If you’ve ever merged two healthcare organizations while implementing Epic, you already know that the biggest challenges aren’t technical—they’re clinical, cultural, and operational. Reconciling how two organizations document care, capture charges, and coordinate workflows is a monumental task, and a successful rollout requires far more than a project plan.
From combining clinical workflows to navigating Epic-to-Epic transitions, here’s what you need to know about Epic implementations during mergers and acquisitions.
The Epic Challenge of Integration
Implementing Epic is a major milestone—but in the context of a merger or acquisition, it’s only part of the equation. After installation, you’ll also need to blend clinical philosophies, operational processes, financial structures, and IT infrastructures. Add to this the burden of unifying two organizational cultures around a shared vision for the future, and it’s clear that go-live is just the beginning.
For organizations looking to achieve seamless integration, here’s how to achieve alignment in each of these critical areas, so you can minimize disruption and build a unified system that works:
1) Clinical
Merging clinical workflows is like trying to agree on the “best” pizza topping—everyone’s passionate, and someone might walk out of the room angry. You’ll want to watch for things like conflicting note templates, order sets, and decision support logic—and don’t make any assumptions. Just because two organizations both treat diabetes doesn’t mean they chart it the same way.
The golden rule? Get physician and nursing buy-in early. Otherwise, you’ll be playing catch-up until your first optimization sprint.
2) Operational
Scheduling, registration, MyChart—every organization prefers its own workflows, and they’re all unique. From disparate appointment types to multiple patient identifiers, it’s not uncommon to unearth surprises—like phone trees from 1998—that will need to be addressed.
Consider developing a shared access model, as well as a harmonized front-desk script, to make operational alignment easier. You’ll also need to unify self-service tools as well, so patients don’t get two reminders for the same appointment.
3) Revenue Cycle
When it comes to Epic implementation during M&A, revenue cycle is where system differences show up in dollars. Small misalignments in charge capture, edits, or payer rules can lead to delays, denials, or lost revenue—none of which you want post-go-live.
Start by centralizing decision-making, rationalizing charge workflows, and prioritizing payer mapping sessions, and watch for things like wildly different fee schedules, overlapping financial classes, and bolt-ons that no one remembers configuring. Training is also critical. Billing teams should be empowered with clear guidance, updated reference materials, and support as they shift to new processes.
4) IT & Infrastructure
Your technical teams are merging two ecosystems—including access, devices, printers, interfaces, and environments—which requires more than simply flipping a switch. Look out for identity provisioning, environment naming wars, and integration migrations that “should be simple.”
Instead, focus on making the necessary decisions early:
- Will you merge instances or coexist?
- Are you using central hosting or federated?
- Will the organization be using cloud or on-prem storage?
At the end of the day, your technical design should support efficiency and clarity—so clinicians can access the right information in the right environment, without needing to log into multiple systems.
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Special Considerations
Finding alignment in each of these four areas is a challenge, but—for some organizations—it’s only the beginning of the process. If you’re preparing for an Epic-to-Epic transition, or if you’re merging with an organization in your region, there are additional challenges you’ll need to address.
Epic-to-Epic Transitions
It’s tempting to assume that if both organizations already use Epic, the hardest work is behind you. However, identical platforms don’t mean identical operations. In fact, Epic-to-Epic transitions can introduce their own set of difficulties—especially when configurations, workflows, and governance structures don’t line up.
As a result, decisions will need to be made around instance consolidation, shared services models, and long-term ownership of build and maintenance. You’ll also need to pay attention to workflow alignment, data reconciliation, instance consolidation, and EMPI management to clean up any patient data overlaps.
Geographic Proximity
If your organizations are neighbors, geographic proximity creates additional challenges, all of which need to be identified and addressed early. From duplicate patient records to inconsistent identifiers and overlapping charts, even minor discrepancies can ripple across the entire organization.
In these cases, a well-defined EMPI strategy is essential for managing patient identities across systems and avoiding downstream complications. You’ll also want to invest in strong patient matching early, train staff to avoid creating duplicates, and coordinate consent models so patients don’t get surprised by shared data access.
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The Bottom Line
Bringing two healthcare organizations together on Epic is a complex, high-stakes endeavor, and success depends on aligning strategy, structure, and culture across every part of the organization—not just within the electronic health record (EHR).
If you’re preparing for an Epic implementation during M&A, Healthcare IT Leaders is here to help. Our experts bring deep experience in guiding hospitals and health systems through the complexities of integration, and we help teams navigate clinical, operational, and technical change with confidence.
Ready to learn more? Contact us today to get started.