Options for Historical Patient Data while Upgrading your EHR

15 June 2015

AUTHORED BY: DB Technology


Are you getting ready for the BIG MOVE to your new EHR?

Like most US hospitals you are either in midst of negotiations with a new vendor, preparing your implementation project plan, or scrambling to make your new system “fit in” with your hospital family.

So why change?

Based on conversations with executives and industry trade rags, your reasons for switching can be categorized into…
• Increasing dissatisfaction with your existing platform
• Concerns about interoperability
• Worries about your current vendor’s status
• Non-compliance with government mandates

Years ago choosing the right platform was easy for the financially minded CEO; the system merely had to collect charges and manage billing and payments. Today the need for a holistic EHR, which accommodates both financial and clinicals as well as patient access drives the decision making process.

A new EHR is an exciting and terrifying prospect. It’s like purchasing a new home. A few more kids, a new job, 2 more cars and your current arrangements no longer satisfy your needs. Pulling up roots and moving elsewhere will fix this need but comes with uncertainty and inevitable tantrums by your children. The move is difficult, and not everything might fit in your new EHR. So what are you going to do with all that Historical Patient Data that exists in the old platform? I have categorized your decision down to three choices.

The Great Migration:

The first choice of most hospitals is to migrate ALL data from the old platform to new. This is an attractive option because most decision makers want their users to “live” in the EHR. Leaving the EHR to look for historical data is time consuming and encourages people to NOT look for the information they could use. As attractive as this options sounds it comes with a hefty price tag. Not only do you have to import this vast amount of historical data into your new EHR, but you have to get your old vendor to comply with the data export requirements.

Sorry, your data has been kidnapped but will be returned for a hefty fee.

The Clean Slate:

In this approach you keep your old vendor or platform for as long as you need the data, which in most case can be a LONG time. Your new EHR starts fresh with only the most recent patients from your older solution being loaded. Keeping the old and new platforms is attractive because you don’t have to worry about normalizing the data between two systems. Normalizing means assuring your data makes sense in your new EHR. As an example, perhaps your old system categorizes Race as W,B,A,H etc, whereas your new platform categorizes as White, Black, Asian etc. Before you can place that old data into the new system you need to “normalize” their values.

This can take a long time, and as mentioned before when you have two systems that represent the entire patient profile, most users will only see half of the story.

PLUS, you will be paying support/maintenance for that old vendor/solution for years to come.

Are you ready for that unexpected expense?

The Ideal Compromise:

Using a Document Management platform as a Vendor Neutral Archive (VNA) is the most cost-effective approach used by providers to access the old EHR data. With the VNA approach, recent patient records are transmitted to the new EHR, whilst the older patient data is saved in a VNA. The VNA approach will cost your organization a lot less money than the previous options, and most VNA solutions are built with an Application Programming Interface (API) which seamlessly connects your EHR to this vast storage of archival information. Users can live in the EHR and click a button to view historical data for the patient they are viewing.
But the VNA is not just about old patient data, it is also about connecting that unstructured data and documents to your new EHR. Images scanned at registration, clinical reports from outside providers, remittance advices and those pieces of paper you just can’t control (or have time to control) can be stored in your VNA and linked to your EHR.

Simply put, ensuring successful EHR migration largely depends on the way the data migration project has been managed. While critical patient data can save the life of a patient, there are many causes that might lead to data loss. Using an effective data migration strategy can ensure easy access to patient data, and efficient use of the new EHR.

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