Realized Benefits of a Single Version of EMR

Goals

To obtain examples of realized benefits of having a single version of EMR for the purposes of informing a decision on a potential case for change.

Early Findings

Preliminary information shows there are several examples of two instances of an EMR being consolidated into a single instance. However, actual realized benefits are less clear.

GENERAL BENEFITS

  • It is assumed that EMR stands for Electronic Medical Record and is synonymous with EHR (Electronic Health Record).
  • According to health affairs, the benefits of having a consolidated EHR include reduced operating costs due to less redundant information technology, less staff, and the ability to achieve economies of scale.
  • Consolidation of an EHR system also benefits patients by "reducing information gaps and information-sharing frictions when patients move across care delivery sites."
  • Unified EHR systems are "widely regarded as both beneficial and expensive endeavor for health systems, providing a uniform platform for physicians and nurses to use while also costing millions to install and maintain."

TWO EPIC SYSTEMS INTO ONE

  • A successful consolidation from two Epic EMR systems to one two hospital systems in Illinois that merged to "form the largest Catholic health organization in the state."
  • The 2011 merger created a single health organization consisting of "12 hospitals, 27 senior care facilities, six urgent care facilities, and numerous physician offices and retail clinics."
  • It was determined that "consolidation of the systems would help support the corporate merger goal of organizational alignment and performance improvement."
  • One entity's system was an enterprise-wide system and was more comprehensive than the other, so it was decided that the second entity's ambulatory instance would be merged into the enterprise-wide system and they would seek to "incorporate best practice between the two environments."
  • Planning and implementation of the consolidation took 12 months and required gap analysis, design reviews, and data preparation.
  • The consolidation resulted in a single instance of the Epic EMR system with minimal disruption to the two entities involved.
  • "The new unified clinical and financial capabilities will help the client achieve faster and more convenient service for patients, make scheduling easier for staff, enhance provider satisfaction, and provide better insight into operations."

ADVOCATE HEALTH CARE AND AURORA HEALTH CARE

  • In 2018, Advocate Healthcare decided to migrate its EMR from Cerner and Allscripts to Epic to be aligned with Aurora Health Care's EMR as the two entities merged.
  • According to Advocate spokesman Adam Mesirow, Advocate "determined that a single platform is ideal to further advance our safety, quality and consumer-first strategies."
  • The move to a single instance of Epic was expected to "improve care coordination and operational efficiency," but it is projected the migration will take three years.
  • Chief Information Officer of Advocate, Bobbie Byrne, stated the "transition will allow for better interoperability throughout our entire geographic region, benefiting patients through a seamless, integrated approach... We are confident this single-platform EHR will be a nimble, long-term solution that can be continually adapted and developed as technology advances to keep us on the leading edge."
  • Kelly Jo Golson, Senior Vice President and Chief Marketing and Digital Officer of Advocate indicated another benefit would be that "a single platform allows us to expand our digital efforts as we continue to deliver on our promise to transform care delivery and meet consumers’ desire to literally access and improve their health from the palm of their hand."

WAKE FOREST BAPTIST HEALTH AND NOVANT HEALTH

  • Both Wake Forest Baptist Health and Novant Health operated on Epic EMR systems, but decided to merge them to better share information and allow patients to access their health data from both health systems via a single portal.
  • According to Keith Griffin, M.D., Chief Medical Informatics Officer at Novant Health, "The goal is to improve patients’ understanding of medications, lab results, plan of care and follow-up appointments."
  • Patients are now able to access health data through a single MyChart account even if they have not set one up with both facilities.
  • Griffin also stated that the collaboration is a "major step forward towards the goal of patient engagement and elimination of barriers of information and confusion."
  • Moreover, the merger "improves provider access to EHRs at both organizations to streamline care coordination."
  • The collaboration makes patient data "easy and convenient" to access so they can "receive care when and where they need it most."

UC IRVINE HEALTH AND UC SAN DIEGO HEALTH

  • In November 2017, UC Irvine Health and UC San Diego Health began "sharing the same instance of Epic."
  • By sharing a single instance of the Epic EMR, "UCI cut the cost of implementation by an estimated 30 percent."
  • Another goal of the collaboration was to "share health services and generate efficiencies across campuses through the shared implementation and maintenance of technology platforms."
  • Moreover, having a single instance of an EMR would "enable better management of medical information, help align clinical pathways and practices that leverage the best of both organizations, as well as better support joint research efforts."
  • In addition, UC San Diego Health also shares its Epic instance with UC Riverside Health clinics and community practice affiliates, which was meant as a "cost-saving arrangement that improves coordination of care among physicians."

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