What Are the Old EHR to New EHR Conversion Issues?

Data conversion from an old EHR to a new EHR is challenging and problematic.  In most cases, old contracts (and unfortunately many new contracts) do not obligate the current EHR vendor to provide the patient’s data or support the conversion.  Indeed, many practices are left to deal with the data that the current vendor “can” provide and the loading of data that the new vendor is ”willing”  to support. 

The gap between the old EHR information and the new system could pose a variety of operational issues and call into question continuity of patient care and even your stewardship of the patient medical record.  Indeed, contextual issues due to missing information and placement in the new EHR may complicate clinical decision making.

What Should You Worry About on Transitioning from Paper Charts to an EHR?

The transition from paper to EHR is a major policy decision that can have repercussions on patient service, your operations and even your medical professional liability (MPL.)  Unfortunately, many practices are not taking the time to analyze their options and responsibilities from a patient care and compliance standpoint.  In order to set the correct framework for your effort, you should think about how you would answer questions about your paper chart transition strategy in order to prove due diligence in maintaining the patient record and/or in the transition from the paper chart to your EHR.

ISSUE:  Disposition of the Paper Chart in the Move to EHR -

What MPL Issues are Associated with Meaningful Use (MU)?

Any transition of patient clinical records presents potential problems and issues that could affect medical professional liability (MPL).  Attainment of Meaningful Use is no different.

The Meaningful Use (MU) Criteria frames the use of a Certified EHR that enables a practice to qualify for the Medicare and Medicaid incentive payments.  Eligible Providers must fulfill 15 Core Measures and 5 of 10 Menu Set Measures to attain MU (For a complete list, go to https://www.cms.gov/EHRIncentivePrograms/Downloads/EP-MU-TOC-Core-and-MenuSet-Objectives.pdf ).  Many measures are associated with level of use based on a defined way of counting eligibility and usage.  For example, clinical summaries are to be provided for 50% of all office visits within 3 days of the visit to meet the clinical summary measure.

Your MU strategy should consider several MPL issues:

How Can You Attain Meaningful Use?

Attaining Meaningful Use (MU) is not an event, but a process.  As a practical matter, MU should be organized around packages of MU criteria in a sequence that leads to achieving Meaningful Use.  For example, it would not be practical to provide patients with electronic access to their patient records (MU Menu Set 5), until you maintain an electronic copy of patient health information (MU Core Measure 12). 

Meaningful Use can be divided into three stages:

Why Should You Worry About Your Next EHR Now?

While you are looking for a new EHR to qualify for Meaningful Use, it is not too early to think about what you are going to do when you stop using this new EHR and move to the next generation of EHR products in (hopefully) a number of years down the road.

The significant and troublesome barriers to moving from one EHR to another and the vendor issues that impede such moves are a strategic concern for anyone buying an EHR.

Is Your Practice Ready for an EHR?

From Medicare/Medicaid incentives to EHR industry ads, it is hard to cut through the hype and determine if your practice is even ready to try to select and implement an EHR.

Implementing an EHR is a transformational exercise for any practice that requires redesigning every aspect of charting, clinical workflow and interaction with patients.  However, in too many cases, practices approach EHR projects without considering the organizational commitment needed to succeed.

Governance and Management –

What is a Certified EHR?

In order to receive the Medicare or Medicaid stimulus monies, you have to attain Meaningful Use using a Certified EHR.  One would think that all Certified EHRs offer a high level of capability and functionality.  Unfortunately, you would be wrong.