Now that most providers have started using an EHR, the single biggest deterrent to shifting to a better system is usually the time, cost and loss of productivity involved in migrating your data to a new system. Some providers also fear losing access to part of this data during transition which can compromise patient care.
This actual and presumed difficulty in data migration largely happens because conceptually, most EHRs capture the same types of information. However, when early yet still market-dominant EHRs were first introduced, there were few mature medical content standards which came into use. Even for important categories of medical content, like diagnoses, lab results, medications, and allergies, a lack of uniformity was visible. As a result, many of these early systems created their own proprietary terminology, which can make data migration a major hassle.
Additionally, without accurate translation & coding, the new EHR will not be able to properly transfer important parts of a patient’s record to another healthcare system, like a patient portal, a clinical decision support service, an HIE, or another EHR.
However, a good understanding of the process can help overcome this challenge and lead to a successful EHR transition.
Thus, for anyone considering a move to a new EHR system, here are 7 things to know before considering data migration to a new EHR.
There’s no doubt that a good EHR can be a lifesaver. However, for anyone who has used the software available in the market, they would know how even a simple error can take a while to fix. In the same sense, the transfer of data between the same or two different EMR systems can also be a task that needs to be managed if they need their practice to be functional in time.
The importance of careful planning, preparation and use of EHR migration best practices cannot be understated. For example, your practice may need to recreate clinical forms or may have to manually extract data to the new system. The involvement of staff, excellent communication and allocating sufficient time will help ease the process.
Choose your data
Depending on how long you have been in practice, you may have decades of data on your patients. Some of it might be historic information that you don’t even use. For data that will have to be manually entered in the new EHR make a system of how far back you want to go in choosing the data to be uploaded. Also is it ok to just save a scan of this data or do you need to hand-key the information in the new system? Remember data keyed by hand into the new EHR will be searchable and usable for data mining. Documents scanned as images may be accessible, but the information will be static and can only be viewed as an independent snapshot.
Also, there are legal requirements for record retention in the United States. Depending upon your state and provider type you may need to retain your patient records for up to 10 years. Visit www.healthinfolaw.com to see the requirements for your state.
What are the likely options for data transfer from your vendor?
These are the likely options your existing vendor will have for exporting data from their system.
- C-CDA – This is a standard used by certified EHR to share patient data with other providers for ongoing patient care. Because most EHRs must be able to produce the CDA, most EHRs can also mass export the CDAs for use in another EHR. Keep in mind the CDA only includes the current medical data per the CDA structure. As such, it will not contain all past records and will not satisfy legal retention requirements. As a result, if you elect to import CDAs from your prior EHR, you will need to make arrangements to have access and retention of the detailed records of previous visits.
- .csv file with standard demographics and possibly additional fields. Similar to the CDA this structure cannot contain all past records so will not satisfy legal record retention requirements. In addition, since there is no standard for many demographic and other fields, it is very possible that a new EHR will not be able to import all information on a .csv as data.
- If you are migrating your billing, your old EHR (and new EHR) may have options available for billing related fields. These options are typical:
- Demographics only without insurance
- Full Demographics including the patient’s full insurance information
- Full Demographics plus the patient’s balance
- Full detail conversion – Full Demographics plus the detail records for all outstanding claim
- PDF(s) – Some EHRs will be able to provide one or multiple PDF files for each patient that include all prior information – office visits, lab results, etc. If provided as one big PDF per patient the pages are typically in data order. If provided as multiple PDFs, some vendors will group the PDFs into folders such as Office Visits, Labs, etc.
- .bak database back-up file – this is a copy of the practice’s entire database. While this may sound appealing, a .bak file is designed to be read by the software that created it. Since your new EHR vendor will not have access to your old EHR system it may extremely difficult if not impossible for the new EHR to decode the data in order to import it.
- Combination – your existing EHR vendor may offer a combination of the above.
- None – Unfortunately some vendors do not offer any way to mass export patient data
Type of EHR
If the practice is shifting to a newer version of the same product, perhaps running on a new technology platform, it will allow data migration to be a comprehensive and smooth transfer which will cause the least amount of disruption. However, if there’s switching to a new EHR from another vendor involved, it may cause several issues.
Usually, the most common problem is that the vendor of the current system is not willing to share more than the legally-required level of information. In such a case, the new vendor must rely on either a proprietary data extract or a batch of patient C-CDA files, which will then need to be manually loaded, reviewed, and electronically reconciled for every patient chart.
Functionality and Work Flow
When upgrading from an older system, there’s a chance that some of its functionality doesn’t work well with the new EHR. This is usually because of the new system’s better-optimized workflows. Thus, practice will have to realize that the new EHR will not do everything the same way as the old EHR.
The goal is to ensure the new EHR vendor understands and supports the various workflows in your health system: billing, scheduling, pharmacist, physicians, etc. Make sure that the new system can load enough data from your old system so that the impact on your staff’s workflows will be tolerable.
Data Migration Duration
Let’s get one thing straight, migrating data is a gargantuan task. It involves giving the new system a large span of time to transfer data which can take anywhere from a day to a week.
Data that automatically maps must be verified, whereas data that does not map cleanly needs to be manually reviewed. Even well-planned migrations require a period of transition, which must include ample time for staff to learn how to use a new system and implement new workflows. While Physicians and staff want to treat patients, and not learn new systems, there will be a lot to learn on a new EHR, and even some new workflows to adapt to.
Both your existing vendor and the new vendor may charge you for the retrieval and import of new data respectively. However, there are many EHR companies that do not charge the vendor for simple non-clinical data migration. Understand the terms while you are signing the contract with your vendor.
You may also decide to bring in third-party data translation services to manage the complete migration process for your practice. These services are typically at least $1,000 per provider and depending upon the technology there may be ongoing costs. Understand the cost both in terms of money, time and loss of productivity while deciding who will spearhead the data migration process from your side.
You can take a few steps to minimize the cost :
- Search for vendors that provide free or reduces cost imports. Software Finder can help you find such vendors. Reach out to us at email@example.com
- You have multiple options in transporting billing data. Consider if it’s worth transporting all this data. It may be less expensive and more accurate to simply obtain information from patients the next time they visit once you implement the new system. Or to ask them to provide the information through their new patient portal.
- Maintain access to your old EHR for several months and gradually export patient notes and import them into your new system. Even if your old system does not have a formal export process you can easily print PDFs and import them to your new EHR gradually as you see the patients again.
- if the old EHR provides multiple export options consider the lower cost options, particularly if you don’t need all the old detailed information.
If you’re looking for a new EHR vendor with good and least costly data migration options reach out to our consultants at Software Finder to connect you with the right vendor for your practice.