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How Healthcare Mergers and Acquisitions Affect EHR Interoperability

April 10, 2018 BY Alanna Moriarty

How Healthcare Mergers and Acquisitions Affect EHR Interoperability

*updated October 2019

The healthcare industry continues to consolidate, with new players emerging to acquire payers and health systems while existing health systems merge and acquire independent hospitals. Though the effects for some of these mergers and acquisitions--such as the Amazon partnership with J.P. Morgan Chase and Berkshire Hathaway--are fairly straightforward, mergers like that of Walmart and Humana or CVS and Aetna are open to speculation.

For health system mergers, like that of Advocate and Aurora Health Care, barriers exist that don't necessarily affect retail corporations--like technology synchronization. When the health systems finalize the merger to become Advocate Aurora Health System, they will have to reconcile three separate electronic health record (EHR) systems. Aurora currently uses Epic as its vendor for both inpatient and outpatient EHR systems, while Advocate uses Cerner for inpatient and Allscripts for outpatient EHRs. As a conglomerate, Advocate Aurora plans to fully implement Epic as its inpatient and ambulatory EHR vendor by 2021, according to Definitive Healthcare data.

5 Recent Mergers & Acquisitions and Player Inpatient EHR Systems:

  1. Ochsner Health System (Epic) has acquired the operations of Teche Regional Medical Center (MEDHOST).
  2. Summersville Regional Medical Center (MEDHOST) officially joined the West Virginia University Health System (Epic).
  3. Doctors Hospital of Riverside LLC, an affiliate of AHMC Healthcare Inc., (Evident) acquired Parkview Community Hospital Medical Center (NTT Data).
  4. DeKalb Health (Epic) has officially joined Parkview Health (Epic).
  5. J.C. Blair Health System (Meditech) has officially joined Penn Highlands Healthcare (Cerner).

EHR consolidation is not absolutely necessary for a successful merger or acquisition, as most EHR systems are interoperable on some level. However, using one single system for 27 distinct hospitals within a health system facilitates care coordination and data sharing more than using two or three disparate systems. Though technology implementations are time-consuming and expensive, consolidating data management systems can save money in the long-term as well as improve physician communication. SSM Health stated that its EHR consolidation will save more than $10 million annually.

Accessibility is essential for improved care delivery for physicians, but many providers claim that simply finding the data is not enough. Now that EHR and other data sharing systems are nearly ubiquitous, it is the value and functionality of data that is most important according to industry leaders. The trend has shifted from ease of access and sharing to interoperability--specifically, "deep interoperability."

Deep interoperability refers to four factors that indicate whether a hospital or care facility is effectively leveraging an EHR system to improve patient care.

The 4 elements of deep interoperability are:

  1. Providers often or nearly always have access to the relevant patient data
  2. Providers can easily locate individual patient records OR have them automatically presented to physicians
  3. Providers can successfully integrate patient records into EHR data fields (for the same or disparate EHR systems)
  4. Providers believe the patient data in the system often or nearly always benefits patient care in a significant manner

According to a 2017 survey from KLAS, only 14 percent of healthcare organizations report having deep interoperability, an increase from the 6 percent recorded last year. The survey also reported interoperability of EHR vendors with the same and different systems. Epic topped the list of vendors reaching deep interoperability within the same system, with Athenahealth leading the way in interoperability with disparate systems.

Top 10 EHR Vendors Reporting Deep Interoperability:

Same System:

  1. Epic: 51%
  2. Athenahealth: 34%
  3. GE Healthcare: 27%
  4. NextGen Healthcare: 25%
  5. Meditech: 22%

Different System:

  1. Athenahealth: 23%
  2. GE Healthcare: 22%
  3. Greenway Health: 20%
  4. Allscripts: 18%
  5. NextGen Healthcare: 13%

As the industry continues to consolidate, and healthcare mergers and acquisitions become more common, hospitals and health systems will have to consider whether they have competing or cooperative technology vendors. This will become even more prevalent as tools such as telehealth and artificially intelligent computers become more commonplace at hospitals and other care facilities.

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