WAKE FOREST BAPTIST HEALTH AND NOVANT HEALTH

Enhanced Patient Information Access

• The merger of Wake Forest Baptist Health and Novant Health's Epic EMR systems resulted in the consolidation of patient data that was previously maintained in two separate Epic MyChart accounts for patients who visited the two healthcare institutions.
• After the merger, "approximately 6,700 Novant Health patients had connected their Novant and Wake Forest MyChart accounts" by January 2018. All this was because the patients wanted to enjoy the benefit of enhanced information access regardless of hospital visited.
• With patients able to access their records in either hospital's system via a single account, the patients were able to have an enhanced experience in regard to information access and care. 
• This resulted in the improved understanding of medication, lab results, plan of care, and follow up appointments for patients and their physicians.
• Consequently, the merger of Wake Forest and Novant Health's EMR systems resulted in enhanced patient information access that reduced confusion and improved patient experience in both healthcare facilities.

Streamlined Care Coordination

• With the merger of Wake Forest and Novant Health's Epic EMR systems came the access of patient records in a single Epic MyChart account.
• The merger made it possible for streamlined care coordination as patients moved from Wake Forest to Novant Health and vice versa.
• Additionally, through streamlined care coordination, a patient's journey became more improved because of better managed plans of care and follow up appointments that are all detailed in a single MyChart account.
• As Novant Health CMIO Keith Griffin, MD noted, the merger was "truly a major step forward towards the goal of patient engagement and elimination of barriers of information and confusion."
• By improving patient engagement and eliminating information barriers, the merger introduced streamlined care coordination to the two hospitals making it easier for physicians from both hospitals to care for patients through a single MyChart portal.

UC IRVINE HEALTH AND UC SAN DIEGO HEALTH

Cost Saving

• A major benefit for the merger between UC Irvine Health and UC San Diego Health is in cost saving.
• According to Chuck Podesta, the Chief Information Officer of UCI Health, "by collaborating with UC San Diego, and leveraging its existing infrastructure, UCI Health was able to avoid many of the start-up costs associated with implementing a new EMR application."
• The shared Epic EMR system that resulted from the merger of the two hospitals' systems resulted in an estimated 30% in cost avoidance for implementation.
• Chuck Podesta estimated that by choosing the merger route, UC Irvine saved an estimated $40 million in costs.
• By sharing the same Epic platform, the two organizations were able to increase operational efficiencies and cut costs resulting in improved care coordination to UC physicians from both UC Irvine Health and UC San Diego Health.
• According to Carl Dvorak, Epic president, the EMR merger enabled UC Irvine Health and UC San Diego Health to work together and lead the way in the reduction of cost of care, improvement of outcomes and creation of a patient-focused experience.

Increased Value Proposition

• After merging their EMR systems, UC Irvine Health and UC San Diego Health were able to benefit from an increased value proposition.
• The value proposition of the two healthcare facilities increased because the population served by both hospitals doubled from the previous figure.
• Additionally, with an integrated Epic EMR system, patients also benefited from better management of medical information and the alignment of "clinical pathways and practices that leverage the best of both organizations, as well as better support for joint research efforts."
• This EMR merger advanced UC Health’s strategic goal of "sharing health services and generating efficiencies across campuses through the shared implementation and maintenance of technology platforms."
• Lastly, the above-mentioned and all other advantages of the EMR merger between UC Irvine Health and UC San Diego Health on both the patient and physician side all resulted in an increased value proposition to all stakeholders.

Advocate Health Care and Aurora Health Care Merger

•  The merger of Advocate Health Care and Aurora Health Care to become Advocate Aurora Health has successfully led to a number of benefits.
• One of the key benefits of the merger is an increase in revenue. In 2018, the first full year after the merger, Advocate Aurora Health's revenue increased to $12.2 billion, up from $11.7 billion in 2017.
• Another key benefit is an increase in patient volume. Advocate Aurora Health reported that "outpatient visits and home care visits climbed 4.7 percent and 6 percent, respectively, year over year."
• However, there was also an increase in operating expenses after the merger. Operating expenses increased by 4.2% year-over-year, partly due to "the $34 million in costs related to both the merger and implementation of a new EHR."
• Operating income was also affected negatively, decreasing from $554.7 million in 2017, to $472.4 million in 2018.

The Merger of two Epic Systems

• The two Epic systems that merged in 2011 are Resurrection Health Care Corp. and Provena Health. After the merger, they became known as Presence Health.
• The merger cost $18.34 million, and the CEO at the time, Sandra Bruce, noted that the merger would allow them to save $100 million in expenses.
• Sandra Bruce also said that the merger would enable them to increase revenue to approximately $3 billion.
• Revenue before the merger for Resurrection Health Care was $1.4 billion, and their operating income was $17.8 million, while that of Provena Health was $1.2 billion, with an operating income of $8.5 million. This represented a total revenue of $2.6 billion ($1.4 billion + $1.2 billion) and a total operating income of $26.3 million ($17.8 million + $8.5 million) in 2011.
• There was a slight increase in revenue to $2.62 billion in 2013, from $2.6 billion in 2011, but they reported an operating loss of $61 million.
• The merger didn't bring the expected benefit for Presence Health, with revenue falling to $2.5 billion in 2015. They also reported "losses of approximately 7.4%, or ($185.6 million) on operating revenue of $2.5 billion."
• A new CEO, Michael Englehart, came on board to attempt to save Presence Health, however, another merger was finalized in 2018 with Ascension Health to help shore up finances.

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