Electronic Health Record (EHR) Transition

Is it Time to Replace Your Existing Electronic Health Record (EHR)?

When considering switching/transitioning to a new EHR system it is important to consider the following questions:
  • Is your EHR preventing you from accomplishing your goals? (quality reporting, patient engagement, improving costs etc.)
  • Has your EHR affected your productivity and workflow?
  • Is your EHR vendor responsive to your issues?
  • Are there penalties for breaking your contract?
  • Was your EHR too expensive and not returning on its investment?
  • Are you having integration issues with other software?
  • Do you want to consolidate your system under a single vendor?

Transitioning to a New EHR System

Choosing a New EHR System:
Assess existing workflows and resources to determine what processes must be restructured. This information can also identify potential barriers that may have contributed to a previous failed implementation.

Create a needs assessment focusing on these three areas:
  • Workflow
  • Data Migration
  • Training Needs

Use this information and incorporate it into the selection process of the new system and the implementation strategy. Conduct in depth research on various EHR systems and narrow your list to three to five vendors. Contact other similar healthcare practices (specialty/size) that have implemented the EHRs you are interested in and see what their challenges were and if it was a successful transition.

Set up demonstrations with each of the vendors. This will allow the key players in your practice to compare and contrast the potential EHR systems with your practice's current EHR system. Use the demonstration as an opportunity to ask questions about how each individual EHR software will function within your practice.

When an EHR vendor has been chosen it is very important to thoroughly review and possibly negotiate your EHR vendor contract before signing to avoid possible issues or costs in the future. 

When planning for implementation, consider doing a phase implementation where one functionality of the EHR is introduced at a time. This will allow staff to get accustomed to each feature individually instead of all features at one time. Use this time to document procedures and policies that can be used as a guide by staff members when using the EHR system.

Resources: Establish a Data Migration Plan
Create a migration plan on how to transfer data from the current EHR system to the new EHR system. Majority of EHRs have a list of standard data (basic record information) that it typically brings over. Doing a basic conversion is typically less expensive and faster than doing a custom conversion that includes many specialized data fields. If your current EHR system and potential EHR system both generate continuity of care documents, data migration will be greatly simplified.

Key challenges to data migration projects:
  • Content that requires near-perfect accuracy such as medications, immunizations and allergies
  • Patients with multiple charts throughout the system
  • Multiple sources, data types and inconsistent source data
  • IT staff has no prior experience with EHR data migration
  • Maintaining records and keeping them up to date during the migration process
  • Making data fully operational
  • Meeting go-live schedule critical for successful implementation
Resources: Potential EHR Conversion Costs/Losses:

EHR Post Implementation Guide

Moving from implementation to use - Five tips:
  1. Create an EHR Leadership Team - A leadership team will be essential in making critical EHR decisions in a timely manner. It is important to have a decision-making approach set in place when making decisions about your EHR system.
  2. Engage Your Staff - Staff engagement is one of the most common problems practices face post-implementation. Set high expectations for your staff and how they should utilize the EHR system. The EHR leadership team can play a crucial role in supporting staff as they learn to fully utilize the EHR system. The leadership team should request feedback from staff in meetings or surveys to learn about which parts of the EHR are working for the practice and which aspects are not.
  3. Post-implementation Training - Many times, your staff will have questions about the EHR and a second round of training can be very beneficial. It is important that the staff is aware of EHR updates and how to use them. More training can also be beneficial when there are new policies implemented, such as the Merit-based Incentive Payment System (MIPS). Training ensures that everyone in your practice knows how to use the EHR system efficiently. After your staff completes training, the leadership team can assess progress by setting time frames new EHR features should start being utilized by staff.
  4. Watch for Problems - Monitor staff and physicians as they use the EHR to make sure they are using it correctly and efficiently. You will be able to identify common mistakes or habits that have formed and be able to correct them. Running a EHR utilization report is the easiest way to monitor use.
  5. Security - After implementing your EHR system it is crucial to implement administrative safeguards, physical safeguards, organizational standards, and policies and procedures to protect your practice and patient information. Set up an EHR security training program with your staff. It is valuable to have an IT support system in case the EHR is not working correctly. View the HCMS EHR and IT Consultants Grid for local vendors and their services.