Checklist for EHR data migration

As we continue to see more and more certified products from the ONC on  http://onc-chpl.force.com/ehrcert), many early adopters of EMR are facing a serious challenge. They are at a crossroad where they have to make the choice between either upgrading their current system to a certified version, or completely replace the existing system with a new one.

For the organizations that are engaging in a full system replacement, they are faced with a full fledged electronic medical records conversion.

At this stage, many of the mature EHR systems do provide with data extraction and export capabilities. But the challenge is always what steps to take to ensure a successful data conversion from one system to another. There are some important steps to take to ensure a successful migration:

Define the data that will be converted and migrated:

One of the critical steps to start the process of data conversion is to first identify the scope of the project. This would require the participation of several departments to ensure that all the data that is critical to patient care is in fact being migrated. Some of the data that would be discussed during these round table meetings are:

Lab results

Radiology documents and results

Patient Mediations

Scanned patient documents (business office as well as clinical)

Immunization Records

Allergy list

Progress Notes, Consults, letters, Reports and other clinical documentation

ECG and vitals

Patient Demographics

Billing or general account information

Identify the data format:

The next step would be to identify what information will need to be discrete data and which one will stay as unstructured data. During this step the conversion team will be able to identify the level of complexity for the conversion. For example, some labs maybe in one system as simple ASCII files or simple text files, but the organization may need to have lab results in the flowsheet which would mean that the data must be in a discrete format, and that may mean some additional data manipulation.

Identify what is the best route for the best outcome

With many of the EHR products in the market under pressures to add interoperability to their solutions, this makes the conversion process a little easier for many. By having the ability with most mature system to export and import data by using the widely used HL7 standards, it would mean that most of the burden would be placed on areas relating to the cross referencing the different clinical vocabularies between the two systems. The only piece of data that may add some challenges to the conversion process would be the unstructured data such as Images, PDFs, Tiff files and any other

In house or outsourced data conversion

When converting data from one system to another, it is important to review all your options. In many cases the interface team at the hospital organization or mid size practice would be an expert in the “old” system, which means they would know the best way of extracting the data. But when it comes to the new system, this stage would require working closely with the new EHR vendor or a third party reseller who has plenty of experience with other conversions. This will help identify what would be the best format for the extracted data as well as what capabilities the new system has in terms of importuning electronic patient medical records.

Test, test and test:

Once a road map is defined for the data migration or conversion, it is useful to perform test conversions early on and review the converted information by several of the clinical departments that will be utilizing the new system. This will ensure that all the information did convert as expected, and that everyone is on the same page.

Clearly technology helps care givers save lives, and that means that ensuring the patient data is safeguarded and properly maintained regardless of the system it resides on. When migrating millions of records, it is critical to have checks and balances throughout the entire cycle of the conversion. By using the already defined interfaces from both system, and involving everyone in the process, this will ensure a smooth and success data migration.