Sharing health data remains a major challenge for accountable care organizations (ACOs), and a barrier to improved care that is preventing many ACOs from achieving greater gains, according to a new survey.

While technology tools are being used to improve care in most ACOs, poor interoperability across differing health information systems and provider organizations was a problem in all 62 ACOs surveyed by Premier, Inc. and the eHealth Initiative.

READ: ONC unveils proposal for health IT interoperability

All of the 62 ACOs said that accessing data from external organizations is a challenge. In addition, half of the ACOs surveyed said that access to data even within their own organization is challenging.

“While accountable care organizations are providing quality care for many patients, even more could be accomplished if interoperability issues were addressed,” said Jennifer Corvich Bordenick, chief executive officer of the eHealth Intiative, in a news release.

Even when ACOs successfully integrated technology systems into operations, they were unable to derive value from their investments, said Keith J. Figlioli, Premier’s senior vice president for healthcare informatics and a member of the Office of the National Coordinator’s Health IT Standards Committee.

“The survey proves this is a pervasive problem among ACOs, and it could stymie the long-term vision for ACO cost and quality improvements if not addressed,” Figlioli said in a news release.

Bordenick said the cost of interoperability is prohibitive, a point backed up by the survey. More than 90% of the participating ACOs cited cost and return on investment of health information technology as a barrier to improving in this area.

One bright spot: Many ACOs did report improved patient care by using technology, specifically in the areas of clinical quality (66%), preventative screenings and vaccinations (63%), chronic disease management (59%) and health outcomes (55%).

The majority of the responding ACOs had been in operation for at least 18 months. Most are medium to large, with upward of 100 physicians. The survey was conducted in July and August 2014.