It will likely take years for Sharp HealthCare and UC San Diego Health to integrate Tri-City Medical Center and Palomar Health into their electronic records systems, but existing patients are demanding access now, forcing the medical providers to look for ways to shorten the timeline.
Sharp began running Tri-City on July 1, the same day that UCSD finalized a joint powers agreement with Palomar, and both organizations put their logos on the buildings of their new partners up north. These very visible changes have increased the expectations of both providers’ existing patients eager to avoid long trips to San Diego for hospital care.
A recent example was highlighted online by Vista resident and small business owner Jen Drury, who posted on social media about taking her husband, a longtime Sharp member, to Sharp Tri-City Medical Center, which Sharp started running on July 1. Previously, getting care for his complex medical situation required traveling to Sharp facilities in San Diego, so seeing the provider’s familiar logo on a hospital much closer to home was exciting. But the couple quickly found that the doctors and nurses at the Oceanside hospital had no access to Sharp’s electronic medical records system and thus were unable to quickly get up to speed on his care.
Ultimately, the couple chose to drive south rather than try to explain a deep medical history to busy health care workers.
“My concern is that people are seeing the Sharp name on that building and assuming they’ll get Sharp’s system and continuity of care when, right now, that’s not true,” Drury said in an email. “I think that’s information the public deserves to know upfront, rather than discovering it during a medical emergency.”
The situation in inland North County is even more complex. In July, UCSD Health and Palomar Health formed Palomar UC San Diego Health, a joint powers authority built to run Palomar’s hospitals in Escondido and Poway and also its outpatient system, including its name-brand medical group.
A town hall meeting on Monday included a patient who said she had been well treated by UCSD down south but wondered where she would go for care now that the university health system has added specialists in cardiology and cancer care at Palomar.
Patricia Maysent, UC San Diego Health’s chief executive officer, said that transferring care from, say, the main Moores Cancer Center facility in La Jolla to the team of university oncologists now stationed in Escondido should technically be possible, but such moves are not likely to be smooth at the moment.
“I think a lot of people think we’re all the same now that we’ve come together,” Maysent said. “We’re not yet, and so just to, you know, manage the community expectations, it’s still clunky.
“So, you know, you have to give us time to get it less clunky.”
As is the case with Sharp’s management of Tri-City, electronic medical records systems are a big stumbling block. Both Sharp and UCSD use a system called Epic, while the two North County entities use a competing platform called Cerner.
After the meeting, Maysent said that the long-term goal is for there to be a “massive integration” between the two organizations, which are still legally separate entities, but the full melding will likely take at least five years.
Ultimately, she said, UCSD Health needs to grow the network of medical specialists that its medical group can access.
“I talk to our primary care docs, and they’re thrilled,” Maysent said. “We’re going to have more access to more specialists here.”
Drury, the Vista resident who is still driving to Sharp facilities in San Diego due to the current lack of integration with Sharp records systems, said that employees told her that it would take years for Tri-City’s system to be fully converted.
Asked to confirm that timeline last week, Terri Couts, senior vice president and chief information and digital officer at Sharp, said that the “go live” date set for Tri-City’s records reboot is the third quarter of fiscal 2028.
There has been, she added, a focus on installing operating infrastructure first, including systems to handle payroll and attendance, and also in implementing Sharp’s clinical processes for delivering care.
“Making sure that we have standards of care, and that we are measuring those standards is happening immediately,” Couts said.
While it may take years to convert the backlog of records in one system to another, why couldn’t Sharp find a way to extend remote access to its full records system for use with preexisting Sharp patients in the meantime? Certainly, this is something that Sharp’s network of hospitals and medical offices already does, drawing from a central digital repository that can deliver the same medical history no matter which location a patient visits.
It appears that improvements are underway. Sharp said in a subsequent statement that it is “actively developing interim solutions to enhance access to Sharp patient records for providers caring for patients at Sharp Tri-City Medical Center ahead of Epic implementation at the hospital. Those efforts include education on health information exchange access as well as improved communication between facilities and providers.”
While all patients experiencing medical emergencies should continue to call 911 for help and go to the closest emergency department for care, Sharp’s statement indicates that its interim fix should “provide clinicians at Sharp Tri-City with more comprehensive access to relevant Sharp medical records, helping support continuity of care and informed clinical decision-making.”
Additional information on how such an interim system might work was not available. Some North County Tri-City patients also found themselves referred to other providers this week for magnetic resonance imaging (MRI) scans. A Sharp spokesperson said that the referrals were necessary due to maintenance and upgrades to Tri-City’s MRI equipment.