UC San Diego, UC Irvine share cloud-based EHR

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In an effort to increase operational efficiencies and decrease patient costs, UC San Diego Health and UC Irvine Health are now sharing a single cloud-based Epic electronic health records system, marking the first time that such a system has been extended from one U.S. academic medical center to another.

“We were approached by UC Irvine about the opportunity to share our instance and extend it to them,” says Christopher Longhurst, MD, chief information officer at UC San Diego Health. “After some analysis, we felt like it was the right thing for both organizations.”

The shared system integrates patient records from both UC San Diego and UC Irvine. According to Longhurst, UC Irvine’s go-live using UC San Diego’s version of Epic occurred earlier this month. He adds that its system is also supporting UC Riverside Health clinics and community practice affiliates as a cost-saving arrangement to improve coordination of care among physicians.

“By collaborating with UC San Diego, and leveraging its existing infrastructure, we have been able to avoid many of the start-up costs associated with implementing a new EMR application,” said Chuck Podesta, chief information officer at UC Irvine Health. “We foresee that the partnership will not only enable better management of medical information but will better support joint research efforts.”

UC San Diego first implemented Epic in 2005, and this past August, the health system successfully migrated its on-premise Epic system to a cloud environment hosted by the EHR vendor as part of a long-term strategy to shift away from a traditional data center model. In fact, they were the first academic medical center to make the transition from a self-hosted Epic IT infrastructure to the vendor’s cloud hosting environment.

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“With the Epic hosting, there’s some significant transition costs of getting to a cloud-hosted environment—part of the reason we were able to get there is because we did it in partnership with UC Irvine,” Longhurst adds. “There were some efficiencies by sharing resources. At the end of the day, systems that are serving a larger customer base are going to realize economies of scale and cost benefits.”

He emphasizes that the most difficult part of the implementation was not the technology but the people and the processes involved. “In order for two institutions to share an electronic health record, there has to be alignment on processes and workflow—that’s where the hard work came in,” contends Longhurst.

According to Longhurst, the average time it takes to implement Epic at an academic medical center is 24 months. However, in this case, he notes that it took just 17 months to bring UC Irvine on to UC San Diego’s system, while the projected cost avoidance for implementation is estimated to be 30 percent.

“It’s just silly when you look around the country and you see so many separate instances of Epic, Cerner or whatever is being stood up—when in fact, nothing really scales better than these IT systems,” concludes Longhurst. “Why are these hospitals spending so much overhead to put in another instance for just their hospital?”

He sees EHR sharing as an emerging trend for health systems to achieve greater efficiencies through “systemness”—the practice of combining assets and services to provide better and more efficient healthcare.

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