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Top 5 Considerations for an Affiliate Partnership

Collaborating and integrating electronic health record (EHR) systems between a host and an affiliate network carries several advantages. For the host, it can lower the overall budget of technology by spreading the burdens associated with large technology implementation and transferring some of those costs to affiliate hospitals and clinics. The affiliate hospitals and clinics gain the advantages of a single EHR system that can extend services to their patients through technology such as online patient portals, allowing their customers access to test results, appointment scheduling, and communication channels with clinicians.

It’s important to note, however, that a successful affiliate program doesn’t happen at the press of a button, and EHR transitions from host to affiliate are not plug and play. Affiliate programs require planning, resources, and time. In many ways, affiliate programs are an investment in the future and require planning, budget, and support to overcome the challenges associated with a strategic partnership between healthcare providers.


Challenge #1: Know thy self: Too often hosts and affiliates seek to undertake a partnership without performing the internal analysis and due diligence that explores every facet of their respective organizations. This work requires, among other things, asset planning, resource mapping, current and future state analysis and subsequent system workflow gap studies.

Challenge #2: Pivot to Vendor: Until the affiliation relationship fully occurs, the host is just a regular hospital. Their charter and mission are solely to provide healthcare, and their processes and procedures and culture are designed for those purposes only. Moving to a host relationship is akin to moving from being a hospital to now being a technology service provider. With these moves come the considerations of catering to a client, not a customer. Mitigating this step requires reflection and internal discussions, too often left out of the decision making process.

Challenge #3 Prepare for Change: Affiliates must educate themselves, regardless of their size, on what process, technologies, procedures and resources they will need to get ready for the EHR integration. Oftentimes, smaller organizations lack the infrastructure needed to provide the strategic decision making process during a large transition. By researching and building a strong governance structure and foundation, affiliates can be better prepared for change.

Learn why Nebraska Medicine turned to Leidos Health to manage its Epic Community Connect roll-out.


Challenge #4 Loss of Control: The affiliate is receiving a new system that is often owned by a separate entity, in this case the host. This could have direct impact on the process to access the future system relative to the current vs future state and loss of functionality. For example, when the host provides the EHR, the affiliate may lose the ability to customize applications relative to their current state.

Challenge #5 Good Communication: Finally, on all sides, communication must take a prominent role before, during and after the EHR transition. Internal communications can help transition teams determine the EHR application build, agreed upon workflows, overall training plans, and communicate to their staff what to expect from all phases of the implementation and eventual transition.

By addressing these issues, hospitals and clinics can go a long way to determining if they are in the right place to offer or receive an EHR through an affiliate partnership.

Noel Allender has over 20 years of healthcare experience including clinical delivery, EHR implementations and management. Her strong Epic background expertise includes 16 years in Epic system implementations with specialty in Epic Connect strategy, methodology and delivery and EpicCare process improvement. Her experience provides her with a big picture perspective on Epic projects due to background across a variety of roles within Epic implementations.