The technology being used by accountable care organizations is fairly limited, according to a new survey of 69 ACOs recently conducted by the eHealth Initiative. While 75 percent used EHRs and 62 percent offered a patient portal, only 20 percent used some kind of telemedicine and 30 percent use electronic forms to capture patient data.
"We think this shows technology isn’t really central to patient engagement activities right now," Alex Kontur, manager of research and projects at eHealth Initiative, said in a recent webinar. "It’s unclear how much health IT is supporting these care transitions and planning programs, but when asked about certain activities, nearly half of ACOs reported having difficulties engaging patients, which seems to suggest that the technology side isn’t quite up to snuff yet. So aside from the patient portal, some of the technologies that we’ve imagined ACOs would be using, things like telemedicine or interactive forms, they’re not widely used by ACOs today."
Eighty percent of the ACOs surveyed served Medicare populations, 45 percent were commercial, 36 percent were Medicare Advantage plans, 35 percent were employer-based, and 25 percent served Medicaid populations. Eighty percent used a shared savings contract model and 35 percent used some kind of enhanced fee-for-service model.
When asked in general what kind of software they used, respondents named analytics software (82 percent), EHRs (75 percent), care management software (62 percent), computerized order entry (57 percent), and data warehouses (56 percent). But 49 percent of respondents said they had difficulty engaging patients, so eHealth Initiative also asked what patient engagement tools specifically were being used.
While a relative few offered telemedicine or electronic data capture, 66 percent offered post-discharge care coaching, 62 percent offered a patient portal, and 57 percent offered a patient navigator software. Fifty-four percent offered notifications or reminders for preventative care and 48 percent offered notifications or reminders for gaps in care.
The biggest challenge to ACO operations came from interoperability and capturing data from outside organizations' own networks, Kontur said.
"A majority of ACOs now have those foundational IT pieces in place but they have to connect them so they can support advanced functions like care coordination across the network," he said. "Difficulties obtaining and integrating data are really steeped in the interoperability challenges ACOs are facing."
Forty-four percent of respondents said they have 11 to 50 integrated systems and 39 percent have one to 10. Just 10 percent had more than 50 integrated systems.