EHR Replacement: Three Dirty Details your New Vendor May Not Mention

EHR Nurse Ipad

Your healthcare organization has decided to replace its electronic health record (EHR or ERP).  From features and benefits to care template customization to meaningful use requirements, there is much to consider in a system replacement. The EHR project plan can become so overwhelming that you might find yourself leaning on the vendor for more guidance than expected. While that dependency can allow you to gain insight to some very valuable best practices, it might also expose a few “gotchas.”  Here are three dirty details that your new vendor may not mention during implementation planning.  We encourage you to investigate them early on as we consistently see them crop up as challenges for many of our clients replacing an EHR.

  1. Many EHR vendors expect customers to extract their own data from legacy systems.One of the first steps in EHR and/or ERP replacement is to determine what data is required, cost effective, or even possible to migrate to the go-forward solution. First, prioritize what clinical summary data is critical to provide quality care. Then, determine what data elements can and should be migrated. Last, determine who will extract the historical data from the legacy system. Will it be your own internal resources?  The new EHR or ERP vendor?  The legacy EHR or ERP vendor?  Legacy vendors — knowing they are going to lose a client — are often less than cooperative and have been known to charge the equivalent of “ransom” fees to provide extracts of your data from your legacy system. There are alternative EHR data conversion resources available to extract and migrate historical data in an affordable and timely fashion.  Plan ahead and budget for this expense.
  2. Some EHR vendors do not allow volumes of historical data into the new system. Clinical data can be complex when mapping it to a new EHR database schema. For that reason, some EHR vendors do not allow volumes of historical data to populate and “pollute” the new environment. Healthcare organizations that choose systems with this data migration restriction may not realize it until it’s too late.  As a result, they find themselves unable to convert the data they’d like to, or, spending extra time, money and effort on the conversion. There are some great options for storing historical data in a patient data archive that provides both accessibility for caregivers using the new EHR and compliance for HIM Directors meeting long-term medical record retention requirements. Ask your new vendor about any inbound data conversion restrictions before you buy.
  3. Most EHR vendors do not offer an archive solution to meet medical record retention requirements. A key consideration to think about during EHR and/or ERP replacement is the value of the data being retained from the legacy system. As planning and implementation takes place – surprisingly – the historical clinical, financial or administrative data is often an afterthought. EHR vendors are often so concerned about recognizing revenue by hitting milestones in the implementation of their own system that they neglect to counsel clients on the management of legacy patient data.  Review the legal and regulatory mandates for legacy data from a national, state, facility type and accreditation perspective. Compliance with HIPAA and numerous other regulations are must-have considerations that every healthcare organization is obligated to consider when replacing an EHR. Any solution for data archival should be easily accessible from across the go-forward system(s). This is not simply for immediate access to individual patient visit history, but for the wealth of value it provides for analytics across an historical patient population as well. Reporting on historical data is a topic often raised after an “aha” moment when it’s realized it can’t be done because legacy data may have been archived in PDF format only. Investigate options for discrete historical healthcare data storage.


Is there other information you wish your EHR vendor shared with you?  What tips do you have for other healthcare organizations replacing an EHR?

Editors Note: This blog contains some content from an earlier blog posted on April 7th, 2015.

Jul 19 2018

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