Recently, consulting giant Deloitte announced a new program, named “Evergreen,” designed to cut down the cost of implementing and operating hospital EHRs. Unfortunately, much of the Evergreen coverage in the health IT trade press was vague or downright wrong, as it suggested that Deloitte was actually going into the EHR business itself. The key point Deloitte sought to make — that it could implement and operate EHRs for 20% to 30% less than hospitals — did come across, but the rest was a bit jumbled.
Having spoken to Mitch Morris, global healthcare leader for Deloitte Consulting LLP, I can clarify much of what was confusing about the Evergreen announcement and subsequent coverage. Here’s some key points I took away from my chat with Morris:
- Evergreen is a suite of services, not a product: Though some HIT editors seem to have been confused by this, Evergreen isn’t an EHR offering itself. It’s a set of EHR implementation and operation services provided by Deloitte Consultants. Evergreen also includes a financing scheme allowing hospitals and health systems to obtain a new EHR by making a series of equal payments to Deloitte over five to seven years. (“It’s like leasing a car,” Morris noted.) This allows hospitals to get into the EHR without making an enormous upfront capital investment over the first 18 months.
- Evergreen is only offered in tandem with an Epic purchase: The Evergreen program arose from what Deloitte learned after doing a great deal of work with Epic EHRs, including the famous multi-billion install at Kaiser Permanente and an extensive rollout for large hospital system Catholic Health Initiatives. So at the outset, the program is only available to hospitals that want to go with Epic. Deloitte is considering other EHR vendors for Evergreen partnership but has made no decisions as to which it might add to the program.
- Both onshore and offshore services are available through Evergreen: One might assume that Deloitte is offering lower implementation and operation costs by offshoring all of the work. Not so, Morris says. While Deloitte does offer services based in India and Ireland, it also taps U.S. operations as needed. Clients can go with offshore labor, onshore labor or a mix of services drawing on both.
- This is a new application services management offering for Deloitte: While the consulting giant has been managing Oracle and SAP installations for clients for some time, managing EHR platforms is a new part of its business, Morris notes.
According to Morris, Deloitte expects Evergreen customers to include not only health systems and hospitals that want to switch EHRs system-wide, but also those which have done some acquisitions and want to put all of their facilities on the same platform. “It’s expensive for a health system to maintain two or three brands, but they often can’t afford the upfront capital costs of putting every hospital on the same EHR,” he said. “We smooth out the costs so they can just make a payment every month.”
This could certainly be a big score for Epic, which is likely to scoop up more of the EHR-switching systems if Deloitte helps the systems cope with the costs. And Deloitte is likely to get many takers. Let’s see, though, whether it can actually follow through on the savings it promises. That could change the EHR game as we know it.