As many healthcare organizations migrate from legacy electronic medical records (EMRs) to more integrated EMRs, medical providers and practitioners have valid concerns about if they will be able to view all the data they have collected on their patient population for clinical decision making throughout the years.
Frequently we hear the question, “Will I be able review my clinical notes, allergies, medications or labs in the new EMR?” For a successful implementation it is an absolute necessity to answer this question, with a well thought through “Historical Data Conversion” strategy for the implementation.
Some of the key goals of the data conversion plan are to maintain patient safety, assist with clinical decision support, provide continuity of care, provide comprehensive patient care, maintain physician productivity, strengthen physician trust in the new system and drive utilization and adoption of the new EMR system.
Listed below are the top 5 success strategies for historical data conversion implementation:
1. Define the scope of the conversion in detail.
- Engage appropriate clinical/revenue cycle leadership for definition of scope at the start of implementation.
- Obtain appropriate “buy-in” from the key identified stakeholders on what legacy data will be converted and what will not.
- Define the boundaries between data conversion vs. data archiving and their distinct purpose.
2. Validate the quality of the data in the legacy systems.
- Have open and candid conversations about the quality of the data in the Legacy system.
- Determine if it is reasonable to exclude any “free-text” data from the scoping.
- Avoid conversion of data that may create patient care/safety risk.
- Perform patient duplicate analysis and clean-up prior to the conversion process.
3. Employ a rigorous testing and validation plan.
Defining the validation strategy and scope of different phases of validation:
- Validation Phase I: Testing and Validation done by IT conversion team.
- Validation Phase II: Testing and Validation done by SME team.
- Validation Phase III: Typically, this phase is more for statistic gathering and planning for the timing of the conversion process prior to the Go-Live.
A layered validation approach of the data is an absolute necessity. This allows a comprehensive approach to validation of data from multiple points of view: Listed below are some sample groups of how validation could be layered:
- IT team, both integration and application validation.
- Departmental SME’s validation.
- Physician and nurse champions validation.
4. Engage vendors early in the process for extracts.
- Technical specifications are key to a successful data conversion. These tasks often either gets missed or are completed verbally. Proper documentation during this stage is imperative.
- Getting the extracts from legacy systems can be a challenge and working in advance with the vendor is required. Trying to line up the vendor dates and the project implementation can be a monumental task. Sometimes these extracts can be written internally with the organization, however that can be another resource constraint on the implementation project.
5. Resource allocation planning and identifying any gaps.
- Identifying resource needs at the beginning of the project is a requirement that cannot be ignored or taken frivolously.
- Setting the appropriate expectations with the executive leadership team and key stakeholders during the “preparation” phase is crucial. The design, build and validation effort for conversion and resources needs to be clearly communicated.
- Conversion is not only an IT task with integration resources, but for it to be a success, engagement from several teams is needed at different phases of implementation.
Historical data conversion is a crucial piece of EMR implementations in the healthcare industry. It requires extensive planning and needs considerable resources for execution. Usually the same resources that are planning the implementation of the EMR have to be leveraged to assist with the conversion of the data. Historical data conversion initiatives may seem like a harmless endeavor at first, however, once you start peeling the layers of multiple and complex components it can be a very challenging undertaking. The strategies listed above can help increase the chances of success for an organization that intends to embark on this journey.
Shaman Akhtar is a Senior Advisor at the Naperville, Il.-based consulting firm Impact Advisors.
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