Analytics, EHRs and interoperability remain top-of-mind issues for healthcare executives, particularly as mergers and acquisitions continue to dominate the industry landscape.
This content is sponsored by Allscripts
Thirty hospital and health system M&A transactions were announced during the first quarter of 2018, up 11-plus percent from one year prior, according to an analysis by Kaufman Hall. In March, Bloomberg reported the first three months of 2018 marked the biggest first quarter for healthcare M&A in more than 10 years.
IT often poses a challenge during these transactions, as hospitals and health systems must debate whether to implement a single EHR platform or continue to use disparate systems. For those using disparate systems, ensuring adequate interoperability for sharing data related to patient care and quality metrics becomes the next hurdle.
To investigate how hospitals completing organizational transitions — including acquisitions, mergers and affiliations — use IT to manage and connect the disparate but merging aspects of their businesses, Allscripts convened a roundtable discussion and survey of 26 senior healthcare leaders April 12 during the Becker's Hospital Review 9th Annual Meeting in Chicago.
Here are four major findings from poll questions posed to the executives, who represented hospitals, health systems and physician groups across the U.S. Poll findings are accompanied by firsthand accounts from executives, attributed by their role, organization type and region.
Finding No. 1
Have you gone through an organizational transition in the last six months?
- Acquired, been acquired by, affiliated with or merged with another organization: 41 percent
- Joined an ACO or clinically integrated network: 12 percent
- Tackled shifting payment models, risk based or otherwise: 12 percent
- Other: 33 percent
Firsthand account
"The IT and EMR transition was part of the acquisition discussion," said the vice president of information systems at an academic medical center in the Midwest. "We ended up going with the other facility's instance of Epic … That was part of the strategy of the acquisition with them. It was going with their instance of Epic, rather than building a new one. That was rife with a lot of cultural differences, in terms of the academic physician practices having to comply with the community-based practices' version of Epic, so it's been a challenge across the organization."
Finding No. 2
If you've gone through an organizational transition, what is the main challenge you've faced in terms of interoperability?
- Data migration: 47 percent
- Workflow synchronization: 24 percent
- Common standards of care: 12 percent
- Physician buy-in: 6 percent
- Governance: 0 percent
- Revenue cycle harmonization: 0 percent
- Other: 12 percent
Firsthand account
"The original vision was we'd be able to migrate historical records," said the COO of a West Coast hospital. "It failed. The best we could do is leave historical records available. I think that was a miss. We certainly worked through it, but it was fairly controversial for a while, because that was the vision for how we built the selection of the vendors to move forward, and they were unable to bring it together."
Finding No. 3
What do you rely on to achieve interoperability?
- Regulatory mandates, national or state: 0 percent
- Standards (Fast Healthcare Interoperability Resources, prescription drug monitoring programs, Integrating the Healthcare Enterprise, application programming interfaces, et cetera.): 0 percent
- Vendors: 0 percent
- My staff: 0 percent
- All of the above: 100 percent
- None: 0 percent
Firsthand accounts
"The regulatory mandates got us toward interoperability," said the vice president of technology, program management and planning at a nonprofit accreditation organization focused on healthcare quality. "The challenges are with staff and with vendors. With vendors, the challenges are always overpromising … with staff, the challenges are you have to keep them educated, you have to invest in your staff. If you don't keep them up to date on [FHIR and other interoperability standards], you're going to have to rely on the vendors more."
"It's a combination for us," the vice president of population health at a rural medical center in the Midwest said, describing how the organization balances between training staff on some interoperability standards, while outsourcing to managed services companies for others. "We're a small organization in a rural setting, so we rely on vendors who we're partnering with to help us with our IT. The time commitment is the other thing. How much time can we give our own staff? … It's a real juggling act."
Finding No. 4
What is your primary concern with the data you are using to manage your population?
- Data quality and trust concerns: 36 percent
- Information spread across claims, clinical, survey, et cetera: 18 percent
- Timeliness of data is insufficient: 18 percent
- Governance: 14 percent
- Data blocking issues: 5 percent
- Document-based issues: 0 percent
- Other: 9 percent
Firsthand accounts
"It's the information going across vendors, and the normalization of the data, that's very difficult," said the chief pharmacy informatics officer of a national health system based in the Midwest, speaking to the challenges of tapping multiple IT vendors to manage various types of healthcare data.
"Everybody is concerned about cybersecurity," said the president of an East Coast community hospital. "The risks of it, and the cost of it, [which ties into data trust and governance]. … There's so much chatter out there about cybersecurity with so many other, larger organizations, and even the government and FBI, getting hacked, that everybody's saying basically, 'It's not a matter of whether or not you're going to get hacked, but will you even know it?'"