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EHR convergence versus interoperability

A key strategic question for health care providers

In response to increasing regulatory and consumer demands, more and more health care organizations are turning to technology to help them drive value. But what should health care providers consider before selecting an Electronic Health Record (EHR) strategy?

Driving value from electronic medical records

Regulatory requirements and industry demands continue to drive consolidation in the health care provider market. Virtually every health care organization is wrestling with how to best build scale to cost to effectively respond to regulatory and health care consumer demands. Organizations will also need to consider how technology can help them drive value.

Converging to a single EHR platform can enable smooth sharing of patient data across all entities. But it requires a significant investment of time and resources. An EHR interoperability solution laid on top of existing systems is a faster and cheaper path to value. However, it may not fully realize the vision behind the original consolidation or provide the optimal platform for new value-creation opportunities in the newly formed organization.

Such opportunities include enabling new avenues for revenue, enabling third-party/ancillary system rationalization to lower information technology (IT) support costs, and accelerating the move of application and infrastructure technology portfolio to the cloud—and the associated business agility that brings. Beyond IT considerations, human capital challenges will present themselves, including decision governance and change management, during the rollout of IT system changes.

There’s no one answer for how an organization should approach consolidation and expansion. However, armed with a solid organizational strategic plan, a structured evaluation process, and with insights into current and future tradeoffs, every organization can plan for and implement a strategy to enable a successful transformation over the long term.

Convergence versus interoperability: Evaluating your strategy

Convergence to a single system platform allows for seamless patient information exchange between participating organizations. Standardized processes, platforms, and data and resulting rationalized application inventories across participating organizations enable higher levels of integration while simultaneously lowering costs for maintenance in the long run.

On the other hand, EHR interoperability makes it possible for disparate, heterogeneous systems to share patient-related information to support clinical workflows and business processes across the health system and organizational boundaries. Interfacing—a loosely coupled, asynchronous form of application integration—is at the heart of health care interoperability.

At the highest levels of interoperability, semantic interoperability provides the ability to not only exchange information through interfacing but also enable actionable insights and outcomes from the use of the exchanged information. The health care organization’s challenge is to create a practical, yet forward-looking foundation for a semantic interoperability from a patchwork of available options.

There are several factors an organization should evaluate when deciding on which strategy to pursue:

  • Time and cost to achieve
  • Addressing the future state of IT portfolio
  • Driving organizational and data standards
  • Organizational structure and governance

Regardless of the decision to converge to a single system platform or to implement an EHR interoperability solution, newly formed health systems may be tempted to approach the resultant IT implementation in the same way as previous rip-and-replace technology implementation projects. While a convergence or interoperability project will follow the same life cycle as an implementation, it should be treated more like a post-merger integration project.

IT considerations for electronic health records

As health systems expand their footprint through mergers and acquisitions and partnerships, it’s crucial to engage and consult IT early and often. Technology considerations can even be a driver for deal considerations for some health care organizations.

IT can help identify opportunities by offering a different lens on the strategic alternatives being considered. It also enables much better clarity in understanding the risk, timeline, and cost associated with a convergence or interoperability approach.

Under the framework of value-based care and patient-driven outcomes, it’s essential for health systems to do more with less. This underscores the importance for post-merger entities to share patient information efficiently and effectively. The ability to share this information in real time across the organization enables the health system to reduce operational redundancies and maximize service to their patients.

When making strategic IT decisions, each health system’s distinct composition needs to be evaluated in the context of the patients they serve, geographic footprint, and overall organizational make-up. This requires health care organizations to critically evaluate their application portfolio, organizational structure, and market position to decide how best to share integral patient information across the health system and serve their patients into the future.

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