Implementing a new EHR system at a medical practice is no walk in the park. Migrating data, checking record integrity, Training Staff, and ensuring that the transition to the new EHR does not lead to revenue leakages, requires a great deal of planning and effort.
As disruptive as the process may seem, for many Practices switching to a new EHR may be the only way out – perhaps the existing system has reached its end-of-life or is unable to support the evolving needs of the Practice.
A major obstacle to adopting a new EHR system is migrating data from the erstwhile software. There are two aspects to this problem:
Issue: Mapping the data – The existing EHR vendor may be using its own proprietary technology, and mapping patient data accurately to a new system can prove challenging to say the least.
ISSUE: Level of support received from the existing EHR company – Migrating data to a more sophisticated EMR can be done with the least amount of disruption. However, the problem arises when a Practice decides to switch EHRs, and the existing EHR vendor offers limited cooperation in the transition.
In any event, the transition of EHR systems will require substantial planning. To make the shift more manageable, we recommend the following EHR-Transition Best Practices.
- Partner with an experienced EHR company
According to the 2017 EHR satisfaction survey ‘interoperability of EHR systems with other devices, apps and systems remain a major void in existing EHR systems. In other words, there are bound to be technical challenges in transitioning data to a new EHR. Therefore, choosing an EHR vendor with the best-operating systems to meet your requirements is not enough. Choose an EHR partner with significant expertise in transitioning data from your current EHR provider – and insist on seeing proof of this expertise.
- Data migration – do’s and don’ts
Ensure that you export the current patient demographics, future appointments, referring physicians list with their respective NPI number and list of ICD codes. These are the most common data fields that any new billing company or software should be able to import or migrate from the old system. A good system should also be able to migrate patient-specific ICD & CPT codes, primary and secondary insurance information, and most recent appointment.
If you want to migrate your old patient charts and documents into the new EHR, the simplest way is to upload and scan the relevant data into the new system several days before the patient’s next visit. Trying to import this information en masse may clog your new EHR with irrelevant or outdated data and worst still the data may be imported to the wrong fields in the new system.
Do not try to migrate any financial data as it can cause long-term issues in your system since it does not have the EOB information. However, you may import the financials balances into the appropriate Notes section and post them accordingly when the patient next pays their balance.
- Discuss each workflow with your new partner
Ensure that your new partner understands the data capture requirements for each workflow in your Practice, e.g. billing, appointment scheduling, pharmacy, physician records, etc.
- Do a test migration before importing
Data integrity is very important especially after the import. You need to ensure that all the patient data is imported and that the information is tied correctly otherwise it can create huge headaches for your practice for years to come (thus negating some of the value of your new system). Ensure that your IT person is aware of the patient number, referring providers number and other critical data fields and that they audit the data before the final import takes place. The best way is if the new vendor can show you the data in a test account before doing the final import. In reviewing your data in a test account before permanently importing it into your new system is not available, choose a different EHR system immediately. This is an indication of the lack of technical sophistication.
- Plan staffing requirements for the transition period
Migrating data, training employees, and handling system usage concerns (post ‘Go-Live’) will place some strain on your Staff’s daily routine. Therefore, it is recommended that during the initial few weeks of EHR transition, you keep patient loads at a reduced level, and/or increase staffing levels to ensure that your patient experience is not impacted.
- Set up an internal transition Team
Create a transition Team with representation from each workflow in your Practice. Involve this Team in discussions with the new EHR partner so that your vendor has a clear understanding of what is expected of the new system. Additionally, this internal Team of ‘System Ambassadors’ will become the change agents who will assist in Staff training and in addressing day-to-day concerns once the system goes live.
- Be patient with the new system and especially your Staff
Ensuring that everything goes smoothly may take up to several weeks after the go-live date. There will be pushbacks from Staff and physicians; you may hear people say, “This is not how the previous system worked, why did we have to change”. Assure your Staff that ultimately things will get back to normal. Reiterate the benefits of the new EMR system.
- Make scheduled training mandatory for everyone, especially your Providers (whom should lead by example)
One way to minimize resistance to adopting the new system is to ensure that all Staff is trained in using the system for their respective function. Your ‘System Ambassadors’ must be provided a more detailed training so that they can assist others and answer any questions that the Staff may have.
- Communicate frequently with the vendor post-launch
Have scheduled meetings or conference call for the first few weeks of the introduction of the new EHR to address implementation issues and raise problems faced by Staff. Depending on the size or sophistication of your Practice, in the first week or two, it may be appropriate to have daily meetings.
- Avoid the use of dual EMR’s – establish a hard cut-over date and stick with it
Once the EHR system is launched, ensure that all workflows are switched to the new EHR. Continuing to use the old system for some aspects of your practice can lead to errors that may impact patient safety and cause loss of revenue. Once the system is migrated, the old EHR should ONLY be used as a reference for patient records.
As you plan the transition, it’s important to understand the scope of the migration effort. For instance, someone can ask you thousands of dollars to convert and restore the data in the new system. As you negotiate these things, ensure that you or your technical person understands the entire scope of data conversion well.
EHR transition is a huge undertaking, and there’s a lot of room for error. In such a scenario choosing the right EHR partner becomes critical to ensuring the successful implementation of your new EHR. The PracticeForces Team has more than fifteen years of proven expertise in healthcare billing service, revenue management, and EHR implementation. Contact us today to see how we can help your Practice.
Kunal Jain is the co-founder of PracticeForces Medical Billing and IT consulting company in Clearwater, Florida.