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ACOs Complain Current Health IT Systems Thwart Cost Savings

By John Reichard, CQ HealthBeat Editor

September 24, 2014 -- The Obama administration boasts of successes launching accountable care organizations (ACOs) and fostering adoption of health information technology systems. But the two aren't coming together the way they are supposed to in an effort streamline the delivery of health care.

That was the complaint in a survey of ACOs jointly released last week by Premier Inc., a hospital consortium, and the eHealth Initiative, a nonprofit whose members include doctor, patient, insurer, public health and other groups.

ACOs aim to deliver team based care using health IT systems to coordinate treatment, share medical histories and test results and order tests and prescriptions with fewer errors. But the failure of health IT systems to work together seamlessly blocks these goals, said Premier Senior Vice President Keith Figlioli.

The lack of interoperability is a pervasive problem for ACOs, he added. "It could stymie the long-term vision for ACO cost and quality improvements if not addressed."

Figlioli is a member of the Health IT Standards Committee of the Office of the National Coordinator for Health Information Technology at the Department of Health and Human Services.

Using IT systems, ACOs are supposed to be able to pull in data from sources including hospitals, labs, doctors, pharmacists, and other caregivers.

Most acquire from fewer than 10 other entities. As they try to incorporate more, they're less able to coordinate care and measure quality, the survey sponsors say.

The cost of the systems is supposed to be recovered through cost savings, but the survey of 62 ACOs says they aren't receiving that kind of return on investment.

"The cost of interoperability can be prohibitive for many organizations," said Jennifer Bordenick, chief executive officer of the eHealth Initiative.

HHS is fielding numerous complaints about its inability to foster interoperable systems more quickly. But hospitals themselves balk at the regulations aimed at pushing interoperability, urging delays. Health IT Coordinator Karen DeSalvo is trying to prod a wide variety of health industry stakeholders to agree on a common plan to move toward interoperability over the next several years.

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