What Makes an EHR Data Migration So Difficult?

We’ve all read about the latest issues with Electronic Health Record (EHR) data migrations. Serious ones, like patient safety issues, missing appointments, problems, and time delays. The process of EHR implementation is not a new one. Why is it still so difficult to migrate data from a legacy system to a new EHR? Let’s take a look at three of the most common areas of frustration.

Poor Planning

On average, families spend two weeks planning where their pets will stay while going on vacation. Healthcare IT teams may spend as little as half that time planning a small data migration. We depend on the IT department and the vendor to walk us through each step of the process, yet we never look at the time, resources, training, or usability delays closely enough.

There is no cookie-cutter formula for a successful data migration, and unfortunately, most vendors want to repeat the same rote process every time.

Vendors have a pre-defined training curriculum and a fixed number of days on site, and anything outside of what’s offered requires additional resources. The problem with this model is that every organization’s data landscape is unique. It can include decades of old mainframes or homegrown databases, each with its own set of unique challenges. We underestimate the testing timeframes, the training timeframes, and the integration timeframes.

We are told, “Yes, we can bring that over,” when in reality the statement should read, “Yes, we can bring this over in 6-12 months, and until then you will need to manually input hundreds of data points into each patient’s chart, taking up copious amounts of time and resources. And oh, just to be clear, your operating costs are going to take a nosedive (as in millions of dollars nosedive).”

The latter would make us sit up and take notice, right? But most often the lack of communication and due diligence on the part of the organization leads to frustrations, losses, and unexpected costs, like the number of FTEs required for data input, and the staffers who just decide it’s too much and quit or retire early.

Technical Compatibility Challenges

The lack of compatibility between the data formats of the legacy system and the new EHR can present many issues like data accessibility, database integrity, new system readability, lack of data standards, sharing, and conversion to the new system. Patient demographic clean-up is a long and arduous process. The legacy system (or the transfer to the new system) may have duplicates. Another issue is the way the data is brought over from the legacy system.

An HL7 pipe will bring over all of the data, but it “dumps” it into an area, it does not organize it, and it does not do a good job of cleaning it up.

This is one reason that demographics, labs, histories, medications, and problem lists have to be verified. This means verifying with each patient on their first visit, and manually inputting the data into the new system. The transfer will take 6-12 months if the vendor does it, and healthcare cannot be placed on hold while this happens. The result is an overdue burden on the administrative staff as well as the clinicians. At each step of the patient process verifications must be made for demographics, past medical histories, and medications. Duplicates must also be removed, and updated. It becomes what seems like a never-ending nightmare.

Patient Safety Can be Compromised

When information is missing, unavailable, or not in the right system for the right user, it requires months of manual clean-up. Meanwhile, staff, clinicians, and patients are delayed. These delays and the lack of critical information can compromise patient outcomes. Issues with medications, allergies, and adverse events are commonplace. Not having the right information in the right system at the right time can have fatal consequences on patient safety. The Department of Veterans Affairs (VA) reported significant problems in its effort to implement a new EHR. Thousands of clinical orders disappeared to an unmonitored inbox, causing patients to miss scheduled appointments.

In addition, the EHR failed to deliver over 11,000 orders for specialty care, lab work, and other services without alerting providers the orders had been lost.

The lost referrals resulted in care delays and were categorized by the VA safety team as “dozens of cases of moderate harm” and one case of “major harm.” This is the unacceptable result of a botched data migration effort.

How Can Boston WorkStation Help?

Aligning technology to existing healthcare workflows has historically been a difficult task for vendors. They want to create a “new” workflow, bringing over only partial information to a new EHR, which limits the integrity of the patient record. This impedes care coordination efforts, adding complexity rather than accelerating a culture of quality, performance, and value. What seems like a simple fix of manually entering demographics or legacy appointment data, literally turns into months of manual data entry and an overwhelming burden.

Automating the transfer of legacy information like appointments, schedules, past histories, and labs ensures information comes over correctly, with no duplicates, and is organized in the new system, for the right user, without manual intervention.

It is in the right chart, at the right time, ensuring compliance protocols, and saving time and resources. A strategic attribute of Boston Software Systems is that there’s no reliance on a particular system configuration. We have worked with every EHR vendor. If a person can sit in front of a computer and search, compare, and manually input data, we can accomplish the same thing thousands of times faster, more accurately, with less cost.

Give us a call. We can help at any point of the data migration process. Work smarter, not harder. Add Boston WorkStation to the team!

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