That means for physicians to maintain access to the last ten years of treatment history for adult patients, as recommended by the Alabama Board of Medical Examiners, the old EHR must be kept going along with the new one, and possibly paper charts as well. “So they may be paying for two EHR subscriptions each month for years,” McGinty says. He knows of one practice that’s on its third EHR in 18 months.
Seventy percent of Oceris sales are to offices that want to replace a current EHR. The remaining 30 percent are installing EHRs for the first time. “But not because they haven’t used an EHR before. It’s because they’re a new office,” he says, adding that he rarely sees anyone transitioning from paper to EHR anymore.
Finding out that only a small part of patient data will automatically transfer to the new system tends to be a shock. Generally, EHRs will successfully transfer only a patient’s basic demographics like name, address, birthday, and social security number.
However, those certified to meet Meaningful Use requirements for 2014 have expanded exportation abilities. “But it’s data that the government agreed upon as a core data set—the patient’s demographic info, current medications, current problems, immunizations—basically a snapshot of the now,” McGinty says. “It’s not a complete history. So for past problems or past medications, you still have to pull up the old system.”
Data is stored in each EHR so differently that a complete transfer becomes very complicated and unreliable. The custom coding needed to transfer all data from one EHR to another would cost anywhere from $10,000 to $25,000. In addition, EHR companies often charge upwards of $10,000 to export their own client’s patient data beyond the required core data and also to import that extra data from another EHR.
Most practices opt to electronically transfer only the basic demographics. Then they manually enter the rest of the data as they need it. “This way they get a clean slate,” McGinty says. “And they can set up the information in the new EHR the way they want it.”
“You don’t want a situation where it’s garbage in, garbage out,” says Carrie Gulledge with MediSYS. When practices began using their initial EHR, staff likely documented the same data using different phrasings or in different places. “It’s not that the data was incorrect. It’s just not organized in the manner they wanted to see it,” she says.
Manually entering the data into their new EHR allows staff to sort and display their patient data more consistently and to take advantage of the new EHRs enhanced capabilities.
“One of best things to keep in mind is that you won’t be slowed down like you were when you went from paper to EHR,” Gulledge says. “Because of the experience with EHRs already, the big learning curve doesn’t exist. You don’t have to overcome all those big hurdles.”
McGinty adds that manually entering the data from the old to the new system versus a digital transfer has another advantage. “You don’t have to transition all your doctors at once. You can stagger it,” he says. “Have two or three doctors a week start on the new system.”
“A good recommendation when transitioning is to not get so focused on what you could do on the old system,” Gulledge says. “Every EHR offers new efficiencies and options. So go into this process with an open mind. Don’t get hung up on how something was done in the old system, because the new one may do it better.”
To make the most of the new EHR, physicians should identify what they liked and didn’t like about their old system. Then ask the new EHR’s trainer to replicate those positives and offer solutions to the negatives. “Be upfront with the implementation specialist. What you liked in the old one may just be housed in a different area of the new EHR,” Gulledge says. “Don’t assume that just because your old EHR couldn’t do something you want, the new one can’t either.”