An accountable care organization (ACO) formed by Johns Hopkins Medicine, several Baltimore-Washington-area hospitals and three medical practices stumbled early because of challenges including electronic medical record (EMR) systems that didn't talk with one another, ACO leaders wrote in the current issue of the journal Academic Medicine.
The experiences of the Johns Hopkins Medicine Alliance for Patients, which was formed in January 2014, provide lessons for other academic medical centers looking to partner with community providers in an ACO, Johns Hopkins Medicine said in an announcement. The ACO comprised 2,900 providers caring for 37,000 Medicare beneficiaries.
In addition to dealing with integrating data and generating quality measure reports from disparate EMRs, other initial challenges included receiving and analyzing claims data, governance and trying to engage providers. All "affected timely deployment of the early interventions," according to the study abstract.
Academic medical centers trying to network with community providers can consider working with community practices in a nonemployment model, the paper noted. To be successful, such strategies "will continue to require thoughtful strategic planning and a keen understanding of local context," the authors concluded. The alliance created three regional advisory councils to try to get local leadership involved.
The article focused on academic medical centers in the Medicare Shared Savings Program, the most common type of ACO.
Lessons are beginning to come in from other ACOs as well--some positive, some not so much. Data integration is emerging as a major issue.
For example, data sharing and improved care coordination helped a Wisconsin ACO operated by Integrated Health Network and UnitedHealthcare perform above care quality goals in its first year, FierceHealthcare previously reported. The ACO analyzed care gaps and ER and inpatient care use, and took action based on its findings.
A recent eHealth Initiative population health survey found that common problems in population health management initiatives include barriers to interoperability and data integration, along with competing priorities for health IT.