Empower Your Practice

Journal for Practice Managers

5 Common Questions About Switching to New EHRs Answered

Clinics regularly refuse to switch EHR systems, staying with an old and inefficient one, just for fear of losing data and time. This may be what switching to some EMR looks like, but it is not applicable to all.

With quality technical support and developed client services for the right software, a clinic can not only reduce migration risks but also migrate to a new software in less than a day.

Today we will answer the questions that many medical practices have before choosing a new PMS.

5 Common Questions About Switching to New EHRs:

  1. What are the reasons to change software?
  2. What problems may occur during the transition?
  3. How does the data migration process work?
  4. How do I comply with legislation during the transition?
  5. Who do I contact if I need help with data migration?

Learn how to simplify your practice workflow and free up more time for patients with Medesk.

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#1. What are the reasons to change software?

A healthcare facility may have different reasons for switching from an existing EHR to a new one. Six of the most common reasons are:

  1. Lack of functionality. The clinic is in need of functions that the developer does not plan to implement.
  2. The practice management system is not updated, new functions are introduced slowly, and system improvements are not made.
  3. The system is unreliable; frequent errors or interruptions occur. Work in the system should be smooth and convenient. Constant failures and errors not only irritate the staff and hinder the quality of services, but also damage the image of the clinic.
  4. The current software lacks the ability to integrate with other necessary services or other software, such as laboratories for convenient receipt of test results and billing and inventory software.
  5. The EHR is no longer compliant with legal requirements such as HIPAA or GDPR.
  6. The developer regularly raises prices, and it becomes too expensive to use the software compared to competitors.

Recognise your EHR provider? Then read on to learn the main challenges of changing EHRs and how to avoid them.

#2. What problems may occur during the transition?

The transition to a new electronic health record system comes with a number of potential challenges, among which both technical and legal aspects stand out, as well as a host of other possible problems.

Technical challenges

Data Integration: The migration of data from the old system to the new system is a major challenge. There may be data loss or incorrect display of information after migration.

Discontinuation of the old system: When migrating data, access to the old system may be restricted, jeopardising the availability of important information for patient care and clinicians.

Semantic interoperability issues: inconsistencies in medical and terminology standards between the old and new systems.

Cybersecurity: The transition may increase the risk of data breaches and cyberattacks.

Possible solutions to technical challenges:

  1. Perform a thorough audit and data cleansing before migration.
  2. Perform a test migration and ensure that the data is displayed correctly.
  3. Ensure that the old and new systems run in parallel until the migration is complete.
  4. Create backups of critical information.
  5. Analyse differences in terminology and standards and create appropriate mappings.
  6. Use standardised clinical terminologies such as SNOMED CT or LOINC.
  7. Apply strong security measures, encryption, and security checks for vulnerabilities.
  8. Update and test the security on a regular basis.

Regulatory compliance: The new system must comply with all necessary legal and regulatory requirements to protect personal data.

Contractual obligations: Problems may arise when terminating the contract with the vendor of the old system or when entering into a contract with a new vendor.

Respecting patients' rights: The security and confidentiality of patients' medical information during and after the transition must be guaranteed.

  1. Consult with legal counsel to verify compliance with HIPAA and other regulatory requirements.
  2. Conduct regular system audits to ensure compliance.
  3. Carefully review the terms of the contract with the old provider for potential penalties and liabilities.
  4. Establish clear and transparent contract terms with the new provider.
  5. Ensure that data migration does not affect the confidentiality and security of patient information.

Other challenges

Financial constraints: Transitioning to a new system may require significant capital investment.

Staff resources: The need for additional training and education of staff, which requires time and additional resources.

Change management: Difficulty in getting staff to adapt to the new system and resistance to change.

Business interruption: Transition can cause temporary disruption to the healthcare provider.

