Scripps Health is a nonprofit health care system based in San Diego, California. The system includes four hospitals and 19 outpatient facilities, and treats a half-million patients annually through 2,600 affiliated physicians. The system also includes clinical research and medical education programs. The Scripps name dates to 1924 when philanthropist Ellen Browning Scripps established Scripps Memorial Hospital and the Scripps Metabolic Clinic in La Jolla, California. Scripps Mercy Hospital joined the system in 1995, and was founded in 1890 making it San Diego's oldest hospital. Other facilities are Scripps Green Hospital, Scripps Memorial Hospital Encinitas, the Scripps Clinic and Scripps Coastal Medical Center. In 2002, Scripps Health switched its hospital buying agent from Novation to MedAssets. Scripps Health had issues with fees that Novation had collected from medical supply companies. Scripps estimated that the agreement with MedAssets would save $20 to $25 million per year of the $212 million the hospital network spent annually on supplies.