Meridian Health and Hackensack University Health Network announced merger plans on Oct. 16; if the deal clears regulatory hurdles it would result in New Jersey's largest hospital network. In the meantime, it's offering the CIOs of each organization plenty to think about.
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The proposed new organization would be called Hackensack Meridian Health and would employ some 23,400 people and have more than $3.4 billion in revenues, more than the Garden State's current largest health care system, Barnabas Health.
Combined, Hackensack and Meridian admit almost 135,000 patients annually at nine hospitals and two children’s hospitals. Two additional hospitals are expected to join the network once Meridian’s proposed merger with Raritan Bay Medical Center in Perth Amboy is finalized.
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As with any merger of this magnitude, the information technology challenges for both health systems loom large. From electronic health records to telecommunications systems, IT personnel from each will have a lot of planning to do as merger negotiations move forward.
Rebecca Weber, senior vice president and chief information officer of Meridian Health has been down this road before, having been involved in several mergers.
"There's two different ways to look at this," she said. "In the past, during mergers, my thought was to standardize everything and bring everybody onto the same system. But when you're looking at two larger health systems, you have two options."
On one hand, the combined entity can unify their systems, said Weber, who conceded that there are pros and cons to that strategy. On the other, each can continue on two separate EHRs, combining and storing the data on a population health level.
"As we're moving more into population health, I think that some of the advantages of having the same EHR aren't quite as compelling, so it gives you two different options to look at," she said.
"When you're talking about two large health systems, I think you need to weigh your options," said Weber. "Because you have to ask the questions: What are the advantages? What are your pros and cons? Standardization is a great way to go, but also you can start merging your information, both financial and clinical, on a population health level."
Currently Meridian is standardized in all of its five hospitals: Jersey Shore University Medical Center and K. Hovnanian Children’s Hospital in Neptune; Ocean Medical Center in Brick; Riverview Medical Center in Red Bank; Southern Ocean Medical Center in Manahawkin and Bayshore Community Hospital in Holmdel.
Among the questions that have to be asked, according to Weber: Does standardization save you time and money? And is that better for the health system?
"We haven't made that decision, and we don't have that answer yet as it pertains to the HUMC/Meridian merger," she said. "I can tell you that we have two incredible IT departments, and as we bring people together it needs to be an all for one mentality.
"We're really lucky in that both organizations have advanced, quite professional departments," she added.
Weber said one of the big issues that must be addressed when considering a merger include contract renegotiations and licensing renegotiations.
"Because it changes the picture in a lot of aspects, because sometimes people just think along that EHR line, but it's much bigger. For example, for telecommunications: do you want to stay on one or do you want to increase your minutes using an Internet Protocol type of vendor? All that stuff adds up, and it's not inexpensive."
Another consideration said Weber, is on the health information exchange level and population health level, where you're integrating everything into a very large enterprise data warehouse, with both clinical and financial information.
"There's tons of questions out there – how do you handle your bio-medical, how do you handle your medical records? And what about financially – do you stay on different financial systems, or do you merge into one consolidated business office?"
Weber said one of the first things that should be addressed is how to consolidate information: "To take that first step is the most important piece before we decide the next step."
Weber's counterpart, Shafiq Rab, MD, vice president and CIO at Hackensack University Medical Center, said the merger between Hackensack University Health Network and Meridian Health will improve the overall efficiency and seamless treatment of patients.
"In IT, both Rebecca Weber and I will have to look at clinical systems integration," said Rab. "The community and the patients served at both healthcare systems will benefit from this merger.
"We will begin with developing a common platform of EHR, not only working together with each hospital to bring everyone up to speed, the overall system in each hospital will improve as well," he added.
Hackensack University Health Network is the New Jersey-based parent company of HackensackUMC, the HackensackUMC Foundation, Hackensack University Medical Groups, and corporate joint venture partners with LHP Hospital Group, which also owns: HackensackUMC at Pascack Valley and HackensackUMC Mountainside. In September 2014, HackensackUHN added Palisades Medical Center as a full member to its network.
Among the challenges Rab foresees? Duplication of medical records, bandwidth, and connectivity.
"But there is a great mutual respect between our two CEOs and both CIOs," he said. "This merger should be very smooth, and truly benefit our community and our patients."
He noted that in any merger the most important thing is the mission and the vision of that merger and why it is being done.
"There is no such thing as an individual IT goal, it's always an institutional or organizational goal overall," said Rab. "This merger will serve our customers, patients and community together so we can enhance our overall clinical ability and collaboration."
