When EHRs collide: Dealing with multiple systems after mergers, acquisitions

With the increasing presence of EHRs in hospitals, healthcare organizations are facing the additional challenge of determining what to do when they merge with organizations with different EHR systems.

There are two types of mergers that result in the "collision" of EHRs, Jeffery Daigrepont, senior vice president of Coker Group said at the Becker's Hospital Review 6th Annual Meeting in Chicago. Vendor-driven mergers occur to increase access to market share, gain access to customers, acquire more modern technology or access missing modules. Health system-driven mergers resulting from consolidation or physician employment can also result in EHR collisions.

"The most misleading statement in business is 'Nothing will change after the merger,'" said Mr. Daigrepont.

When health systems or vendors decide to merge, healthcare organizations must choose which system to go with in the future. In some instances, when vendors merge, certain EHR systems may be discontinued, and in that case, hospitals using it will be forced to switch after their contracts expire. When to consolidated health systems merge, however, they need to decide which of their two systems to use going forward.

According to Mr. Daigrepont, the decision to merge is often made before understanding the impact consolidation will have on both organizations' IT systems. Deciding which EHR to adopt for the new consolidated health system can be emotional for clinicians, especially if they believe the worse system was chosen. However, personal preference is not always the best choice.

While in most acquisitions, the acquired practice will adopt the acquiring entity's EHR, but if it is a highly specialized practice, they may be dependent on a very niche, specialized EHR system that suits their specific needs.

Another possible undesirable situation is when an acquiring hospital has a less than satisfactory EHR, and the practice being acquired, which has the superior EHR system, is forced to switch to the worse one. According to Mr. Daigrepont, merger and acquisition deals today must address these possible scenarios and solutions for merging EHR systems in the beginning stages of consolidation talks, not after the deal is made.

Once an acquisition or merger is proposed, hospital leaders should enter the "diligence phase," according to Mr. Daigrepont. Both parties should be looking for red flags that suggest integration will be harder than expected, such as in merging EHRs, and determine whether they should go ahead with the deal. The goal of the next step, the planning phase, is to begin the task of integrating the two (or more) IT systems into one enterprise platform.

To determine the EHR of choice, hospital leaders should look to certain factors, including which EHR is most modern, which is most cost-effective and physician-friendly, which has the most advanced integration, which can support data migration, which is most compliant with meaningful use, prepared for ICD-10 and secure and which has the best roadmap to meet the future needs of the hospital or physician practice.

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