent).

In addition, ACOs report use of additional health information technologies to support network operations. Most prevalent are EHRs (74 percent), care management software (61 percent), computerized physician order entry (57 percent) and a data warehouse (55 percent). Nearly half of ACOs are also using other tools to facilitate population health management, including integrated claims and clinical databases (48 percent) or a population health dashboard (44 percent) that providers can use to visually compare performance. However, despite the potential of telemedicine for collaboration and communication, relatively few ACOs currently use the technology (26 percent). And fewer still utilize remote monitoring tools (16 percent) to facilitate care management outside of clinical settings.

“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. “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.”

The 2015 ACO survey consisted of 19 questions, including demographic data about the ACO, their HIT infrastructure, measures of interoperability, integration, and data use and related challenges. The survey was sent to members of eHealth Initiative, members of Premier’s PHM Collaborative and public contacts at Medicare Shared Savings Program ACOs. The survey was administered electronically in August of 2015. Sixty-eight ACOs responded to the survey. Survey respondents included a mix of Medicare and commercial ACOs.

About eHI

About eHealth Initiative: eHealth Initiative (eHI) is a Washington D.C.-based, independent, non-profit organization whose mission is to drive improvements in the quality, safety, and efficiency of healthcare through information and information technology. eHI is the only national organization that represents all of the stakeholders in the healthcare industry. Working with its membership, eHI advocates for the use of health IT that is practical, sustainable and addresses stakeholder needs, particularly those of patients. For more information, visit www.ehidc.org .

About Premier, Inc.

Premier, Inc. (NASDAQ: PINC ) is a leading healthcare improvement company, uniting an alliance of approximately 3,600 U.S. hospitals and 120,000 other providers to transform healthcare. With integrated data and analytics, collaboratives, supply chain solutions, and advisory and other services, Premier enables better care and outcomes at a lower cost. Premier, a Malcolm Baldrige National Quality Award recipient, plays a critical role in the rapidly evolving healthcare industry, collaborating with members to co-develop long-term innovations that reinvent and improve the way care is delivered to patients nationwide. Headquartered in Charlotte, N.C., Premier is passionate about transforming American healthcare. Please visit Premier’s news and investor sites on www.premierinc.com ; as well as Twitter , Facebook , LinkedIn , YouTube , Instagram and Premier’s blog for more information about the company.

CONTACT: Morgan Guthrie, Premier, Inc.; Morgan_Guthrie@PremierInc.com ; 704.816.4152

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