This article in Academic Medicine discusses the difficulties of an Accountable Care Organization formed by Johns Hopkins Medicine, some Washington, D.C.-Baltimore area hospitals and three medical practices.

One big problem was electronic health record systems that didn’t communicate with each other.

Other problems included trying to getting and analyzing claims data, governance issues and getting the full cooperation of providers.

The authors’ conclusions included this observation:

“Network strategies among AMCS {academic medical centers}, including adding community practices in a nonemployment model, will continue to require thoughtful strategic planning and a keen understanding of local context.”