Abstract
Background:Since the inception of Accountable Care Organizations (ACOs), many have acknowledged the potential synergy between ACOs and health information technology (IT) in meeting quality and cost goals.Objective:We conducted a systematic review of the literature in order to describe what research has been conducted at the intersection of health IT and ACOs and identify directions for future research.Methods:We identified empirical studies discussing the use of health IT via PubMed search with subsequent snowball reference review. The type of health IT, how health IT was included in the study, use of theory, population, and findings were extracted from each study.Results:Our search resulted in 32 studies describing the intersection of health IT and ACOs, mainly in the form of electronic health records and health information exchange. Studies were divided into three streams by purpose; those that considered health IT as a factor for ACO participation, health IT use by current ACOs, and ACO performance as a function of health IT capabilities. Although most studies found a positive association between health IT and ACO participation, studies that address the performance of ACOs in terms of their health IT capabilities show more mixed results.Conclusions:In order to better understand this emerging relationship between health IT and ACO performance, we propose future research should consider more quasi-experimental studies, the use of theory, and merging health, quality, cost, and health IT use data across ACO member organizations.
Highlights
Introduction and BackgroundAccountable care organizations (ACOs), one of the delivery system reforms set in motion by the Patient Protection and Affordable Care Act (PPACA), have continued to grow in number [1]
Accountable Care Organizations (ACOs) could use electronic health data (EHD) to measure physician performance, inform quality improvement initiatives, identify population health needs, and facilitate clinical information exchange [10, 11]. These capabilities largely depend on the implementation and continued development of health information technology (IT) efforts among the member organizations, especially adoption of electronic health records (EHR) and use of health information exchange (HIE)
In order to synthesize this diverse body of literature, studies were grouped into streams based on one of three purposes: health IT as a determinant of ACO participation, health IT as an outcome, and how health IT relates to ACO performance (Table 1)
Summary
Introduction and BackgroundAccountable care organizations (ACOs), one of the delivery system reforms set in motion by the Patient Protection and Affordable Care Act (PPACA), have continued to grow in number [1]. This work emphasized two key mechanisms for success: first, exchange of electronic health data (EHD) among organizations to coordinate care and second, performance tracking within an ACO To these ends, ACOs could use EHD to measure physician performance, inform quality improvement initiatives, identify population health needs, and facilitate clinical information exchange [10, 11]. ACOs could use EHD to measure physician performance, inform quality improvement initiatives, identify population health needs, and facilitate clinical information exchange [10, 11] These capabilities largely depend on the implementation and continued development of health information technology (IT) efforts among the member organizations, especially adoption of electronic health records (EHR) and use of health information exchange (HIE). Conclusions: In order to better understand this emerging relationship between health IT and ACO performance, we propose future research should consider more quasi-experimental studies, the use of theory, and merging health, quality, cost, and health IT use data across ACO member organizations
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