What Consolidation Means For EHR, Health IT Interoperability

The transformation of the healthcare industry is not unlike a puzzle — with pieces constantly moved until the right “fit” is found. A recent report shows a slight decline in the acquisition of hospitals by each other but a steady increase in health system acquisition of services such as home care, medical group, and rehab services. At the same time, another report predicts that by the end of 2013, one-third of US doctors will be truly independent — a decline from 57 percent in 2000. These consolidations result in a frequently changing picture of today’s healthcare industry.

Horizontal consolidation of like entities — hospitals and hospitals or same-specialty physician practices with one other — is most often a strategy to produce economies of scale and to forestall competition. Collaborative care models, such as accountable care organizations (ACOs), are examples of vertical consolidation, or the banding together of different industry segments (e.g., hospitals, physician groups, home care services) to produce efficiency gains and to improve outcomes, which leads to improved financial performance.

Interoperability challenges differ with each type of consolidation. In a hospital-hospital merger or acquisition, the decision may be made to upgrade capabilities of both hospital systems by purchasing and implementing a new system to handle the data sharing and integration needs of the merged organization. Moving both hospitals to the same system is an ideal strategy to create seamless communication but there are two interoperability challenges faced by information technology (IT) staff: