Making an EHR Switch? Plan Your Data Migration
By Sean West, VP & GM, HealthPort Data Conversion Services
EHR replacement is on the rise. According to a KLAS study, the number of organizations replacing EHRs increased from 30 percent to 50 percent last year. Another survey by Software Advice states that the number of physician providers replacing EHRs grew from 21 percent in 2010 to 31 percent in 2013, mainly due to dissatisfaction with initial systems.
For physician practices, drivers for EHR replacement include acquisition by hospitals, upgrades to newer technology and meeting compliance. Overall, the top priority is efficiency—selecting a system that will effectively manage current and future needs of their patients.
Careful planning and preparation can help avoid common mistakes, contain costs and reduce the impact of change. One of the most costly pitfalls is failure to populate the new system with patients’ historical data. This is particularly an issue in physician practices where legacy systems can’t effectively output historical information.
Factors to Consider
Successful migration to a new system requires easy access to old EHR data—at least from the past three years. Key factors in determining the most effective migration strategy include:
- Physician and staff productivity – Electronic conversion of data, rather than rebuilding patient history over time, enhances physician and staff productivity. The ability to quickly access existing data and enter new information is essential to a practice’s overall efficiency. Having a complete patient history streamlines patient encounters, reduces exam room delays, and greatly increases patient satisfaction.
- New system performance – Access to old data in the new system supports quality of care and financial performance by helping to meet regulatory compliance and growing needs for research and reporting. However, it is important to moderate the volume of old data to ensure optimal EHR performance.
- Old system support – Ongoing support for old systems can be quite costly and cumbersome. Fortunately, there are now vendor-neutral data storage options that offer a more cost-effective solution.
Three Options for Data Migration
Making the change from one system to another can be a daunting task even under the best of circumstances. There are many options for migrating data to the new system, ranging in cost and complexity. Practices should diligently assess their needs and the investment required to meet top priorities. Here are three strategies to consider:
- One-time data conversion
- System-to-system interface
- Vendor-neutral archive (VNA)
Strategy One: One-Time Data Conversion
Best practice is to upload all data from the past 36 months. Collaboration among practice managers, HIM professionals and physicians is essential to setting priorities and determining the most frequently used documents—most recent lab results, last two office visits, preventative testing such as mammograms and colonoscopies. Patient information from the past four to ten years can be stored at a lower level of specialty-driven indexing, offline in an accessible repository or vendor neutral archive (VNA).
While one-time data conversion has distinct advantages in terms of access and value, smaller physician practices should be aware of costs incurred from both old and new vendors, along with the cost of the new system. And finally, success will depend largely upon technological support to ensure efficient and meaningful transfer of data.
Strategy Two: System-to-System Interface
The primary value of a system-to-system interface is the ability to ensure constant access to patient data in the historical EHR. Depending on the interface, Physicians simply click the historical icon on their desktop to open the old system, select the patient and view the data. The downsides of this solution are:
- Cost to support and maintain the old EHR
- Vendor costs incurred with multiple systems
- Decreased productivity for physicians working with two systems
For these reasons, VNA is fast emerging as an economical and practical solution, especially for price-conscious physician practices.
Strategy Three: Vendor Neutral Archive (VNA)
This relatively new option delivers a cost-effective “best of both worlds” approach. With a VNA, recent records are migrated to the new EHR, while older data is stored in an online vendor neutral archive. Easily available and retrievable, a VNA complements the new system without demanding large investments in staff time, data conversion fees or vendor system support. Additional VNA benefits:
- Supports HIPAA compliance for the full life cycle of data
- Meets long-term data retention requirements without maintaining legacy EHRs
- Accommodates all types of data—discreet EHR data, audio, video, Dicom, scanned documents
- Destroys data in compliance with state and federal regulations
- Ensures interoperability and control of data for the long term
Susan Evans, CMPE, Sr. Director of Operations, Surgical Practices at Saint Luke’s Surgical Specialists in Kansas City, Missouri, is an advocate of the VNA approach. As Saint Luke’s gradually acquired three paper-based physician practices, the existing paper records for each were scanned into a VNA. “Staff and physicians can easily pull patient charts forward as needed—no time is wasted, clinicians have prior histories, and the practice is truly paperless.”
The flexibility of HealthPort’s VNA has helped Evans address practice merger and acquisition challenges while meeting St. Luke’s IT and IS specifications. And, the VNA solution can bring forward and store electronic data for future acquisitions involving electronic records.
Ensuring Success
Regardless of the strategy you choose, data migration is critical to successful EHR replacement. Making the switch without transferring historical patient data into the new system requires rebuilding records over time, which is costly and inconvenient.
Lessons learned with legacy systems can help inform and streamline the conversion process. Practices should carefully consider the data needed and determine the best approach for optimal accessibility. Emerging best practices that affect patient satisfaction can guide the selection of a system that will efficiently meet future delivery of care. In the end, practices that conduct a full migration receive a tremendous return on investment—well worth the effort.
Tips for Successful Migration of EHR Data
- Start Early – Begin conversion efforts six months prior to anticipated go-live with the new system.
- Create a Committed Team – Include all stakeholders to ensure meaningful data is accounted for and that multidisciplinary interests are represented. Consider lessons learned and emerging best practices from the first time around.
- Gather Data Requirements – What data should you convert? Make sure you know the import/export process and accepted formats of both old and new systems. If not all data is being converted, determine how and where it will be securely stored.
- Engage a Data Analyst (internal or external) – As the person/vendor responsible for the scope of work, the analyst will sit with the team to ensure all requirements are understood and addressed.
- Test – Best practice is to test sample sets of data before going live.
This article is an excerpt / abstract of an article that was published by the Journal of Medical Practice Management in 2013 (Nov/Dec) issue.