Oct 18: Epic EHR becomes topic of hospital legal battle in Idaho

What do St. Luke’s Health System, the Federal Trade Commission, and Epic EHR have in common? The answer is a case before the United States District Court for the District of Idaho.
It should be noted that the Epic Systems is not part of the antitrust case — only that its EHR system has been pointed to as means for St. Luke’s to support its eventually successful acquisition of Saltzer. But it’s clearly the case that having a top EHR vendor and system is seen as a competitive advantage.

Saint Alphonsus Medical Center brought a complaint against St. Luke’s as a result of its acquisition of Saltzer Medical Group in Nampa, Idaho, indicating that the merger will allow the affiliates to “command nearly 80 percent of that market, giving it substantial new bargaining leverage with health plans,” according to court documents filed last month. This in turn has led to the antitrust case now before the US District Court which involves the State of Idaho along with the FTC. (According to St. Luke’s, the challenge is interesting following Saint Alphonsus’s failed attempt at acquiring Saltzer.)

During yesterday’s proceedings, the focus turned to decision by St. Luke’s to implement an EHR system provided by Epic Systems, which is reported to have cost the health system approximately $200 million to adopt and will not be completed until 2017, reports Audrey Dutton of the Idaho Statesman.

As part of its joint pre-trial memorandum, the plaintiffs referred to the benefits of the St. Luke’s EMR system for Saltzer as just as “speculative” as the motivation of its acquisition (i.e., to achieve better costs by employing more physicians):

The Acquisition’s purported benefits for Saltzer are similarly speculative. For example, St. Luke’s asserts that Saltzer’s use of an electronic medical record system (“EMR”) will be enhanced by the Acquisition. But Saltzer already uses its own EMR, providing its physicians and patients with the benefits of EMR regardless of whether it is acquired by St. Luke’s. And of course, neither Defendants nor their experts have measured the purported benefits from Saltzer switching from its existing EMR to St. Luke’s EMR, but even if they had, St. Luke’s admits that Saltzer will not realize any such benefit for at least another five years.

As part of his testimony on October 16, Marc Chasin, MD, St. Luke’s Chief Medical Information Officer, identified the benefits of a “robust system” as improved patients outcomes and higher levels of patient engagement. “It allows the patient to become engaged with their care by participating in their care,” Chasin is reported to have said by St. Luke’s News. “Patients have better outcomes and are more responsible for their care.”

Additionally, the adoption and implementation of the Epic EHR will eventually serve as the backbone of an affiliate program that will allow independent doctors to use the system while only being responsible for picking up 15 percent of the costs, reports Dutton. This 85-15 cost-sharing is the maximum allowed under the safe harbor for EHR donations.

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