Help Your Client Migrate to a New EHR By Ron Sterling A number of medical practices now face the decision A CHANGE MAY BE (or requirement) to replace their existing EHRs. In some cases, practices cannot cope with the products they have, and in other cases, for reasons beyond their desire or control, practices’ EHR products are no longer viable. Less than one-fifth of the eHR products that were certified under the stage 1 meaningful use requirements have been certified under stage 2. Considering that some eligible professionals need to move to stage 2 in 2014, a number of practices are facing an uncertain eHR future and an unforgiving calendar to meet the new requirements. In other cases, the vendor is pushing users to move to another product because their existing product will not be enhanced for stage 2 of meaningful use. The move from one eHR to another is a demanding and difficult process. many eHR vendors do not include or define transition plans to move practices to new eHRs – this presents a significant challenge. Indeed, most contracts are silent on the matter. Practices are left to deal with the data that their current vendors are willing or able to provide and can only load the data that the new vendor is willing to support. Regardless of the challenges, practices are required to maintain patients’ medical records for seven or more years after those patients’ last visits to the practices. If they do not or cannot move the eHR information from an old eHR to a new eHR, practices may have to pay to store information in an antiquated format. To support your clients in their transitions into new eHRs, you need to address three important steps: STEP ONE: DATA ANALYSIS – switching away from an eHR requires analysis of the available information and finding an appropriate place for the information in the new eHR. Your analysis should include the following steps: • Inventory the information in the old eHR and map the information by type to the new eHR. For example, an immunization record from the old eHR may include a single field for the lot number and manufacturer, while the new eHR may have a coded manufacturer file to categorize the separate immunization 44 HBma BILLINg • JaNuaRY.FeBRuaRY.2014 NECESSARY, AND YOU NEED A CONVERSION PLAN TO PROTECT THE DATA lot number field. In some cases, you may have to take structured information from the old eHR and place it in a text field in the new eHR. • Determine if information will have to be converted or reformatted for the new eHR. Not all eHRs use the same image and document types. The old eHR images may have to be converted from a PDF file to a TIFF file, for example. similarly, messages in some eHRs are considered an integral part of the patient record while other eHRs consider messages an outside component of the patient record. The messages that are part of the patient record may have to be converted into an encounter note in the new eHR. • The analysis should produce a design document that will be used by the new eHR vendor to convert the old eHR data. The document will be used to design the verification strategy and kept to demonstrate due diligence for HIPaa security purposes. STEP TWO: DATA CONVERSION – The actual conversion of eHR data is typically hampered by a lack of formal documentation and planning. many eHR conversions proceed without a specific data conversion plan or process. The data conversion process should be a structured effort with ample opportunities for the doctors and clinical staff to verify and check that the old eHR information was appropriately converted: • a test conversion should be completed to verify that the eHR vendors have properly executed the designed conversion. • The practice should design a verification list to check on the efficacy of the conversion effort. The verification checklist
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