A divorce is scary enough when you have to account for all the financial impacts and the legal fees...then it hits you: Data Conversion! Yes, I am talking about divorcing your EMR vendor. It is just as painful as a regular divorce, without throwing pots and pans. OK, maybe a few keyboards are thrown. But the real challenge comes when you need to tackle the issue of data. Your clinical data belongs to you and it is an essential part of clinical quality, which affects patient care outcomes. But far too many vendors treat this as something that they can leverage to squeeze just a little but more of your organization’s budget. Think of it as a penalty clause for leaving or a nice parting gift. Either way you will be paying for the vendor to provide a flat file extract of your clinical data.
Depending on how your providers were using the current EMR will drive your ability to accurately populate the new EMR. Discrete data elements that can populate your vitals, problem list, allergies, etc. will only be exported if your providers actually parked the data within the appropriate fields of your old EMR. If they used a free text note or dictation, you can forget trying to automate a data conversion.
The real scary thought comes in matching records. If your EMR was a standalone system and you are now going to interface to a Practice Management system as part of your new EMR project, then you run the risk of duplicates and error logs. If your feeding multiple vitals, multiple problems and multiple meds during the same visit, then be prepared to do some very creative mapping. The best way to tackle this would be to create the multiple record ID’s for your EMR and PM systems, as well as a Master Patient ID. You almost have to scope creep the project to include these elements in order to avoid the inevitable delays with record errors and garbage data.
Pay now and plan for the added elements or pay later in project delays. New EMR versions that are Meaningful Use (MU) compliant now have the ability to export records electronically as a service to your patients. These records are exported in a format that can be imported into another MU Compliant EMR. I suspect that a routine could be created to take advantage of this feature and provide a clean data export/import. Until this is widely available, we will have to continue to do it the old fashion scary way. Dump the data, create your robust matching criteria and cross your fingers. Happy Halloween!