Underfunded Technology Creates Barriers on Road to Value-Based Care

Center for Connected Medicine survey pinpoints obstacles related to patient engagement, data aggregation and analytics, and precision medicine.

As the healthcare industry marches toward value-based care, a new survey points a finger at the culprits inhibiting progress: limited resources and lack of reimbursement for the underlying technologies.

The third annual Top of Mind for Top Health Systems survey from the Center for Connected Medicine (CCM) identifies patient engagement (which includes patient portals and telemedicine), data aggregation and analytics, and precision medicine as priorities that are "highly connected to the shift from fee-for-service to value-base care."

While health systems are heavily investing in the first two initiatives, and expect precision medicine to play an increasingly important role in the years ahead, financial barriers to widespread adoption remain. Also interesting: the report says lack of patient adoption slows patient engagement initiatives, and vendor's unwillingness to share data creates data aggregation roadblocks.

"Health systems are moving toward a risk-based world where they will have a bigger financial stake in better managing the health of their patients," says Pamela Peele, Ph.D., chief analytics officer of UPMC Health Plan and UPMC Enterprises in a news release. Access to patient data along with the ability to analyze it, keeping patients engaged in their health, and delivering more effective treatments, she says, are "essential to managing risk.”

“Finding the money to deploy these important technologies, while managing the other financial pressures health systems face, is a challenge for all health care providers,” Peele adds. She serves as a member of the steering committee for the CCM, which is jointly operated by GE Healthcare, Nokia, and UPMC.

The report was compiled based on a survey conducted May through August 2019 by KLAS Research, which gathered input from 70 leaders at 65 health systems across the country. Nearly half of respondents were chief information officers, while the rest were at the executive and director level. Highlights include:

Patient Engagement

Patient engagement initiatives have accelerated at health systems due to the focus on consumerism in healthcare, as well as a need to for patients to proactively manage their care and choose less costly care options, according to the report.

• Patient portals and telemedicine are the technologies most often deployed in health systems’ patient engagement efforts, the report indicates. Telemedicine is the most common investment priority.
   
• Some 82% of respondents say their health system’s patient portal, which is commonly an extension of the electronic health record, is the dominant technology for engaging with patients. Telemedicine is used by 33% of respondents.
   
• While patients are increasingly demanding a digital experience on par with what they have in other areas of their life, adoption is still low. On average, 35% of patients have adopted the technologies that are available to them, according to the report.
   
• Respondents identified patients (46%) as the biggest barrier to the adoption of patient engagement technology with lack of reimbursements following closely behind (41%). Organizational barriers (39%) were cited as the third most common sticking point.

Data Aggregation and Analytics

The ability to aggregate and analyze data from multiple sources is essential for health systems that want to produce better outcomes and reduce costs, according to the release. "Effective and comprehensive data aggregation has the potential to enable better clinical decision-making and power population health management efforts, making it a top priority as health systems attempt to shift to value-based care," says the report.

• On average, respondents report having 71% of data from clinical sources integrated; leaders said an average of 61% of all patient data, including claims and other non-clinical data, was integrated.
   
• Limited resources, lack of data standards, and poor utilization were cited as the greatest barriers to complete data aggregation, along with lack of standards. "… aggregated data is useful only if it is accurate, and poor normalization and standards inhibit organizations from being able to trust the data they have," the report says.
   
• Nearly half of participants report that the barriers they encounter are due largely to health IT vendors, according to the report. "Health IT vendors are viewed as the most common source for data aggregation roadblocks," the report says. "Some vendors are unwilling to facilitate data sharing, and even minor differences in data formatting and naming conventions can make it impossible to aggregate and compare patient data."

Precision Medicine

With its potential to improve clinical outcomes, precision medicine is a growing area of interest for health systems, the report indicates, but few have engaged in this endeavor, according to the survey.

• Nearly 70% of interviewed organizations report low maturity or no deployment of precision medicine.
   
• High barriers to entry and uncertain funding models so far have limited adoption, according to the news release.
   
• Reimbursement and earning a return on investment were cited as the biggest roadblocks to adopting precision medicine.

The full report is available from CCM, which seeks to drive improvements in healthcare through technology.