Hospital consolidation alone hasn’t delivered on promises of interoperability

EHR data sharing
Horizontal hospital consolidation doesn't automatically translate to better interoperability, a new study shows. But there may also be a lag effect at play. (Getty/andrei_r)

A common refrain from health systems justifying the acquisition of another provider has been that consolidation will make data-sharing an easier task. But new research shows horizontal hospital consolidation itself doesn’t always translate to improved interoperability.  

Using data from the 2014 American Hospital Association (AHA) annual survey and the 2015 IT supplement that included more than 2,000 hospitals, researchers found that only those systems with a specific business model, centralized physician arrangements and an integrated insurance offering were more likely to perform key measures of interoperability.

In other words, consolidation alone wasn’t enough to incentivize data sharing. Centralized organizational governance coupled with diverse service offerings in hospitals throughout the system was a bigger influence on data sharing than common ownership alone, according to the study published in the Journal of the American Informatics Association.

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“It’s not like hospital systems that buy each other up just start sharing data after that,” A Jay Holmgren, a doctoral student at Harvard Business School and the lead author of the study, told FierceHealthcare.

In some cases, EHR interoperability is a key focus of a merger. Late last year, Advocate Health Care and Aurora Health Care announced plans to form one of the largest nonprofit health systems in the country, but faced the task of consolidating three different EHRs. Advocate later decided to make the switch to Epic to align itself with Aurora.

RELATED: Advocate Health Care switches to Epic EHR ahead of planned merger with Aurora

However, Holmgren added that some lag time may be unaccounted for in the study. Interoperability may not be the top priority given the number of immediate business considerations during a merger, or it may take time to establish new IT systems and functionality.

“This is just a snapshot of what is going on,” he said. “As we get more years of data and we have these measures and national surveys, it may be there that there’s a lag effect.”

RELATED: Meaningful Use legislation led to a 'substantial change' in EHR adoption, study shows

A separate study, published this month in Health Affairs, showed that lag effect may exist when it comes to declining mortality rates following EHR adoption. Tracking more than 3,200 hospitals between 2008 and 2013, researchers found that although mortality rates increased after the initial adoption, annual mortality rates steadily declined in the years following.  

That decline was especially prevalent in small, nonteaching hospitals where researchers surmised there was more opportunity for performance improvement.

“These findings suggest that national investment in hospital EHRs should yield improvements in mortality rates, but achieving them will take time,” the authors wrote.