An EMR conversion brings with it an assortment of questions: What applications are affected and how many will be replaced? What’s the timeline for the project? How will users receive training? What will it cost?
One of the most critical questions is this: What will happen to all existing (legacy) EMR data? This is information organizations need to provide safe patient care and meet state and federal compliance regulations like the CURES Act.
Weighing the options for EMR data during a conversion
Many healthcare organizations assume there’s only one way to handle legacy data during an EMR conversion: extract, transform, and load (ETL) it into the new system. While an ETL approach for EMR data conversion may be necessary for newer legacy data, it’s less ideal for older data. Why? It’s cumbersome. ETL typically requires a complex data mapping process, the first step of which is to identify the data the organization wants to move into the new system (e.g., allergies, medications, immunizations, surgical history, and other data elements relevant to immediate patient care). Then the organization must determine how it wants to move that data (e.g., through a flat file, HL7, or another method). Finally, it extracts the EMR data from the old system and then tests and validates it.
Rather than engage in this labor- and resource-intensive process for older legacy data, organizations ultimately decide to simply leave the data in legacy systems, where it’s unfortunately inaccessible from the new EMR.
But, with the right technology, this patchwork of data availability can be avoided during an EMR conversion. While organizations must use ETL for newer data necessary for direct patient care, they don’t need to use this time-consuming approach for older data. They also don’t need to maintain that older data in legacy systems, which exposes healthcare organizations to potential security breaches and compliance vulnerabilities. The average cost of a breach in the healthcare industry is nearly $6.5 million, according to some estimates. There’s also a significant cost associated with maintaining these systems—potentially hundreds of thousands of dollars a year, according to one recent study.
Alternatively, state-of-the-art EMR archive technology yields data management tools for secure and easy access to EMR data and minimizes reliance on legacy systems. This technology gives organizations the ability to access their older legacy EMR from within their new EMR without the burden of an ETL conversion.
According to KLAS Research, 85% of organizations that archive and retire legacy systems report positive financial results. This data suggests there are many reasons why the 69% of healthcare organizations that currently have legacy systems in place might want to reconsider their EMR archive strategy.
Following are a few dos and don’ts to help healthcare organizations identify the most cost-effective, efficient EMR archive strategy that promotes high-quality patient care before, during, and after an EMR conversion.
What to do during a conversion
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DO establish a clear plan for managing older legacy data before the conversion process begins.
How will older legacy data migration occur? Who will be responsible for managing that data? How long will the organization retain its older legacy data? Work with a data archiving partner that can help identify what you must convert via ETL-type methods and what you can convert using a state-of-the-art EMR archive technology. This partner can also help you identify strategic initiatives, prioritize archiving projects based on clinical and administrative need, and avoid expensive legacy system maintenance fees.
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DO know record retention requirements.
This includes state and facility-specific requirements for patient records, billing data, and other important documents. Also consider the sensitivity and importance of the data when thinking about retention. Leveraging a data archive platform enables healthcare organizations to comply with even the most stringent requirements in a cost-effective way.
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DO think about what end users need and want.
Physicians need expeditious access to trustworthy legacy data to ensure patient safety. Likewise, health information management staff need the same to comply with patient access rights and release-of-information requirements. An EMR archive solution must provide all of this and more.
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DO consider legacy system challenges.
Physical hardware in legacy systems can fail, or individuals with knowledge of how to retrieve data in these systems may have retired. Organizations must decide whether they want to take on the risks associated with not being able to access old EMR data.
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DO migrate data efficiently.
This may involve using automated tools to transfer data or manually inputting data as needed.
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DO focus on verification of data integrity.
Ensure that data transferred to the new EMR is accurate and complete. State-of-the-art technology that omits ETL promotes a faster and easier data verification process.
What not to do during a conversion
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DO NOT assume an EMR archive project will be cost prohibitive or operationally burdensome.
With novel EMR archive technology, the amount of money saved on maintenance fees and lost efficiency far outweighs the cost of the solution used to archive old EMR data. Note that these cost savings are immediate. Novel approaches to data archiving often result in the completion of entire projects within a single billing cycle for legacy system maintenance.
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DO NOT rely on your EMR vendor to validate EMR data and conversion-related information.
Even big EMR vendors don’t have the resources necessary to do this, and some may even require organizations to sign attestations acknowledging that at least 20% of the data has not been validated.
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DO NOT assume your legacy system is—or will remain—secure after a conversion.
Legacy systems are not kept up to date with the latest security tools and techniques. In addition, these systems may not even function on the latest versions of operating systems. This prevents important upgrades necessary to ensure security.
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DO NOT forget about EMR data that’s no longer needed.
Healthcare organizations may need to securely delete data from storage systems or shred physical records after an EMR conversion.
Reach out to discuss your archiving plan
Deciding how to handle older legacy EMR data is an important part of any EMR conversion. Although the decision is facility-specific, there is one commonality: The importance of engaging in conversations about legacy data as early in the conversion process as possible. Communication between stakeholders helps identify and address potential challenges to ensure long-term success. Learn how Olah can help with its simple, fast, and complete solution for any EMR archive project.