Possible solutions to other challenges:

  1. Develop a detailed budget and financing plan for the transition, including possible incentives and subsidies.
  2. Evaluate the return on investment.
  3. Establish a staff training plan and engage change champions.
  4. Ensure technical support and training resources are available.
  5. Develop a change management strategy, including employee communication and governance.
  6. Hold workflow sessions and meetings to discuss the benefits of the new system.
  7. Communicate in advance to all stakeholders about upcoming changes and possible impacts on operations.

Ensuring a smooth transition requires careful planning and management of each of these aspects to minimise risks and ensure continuity of health services.

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#3. How does the data migration process work?

When you decide to switch EHRs, it's important to insist on assistance from your previous service provider. The data stored by them is often organised specifically for their own system and needs to be adapted before being used in another EMR.

If there are no clear agreements in the contractual terms about the data transfer procedure, there is a risk of receiving information in an inappropriate or inefficient format. In such a situation, a past supplier may formally fulfil its obligations by issuing data in a non-standard form instead of organising it in a form that meets industry-accepted standards.

Clarifying the final timeline for data processing is critical to ensuring that the new EHR system launches without delay. A lack of understanding about data conversion can have serious consequences.

For example, if patient records are incompatible with the new system, it could prevent nursing staff from effectively using clinical decision support functions based on legacy data, such as automatically checking for drug interactions or allergy alerts.

If the information is provided in an inappropriate format, there will be additional time and resource costs to bring it up to speed.

In negotiations, it is often necessary to emphasise the importance of guaranteeing prior consent for assistance in these matters. Otherwise, it will be necessary to demand that the previous provider have access to the necessary tools to process the data themselves, which may include the use of data directories, database structures, and other authoring tools.

Formats and filename extension for data transitioning

To safely migrate data to another electronic health record system, it is important to use standardised formats that are supported by both the old and new systems. This format can ease the data migration process and reduce the chances of information loss. Some of the formats that are commonly used for this purpose are:

  • C-CDA (Consolidated Clinical Document Architecture). This is a standard used by certified EHRs to exchange patient data with other providers for continuing care. It provides a universal document structure that includes a complete clinical picture of the patient.
  • HL7 (Health Level 7). An international set of standards that provides guidelines for healthcare data transfer and management.
  • FHIR (Fast Healthcare Interoperability Resources). A relatively new standard for the electronic exchange of health information that is easier to implement and maintain than previous HL7 standards.
  • PDF/A: An archival PDF format that preserves documents for the long term.

However, before beginning the migration process, it is important to contact both EHR system vendors to determine exactly what data formats they can support and how best to migrate. This will help prevent technical obstacles and make the process safer and more efficient. The migration process should also utilise tools and strategies to maintain data integrity, confidentiality, and security.

The file extensions used to migrate data typically depend on the data formats and standards used for migration. The following are file extensions that correspond to some of the data standards:

  • .xml. This extension is used for XML (eXtensible Markup Language) files. C-CDA (Consolidated Clinical Document Architecture) often uses XML to exchange clinical documents.
  • .json is an extension for files in JSON (JavaScript Object Notation) format. FHIR (Fast Healthcare Interoperability Resources) uses JSON (as well as XML) to exchange healthcare data.
  • .txt or.csv: for text and comma-separated values that can be used for simpler or tabular data such as patient lists or lab test results.

These files can be encrypted to protect confidentiality prior to transfer.

Before you begin the migration, it is important to make sure you know which file formats and extensions are supported by your future and current EHR. This will ensure a smoother and more secure data migration.

An example of data transfer during an EHR switch

Let's say a clinic is moving from EHR system A to EHR system B. They've identified core patient data for migration, including:

  • Demographics (name, address, date of birth)
  • Allergies
  • Medications
  • Immunisations
  • Past medical history
  • Clinical notes (summaries).

EHR A might export the data in a standard format like HL7 (Health Level Seven), which is widely used for healthcare data exchange. This format organises data elements into segments and fields, ensuring a consistent structure.

