Mitigating Risk when Migrating from one EMR to Another

Healthcare organization’s digital footprints are becoming more integrated, which is leading them away from legacy electronic medical records (EMRs) to more integrated EMRs. While industry regulations and reporting requirements drive these initiatives, it does leave physicians and providers wondering, “How will I be able to access my patients’ historical clinical documentation?” Also, other operational leadership wonders, “How will our organization manage our A/R moving forward?”

For a successful EMR-to-EMR conversion, it is imperative to vet these questions in the process of advancing a data conversion strategy.The path toward a decision that an EMR conversion is in the best interest of your healthcare organization could also be vendor driven (by denoting that the current system is outdated or reduces the productivity of physicians), or health system directed (as a part of new population health initiatives or mergers/acquisitions). In either case, patient safety, continuity of care, maintaining and improving physician or organizational productivity, clinical decision support, and stronger physician trust in the new system should always be at the forefront for selecting a new vendor.

The conversations about data conversions and implementation should include the proper stakeholders within clinical and revenue cycle leadership to define the scope of the changeover. The “buy-in” from appropriate stakeholders is critical in deciding what data elements the conversion will encompass and what will not. Some patient’s information is more valuable than others, and this is where boundaries for data conversion and data archiving should be established. Whether data is imported as discrete structured data or if it is archived as images or .pdf file formats should also be decided. While the immediate concern surrounding the heavy lifting of “data elements” from one EMR to another is at the front of the project team’s mind, successful migrations also consider the “human elements” that interact with the new technology.

Having a new EMR also provides an opportunity to conduct training and standards around the how each user, as well as patients, interact with the data captured in the EMR. This element is where the planning for resources very early in the project is a requirement that is never inconsequential. The design, build, and validation phases of the conversion should have appropriate expectations established by leadership/key stakeholders and held to a high level of accountability. The IT team cannot be solely relied upon for the conversion. They are primarily responsible for moving data (bits and bytes); instead, the engagement of several functional work groups during various phases are necessary for the conversion to be successful.

There are several other pitfalls to avoid that have caused problems during an EMR-to-EMR conversion, include:

• A flawed EMR system selection process
• The system was missing critical modules
• Insufficient training time allocated to physicians and staff
• Unqualified trainers
• IT infrastructure and/or hardware were inadequate
• Vendor over promised and/or under delivered

Some if not all of these snares can be avoided with the proper analysis via a vendor selection process. If you find your organization in a situation where you are blaming the vendor for a failed conversion, it will always become your problem--and a serious problem. Never attack the vendor as this will decrease the chances of a quicker resolution. Always present facts, stay professional, and always agree on a deadline for a resolution.If your organization finds itself merging or acquiring another hospital or practice and there is a decision for which EMR to consolidate, please consider these factors:

• Which EMR is the most modern?
• Which EMR is the most cost-effective?
• Which EMR is the most physician-friendly?
• Which EMR has the most advanced integration (PM, Devices, LIS, PACS)?
• Which EMR can support data migrations
• Which EMR isthe most compliant?
  1. ICD10
  2. MIPS/MACRA
  3. HIEs
  4. Security
• Which EMR has the best roadmap to meet future needs of the practice/hospitals?
  1. ACO
  2. Population Health
  3. Analytics
  4. Care Coordination
  5. Patient Portal/Communications

Whatever the circumstance that leads your organization along the path for considering an EMR conversion, it is imperative that the critical conversations around data migration are conducted with open minds while keeping patient safety as well organizational viability as your primary goals. In the modern age of healthcare automation, data is a commodity that cannot be overlooked; the quality of the data will ultimately determine its value between your organization and other trading partners. Likewise, human capital and resource allocation are invaluable while testing and validating any conversion.

How well your functional groups will adapt to a new system will be determined by how well resourced the project team is and how early they were engaged. Even when vendors or other circumstances drive the decision to move to a new EMR, always consider the Coker Group’s staff of EMR conversion experts to assist in areas such as vendor vetting/remediation, EMR program management, data conversions, and as training and implementation specialists to make your EMR-to-EMR conversion a success!