Clinical Data Migration – Tips for Keeping Risk, Cost & Timing on Target

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Mergers and acquisitions in US healthcare remain strong for the fourteenth quarter in a row for the beginning of 2018, reports PricewaterhouseCoopers. With 200 deals reported in the first quarter of 2018, healthcare organizations continue to shift and consolidate. With M&A activity also comes data migration as data from newly acquired providers needs to be thoughtfully integrated into the organization. However, there are some considerations to ensure there is a solid marriage of new and existing data.

Without the right resources, moving EMR information from one database to another can be risky, costly and time-consuming.  As healthcare organizations don’t typically have internal resources at the ready to perform legacy electronic medical data migrations themselves, they seek conversion services from their EMR vendor or a third-party.  Here are some medical data migration tips to ensure data integrity, minimize expenses and hit targeted deadlines.

  • Partner with a firm specializing in clinical data migration. Critical to the success of the project is working with a vendor who focuses solely on EHR data migration and extractions and understands the nuances of clinical code sets.  An EMR vendor knows its own database structure inside and out, but, may not be as intimately familiar with the source EMR.  This can be problematic, sandwiching the health organization between the vendors should the source EMR vendor need to be engaged.  Finding a vendor-neutral service provider who has worked with both EMR systems should reduce risk and increase project efficiency.  Be sure to ask the service provider for references and make calls to ensure their “like” migration projects met budgets and timelines with no major obstacles.
  • Assemble a cross-functional data governance team While the technical aspects of clinical migration fall to the IT department, data scoping, validation and quality assurance fall largely to business stakeholders. Appoint a cross-functional team of IT analysts and software users who will collectively weigh in on the electronic medical data migration plan.  Make sure the right HIM resources are at the table to answer questions about what data you have and don’t have as well as what data is highly critical versus less so. Determine how data will be tested, evaluated and approved.  Identify a manager for setting the project in motion and a sponsor for providing ultimate sign-off.
  • Define the scope of EMR data to be migrated. The more clinical data you migrate, the more complex (and therefore the more costly) the project.  Determining what legacy EMR data to migrate versus archive is a key to controlling costs. Ask your data governance team:  which data points, from how far back, are critical to present at point of care? Once this clinical summary data set is identified, the rest of the historical information — including financial transactional history — can be secured as discrete and searchable data elements in a long-term, HIPAA-compliant EMR archive. Note:  while the destination EMR will likely accept demographics, it may limit the type or amount of clinical data accepted.  If this is the case, look into feeding clinical document architecture (CDA) summaries to the destination EMR via its portal.
  • Identify where data from the source EMR will reside in the destination EMR. Third-party vendors don’t always provide an actual demonstration or screen mock-up of where and how the source data will appear in the destination EMR.  Fully understanding the end result data placements and workflows is critical so that expectations — and ultimately timeframes and costs — are met. If it isn’t right the first time, a greater level of effort and time is needed the second and even third time around.  Data mapping and visualization is tedious but necessary, so, negotiate it into the contact as a deliverable.
  • Document the data mapping for future reference. The logic and database structure of the source EMR is likely vastly different from the logic and database structure of the destination EMR.  If one system calls source ID “SID” and the other system calls source ID “SourceID” then the two must be mapped to minimize redundancy and reduce errors.  Data mapping is expected, but, its formal documentation isn’t always provided by a vendor as a deliverable. Documenting the data mapping efforts as the project progresses makes each record traceable.  That means that as breaks in logic or issues in quality occur, they can be quickly corrected.  Think of your data mapping documentation as a quick and easy roadmap back to a source EMR field in question.  A lot of time and effort can be saved by formally documenting the data mapping.
  • Determine the environment in which the clinical data migration will take place. Will the migration take place onsite or offsite?  It is important to consider the equipment, resources and infrastructure required for both.  If it will occur onsite:  How long will it take? How might the network be taxed or degraded as the data is moving?  It may take some math to throttle the throughput so the network is not crippled for your users. If it occurs offsite:  How will the vendor gain access to the data? What is the process? How will privacy and security be addressed?
  • Collaborate with your vendor on a data access and validation process. The two areas where a medical data migration can drag out past deadlines is in the beginning and at the end. In the beginning, the healthcare organization needs to make the data accessible to the vendor, getting the right authorization logistics in place and then successfully granting system connection rights.  A word to the wise: this can never begin too early because it inevitably seems to take longer than expected due to scheduling and resource issues. In terms of data validation, allot an appropriate amount of time for it in the project plan.  A second word to the wise: the amount of time allotted for data validation is directly proportionate to the quality outcome or lack thereof of said data.  In other words, allow for several iterations. No matter how experienced a vendor is, every system is different and, as a result, you typically don’t get 100% validation on the very first-pass. Utilize your user acceptance testing (UAT) environment.

clinical data migration
In conclusion, most healthcare organizations do not have the time or ability to conduct clinical data migrations exclusively on their own, and, most EMR vendors over estimate their ability to migrate legacy clinical data.  Best practice might be to assign a project manager and put out an RFP for Medical Data Storage to find an experienced legacy EHR migration service provider who can keep risk, cost and timing in check. This approach can expedite the process by allowing key data to be migrated while also archiving all data necessary to meet medical record retention policies.


Editor’s Note: This blog contains content from an earlier post on May 9th, 2017.

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Aug 01 2018

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