The 7 Challenges that ACOs face with COPD Care

Accountable Care Organizations (ACOs) face several challenges that can impact the quality and effectiveness of care for their patients with Chronic Obstructive Pulmonary Disease (COPD). Here are the seven common challenges that we hear frequently cited by ACO leaders:

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1. Fragmented Care: High quality COPD care frequently requires multiple healthcare providers, including primary care physicians, pulmonologists, respiratory therapists, and others. Ensuring effective communication among these providers is challenging, which can lead to fragmented care and potential gaps in treatment.

‍Quick Tip: using integrated tools that can automate alerts and workflows across providers can help provide consistency of COPD care.

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2. Care Coordination: A key goal of ACOs is to coordinate care across different healthcare settings. However, achieving seamless care coordination between primary care, specialty care, hospitals, and post-acute care providers can be difficult. In the case of COPD, patients may require hospitalizations, rehabilitation, and ongoing management, requiring effective transitions of care.

‍Quick Tip: automating workflows and alerts, as well as standardizing reporting for tests like spirometry, can drive simpler and more consistent coordination across providers.

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3. Patient Education and Self-Management: COPD is a chronic condition that requires ongoing self-management by patients. However, many patients may lack awareness about their condition, proper inhaler techniques, and strategies for symptom management. ACOs and healthcare providers face challenges in educating and empowering patients to actively participate in their own care.

‍Quick Tip: home monitoring programs can help drive improved patient self-management.

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4. Resource Allocation: ACOs need to allocate resources effectively to provide optimal care for COPD patients. This includes ensuring adequate access to pulmonary rehabilitation programs, respiratory therapists, and other specialized services. Limited resources and competing priorities can present challenges in providing comprehensive care to all patients in need.

‍Quick tip: prioritization is the first step, and with COPD being one of the largest chronic disease categories driving up costs, it presents a significant ROI opportunity to invest in improving patient outcomes.

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5. Adherence to Guidelines: COPD management guidelines (such as the GOLD Report standards) exist to provide evidence-based recommendations for diagnosis, treatment, and follow-up care. However, adherence to these guidelines can be inconsistent across healthcare providers and settings. Variations in practice and lack of guideline implementation can affect the quality and outcomes of COPD care.

‍Quick tip: build the recommended care strategies into automated workflows to ensure consistent care.

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6. Patient Access and Socioeconomic Factors: Access to healthcare services, particularly in underserved areas, can be a challenge for COPD patients. Limited access to healthcare providers, diagnostic tests, and medications may hinder timely diagnosis and appropriate management. Socioeconomic factors, such as poverty, low health literacy, and inadequate social support, can also impact COPD care outcomes.

‍Quick tip: making standard testing, like spirometry, available in every care setting helps ensure patients are being proactively monitored every time they do have access to healthcare services.

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7. Health Information Technology: Effective utilization of health information technology (HIT) systems, including electronic health records (EHRs) and interoperability between systems, is crucial for seamless information exchange and care coordination. However, interoperability issues, inadequate HIT infrastructure, and data sharing challenges can hinder communication and coordination among ACOs and healthcare providers.

‍Quick tip: ensure your respiratory program tools are interoperable with your current systems (e.g., EHR) and focused on achieving coordinated workflows for your providers.

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Addressing these challenges requires a collaborative approach involving healthcare providers, ACOs, policymakers, and patients themselves. Strategies such as care coordination initiatives, patient education programs, guideline implementation, improved access to healthcare services, and enhanced HIT infrastructure can contribute to better COPD care within the ACO framework.

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