Hospitals missing opportunity to increase EHR integration
- Health systems are missing an opportunity to deliver on a potential benefit of consolidation by not aligning their acquisitions with their EHRs, according to a new Health Affairs analysis.
- Health Affairs reviewed data on 4,720 hospitals from the American Hospital Association survey and IT supplement from 2012 to 2016. Of 88 hospitals acquired between 2012 and 2014, just 31 (35%) switched to the acquiring systems' EHR vendor following the transaction.
- Of the remaining 57 hospitals, 18 were already using the primary EHR vendor of their new parent company and 39 continued to use a different vendor following acquisition.
Hospital mergers and acquisitions have come under increasing scrutiny to live up to promises of lower costs and better care. A 2017 Deloitte-Healthcare Financial Management Association report said the right M&A "can achieve valuable outcomes" such as cost efficiencies and capital investments. But the Center for American Progress claimed provider consolidation often fails to live up to that promise.
Health Affairs found that of the 31 hospitals that switched following acquisition, six did so in the year the deal happened, 13 switched after two years and one switched after three.
Among hospitals that used the primary EHR of the health system acquiring them, the predominant vendors were Epic and Cerner. That was true whether they were already using the system before being bought or switched after the deal.
In all, about three-fourths of hospitals that switched EHR systems post-acquisition switched to Epic or Cerner, suggesting that switching, when it occurs, increases market concentration.
The findings have policy implications, the authors note. Integrating EHRs following a merger or acquisition could lead to cost savings through economies of scale and less duplication, as well higher quality of care with increased data sharing.
That this doesn't routinely happen "could be cause for continued concern that many acquired hospitals may not deliver on their promised benefits," the authors write. "As policy makers and regulators consider how much additional horizontal consolidation in the hospital industry to allow, claims of EHR system integration should be taken with healthy skepticism."
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