EHR B can then import the HL7 data. However, System B might have different data fields or use specific terminology. Here's where data mapping comes in:

  • A mapping tool translates the data elements from EHR A's format to match the corresponding fields in EHR B.
  • For instance, "allergy to penicillin" in EHR A might need to be mapped to "penicillin allergy" in EHR B to ensure consistency.

After mapping, the data is transferred to EHR B. The clinic's IT team or the vendor might perform this step.

Data validation is crucial. Once the transfer is complete, the clinic staff should verify a sample of migrated data to ensure accuracy. This might involve checking patient demographics, medications, and allergies for any discrepancies.

Not all data may be transferable. EHR A might have custom fields or notes that don't have direct equivalents in EHR B. The clinic may need to decide how to handle such data, possibly migrating it into a separate format or keeping it archived in EHR A.

This is a simplified example, but it highlights the key steps involved in transferring core patient data between EHR software. The overall process can be more complex depending on the specific legacy systems, data volume, and customisation needs.

Read also:
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#4. How do I comply with legislation during the transition?

A successful transition depends on complying with legislation to ensure patient safety and data security. Here are some key points to consider:

1. Understand Relevant Regulations:

  • The Health Insurance Portability and Accountability Act (HIPAA) is the primary legislation governing patient data privacy and security in the US. It mandates specific safeguards for protecting electronic protected health information (ePHI) during transfer.
  • The 21st Century Cures Act (Cures Act) prohibits information blocking, which refers to practices that hinder the electronic exchange of healthcare data. This ensures patients have easy access to their medical records and can seamlessly transfer them between providers.
  • In the EU, the General Data Protection Regulation (GDPR) applies if you handle the data of EU citizens. The GDPR has similar requirements to HIPAA regarding data protection and transparency during transfers.

2. Data Security Measures:

  • Implement robust security measures throughout the transition process to safeguard patient data. This includes encryption of data at rest and in transit, access controls, and activity logs.
  • Ensure the new EHR vendor has a proven track record of data security and adheres to relevant regulations.

3. Data Transfer Agreements:

  • Establish clear data transfer agreements with both the old and new EHR vendors. These agreements should outline:
    The specific data elements being transferred
    The data security protocols used during the transfer
    The responsibilities of each party regarding data security and privacy.
  • Obtain patient authorization for transferring their medical records to the new EHR system. This authorization should be clear, concise, and compliant with HIPAA or GDPR requirements.
  • Communicate openly with patients about the upcoming transition and their rights regarding their data. Provide them with information on how to access and manage their health information in the new system.

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5. Documentation and recordkeeping:

  • Maintain thorough documentation of the entire transition process, including data transfer procedures, security measures implemented, and patient consent forms.
  • Document any challenges encountered during the transition and how they were addressed. This documentation can be crucial for demonstrating compliance in the event of an audit.

By following these steps, you can significantly increase your chances of a smooth and compliant EHR system transition. Consulting with a healthcare attorney familiar with HIPAA, GDPR, and data privacy regulations is also recommended for added peace of mind.

Read also:
Upholding Confidentiality in Health and Social Care

#5. Who do I contact if I need help with data migration?

Deciding to change your EHR solution but don't know where to start? The first step is to notify your old provider and talk to your new one.

If you haven't chosen a new PMS yet or still have questions about changing software, contact us and get answers to all your questions.

Our piggy bank has 10,000 happy practitioners, many of whom switched to Medesk from other software and were satisfied. Our dedicated account managers will make the transition and onboarding process quick and easy.


Summing Up

Transitioning to a new electronic health record system requires careful planning and can be a significant challenge. It is important to choose an EHR system that is ideal for your needs, including functionality, usability, support, and price.

You should also pay special attention to the data transfer process, identify mandatory data to be migrated, and proactively work with your new EHR vendor to migrate information correctly.

Preparing and planning employee training, testing the system before the full transition, and providing ongoing support and additional training once the new system is in place will be key to success.

When switching to a new EMR service, it is also important to recognise the complexity of the process. Equally important is consultation with IT specialists, data migration experts, and careful monitoring of all commitments by EHR vendors.

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