Part I: Ditching Your EMR For a New One? Here’s How To Prepare

As many of you know, EMRs have been around for some time. Although I wouldn’t go as far as to say they have matured as a product, there have been some progress in terms functionality (notice I didn’t say innovation).

The new word around the block is that apparently, practices are leaving their old EMR for new shinier ones. Now, some people say that moving from one EMR to another EMR is actually harder than moving from paper charts to an EMR. I find that hard to believe, but hey, what do I know.

Regardless, moving from one system to another is always a challenge and one that very few of us have actually gone through. So, let’s say you are planning to ditch your old EMR, what are the things you need to think about in order to start going down this huge transition?

Chip Hart from Physician Computer Company (my new vendor by the way), sat down with me recently and gave me the scoop on how, based on his experience of doing several conversions, is the best way to go about this monumental task.   It’s worth noting that they weren’t all conversions to PCC.  Chip tells me they’ve had plenty of people switch from one EHR to another and not PCC.

Chip, what is the biggest thing I need to be concerned about when taking on an EMR transition?

Data conversion. How will your data move from EHR1 to EHR2? This issue is, by far, the biggest obstacle in the process of transferring from one EHR to another.

Really? But it is all data isn’t it? Transfering 1s and 0s from one file to another should be easy and quick, is it not?

Any vendor who makes promises about what data can be transferred between the systems without analyzing your actual data is just guessing. Every EHR is different and often very different from practice to practice. Experience with a particular conversion is great, but not a guarantee. Many EHR vendors can’t even transfer data from one of their own systems!

OK, what is the second biggest concern that we need to consider?

You will likely need to manage a three-way balance of timing, cost, and quality for both vendors.

Whew, sound like a lot of work. OK, in your experience, what would an ideal EMR conversion look like?

In an ideal circumstance, an EHR conversion would work as follows:

  1. Comprehensive data from EHR1 is transferred to EHR2 well in advance of the transition to EHR2
  2. Over a matter of weeks the quality of the data transfer to EHR2 is reviewed by your office. Confirm everything from discrete data points like vitals to the transfer of scanned images to your narrative/notes.
  3. Then, on the last day actively putting data into EHR1, repeat the data transfer so that your database is as up-to-date as possible.

On paper this seems pretty smooth, but I know that in practice this isn’t always the case. What are some of the hurdles that come up during this process?

Sometimes, your relationship with EHR1 has deteriorated to the point that access to the database is limited. Additionally, many EHR companies restrict database access or export in their agreements with you. Their reasoning should be obvious, be prepared to fight for your data.

Let’s say my relationship with my old vendor is good. Anything I need to be aware of still?

If the relationship with EHR1 is good, and they are capable of delivering data to EHR2 in a timely and consistent manner, it is perfectly reasonable for them to charge for this service. The range of reasonable charges can be quite broad based on a variety of technical factors, but note that the amount of effort by EHR1 is not usually tied to the size of the practice or volume of the data…so a greater charge for a larger practice usually reflects EHR1’s expectation that a larger practice can afford to pay more.

Anything else?

As noted, make sure that TIMING is a part of any discussion you have relating to data conversions. Some vendors will take 2 to 3 to 6 weeks (or more!) to deliver data to you, the effective of which on a transfer can be devastating. Sometimes, it can take a few days to then convert the data – if you come with 800GB of images, you can’t transfer that in 15 minutes. [Future PediatricInc.com readers will laugh at that comment.]

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For my next post, I will posting Chip’s comments on how to leverage what we already know (as seasoned EMR users), to make the transition into the new EMR a successful one.

Chip Hart is Physician’s Computer Company Director of Pediatric Solutions at Physician’s Computer Company and he blogs at Confessions of a Pediatric Consultant. Chip also contributes from time to time to PediatricInc. To read Chip’s previous contributions, click here.

Lastly, I’d also like to point out that these are the types of discussions that we have on SOAPM, which is the Section of Administration and Practice Management at the AAP. As I’ve said before, if you are in private practice, and you are not  a member of SOAPM, you are missing out.