EHR Data Conversion Guide & Workbook

Transcription

1 EHR Data Conversion Guide & Workbook

2 EHR Data Conversion Guide Healthcare today is faced with an aging population, a shortage of providers and a growing demand for chronic disease management. In addition to those factors, there is rising pressure to keep burgeoning healthcare costs under control. Healthcare organizations rely on technology, including Electronic Health Records (EHRs), to advance patient care, reduce costs, and improve patient experience. Healthcare organizations will not be in a position to surive and remain financially secure in the increasingly competititve marketplace when they fail to keep up with technology trends while maintaining phyisician satisfaction. Many healthcare organizations recognize the importance of preparing for the aging population, recruiting and maintaining physicians, and putting into place systems that positively impact care coordination. The success of these organizations depends on a strong IT partner dedicated to ensuring the accessibility and integrity of patient data as new EHR systems and technologies are put into place. When healthcare organizations change EHR systems, there are many factors to consider. Without the proper plan and support, detrimental and expensive mistakes can be made. However, when a trusted advisor and partner is chosen, the process and outcomes will benefit providers, patients, and the organization. Patient data is the key to solving many of the challenges facing healthcare today. It is important to put together a plan and work with a partner that will ensure its integrity. IN THIS GUIDE WE EXPLORE: EHR Trends Types of EHR Data Conversion EHR Data Conversion Workbook including: * Is an Automated EHR Data Conversion Right for You? * What Should You Ask Potential EHR Data Conversion Partners? * What Might Potential EHR Data Conversion Partners Ask You? Next Steps - EHR Data Conversion Process Just looking for the workbook? Flip ahead to EHR Data Conversion Workbook: Finding and Hiring the Right EHR Data Conversion Partner, beginning on page 6. Page 2

3 EHR Trends Healthcare providers are expected to document encounters with patients to ensure a record of crucial information for decision-making and in cases of dispute. Over the last 10 years, provider adoption of EHRs has grown significantly. As recently as a decade ago, 90% of physicians still updated their patient records by hand. By the end of 2014, the tide had changed and 83% of physicians reported they had adopted EHR systems. The combination of government incentives, advances in technology, and improved outcomes and operations has fueled this growth. When health systems and medical practices view patient information as a critical component in managing patient care at all levels, providers and patients can expect to realize a number of benefits including: Comprehensive View of the Patient Sharing Information & Coordinating Care Streamlined Workflows Preventative Care Greater Efficiency & Cost Savings Reducing Errors Page 3

4 EHR Trends (Con t.) While the last decade has seen advances in patient care through the adoption and implementation of EHRs, the need to change systems while still maintaining the access to and integrity of data has also increased. The two largest reasons for EHR system changes for health systems, hospitals, and private practices are: Provider dissatisfaction Mergers & acquisitions In preparing for these changes, providers and health administrators have been grappling with how to handle the data in legacy systems. Similar to the initial adoption of an EHR system, changing EHR providers is an enormous project. While healthcare organizations work to implement new systems, patients continue to generate more and more data daily. In the US healthcare systems, the volume of electronic data roughly doubles every two years. Determining how to maintain and store data from legacy systems, while utilizing a new system can be extremely challenging. After exploring the options available, including data archiving and running multiple systems, many health systems and other healthcare organizations have found the best option to maintain access to and integrity of data is through EHR data conversion. Page 4

5 What is EHR Data Conversion? EHR data conversion is the process of taking data from an legacy electronic health record system and transferring it to a new system. This process is commonly referred to as ETL. During an ETL conversion, patient data is EXTRACTED from the legacy system, TRANSFORMED to align with the map created for the new system, and LOADED into the new system. EHR data conversion can be completed through two methods: Manual Data Abstraction Chart abstraction is the process where important information is collected from a patient s medical record and transcribed into discrete fields or locations within the new EHR. This is a manual data entry effort where organizationally-defined, clinically relevant elements of data are collected from the legacy system and manually entered into the new target system. Manual data abstraction has a lower initial cost. However, costs exponentially increase with each record. Therefore, it is cost effective when the data set is small, but prohibitive in many instances when the data set includes greater than 30,000 records. Furthermore, this method of conversion is subject to a great deal of human error, and each record runs a significant risk of manipulation. Automated Data Conversion In an automated conversion, source values are extracted from both the legacy (source) system and new (target) system to create a conversion map. That map is entered into a conversion utility software. Data from the legacy system is run through the conversion utility and transformed to meet the needs of the new system. While it is being transformed, the conversion utility is monitoring total errors, parsing errors, mapping misses, percent complete, date/time to finish, and success rates. After the data has met the standards, it is then loaded into the new system. During an automated data conversion, not a single patient record is touched. Companies who specialize in healthcare data conversion should utilize a failsafe ETL methodology specifically designed to mitigate clinical risk. While the initial cost is higher than a manual data abstraction, the additional costs associated with each record are substantially less. Therefore, it is cost prohibitive for smaller data sets, but cost effective when working with data sets greater than 30,000 records. Page 5

6 EHR Data Conversion Workbook: Finding & Hiring the Right EHR Data Conversion Partner Is an Automated EHR Data Conversion Right for You? Planning for an EHR change can seem overwhelming. There are many options for moving or archiving your data. It is important that you seriously analyze your organization and the likelihood of success before jumping into potentially financially risky waters that come with each of the available options. When considering if automated data conversion fits your organization s needs, here are the types of questions healthcare IT leaders should ask their in-house team: Have we acquired facilities with disparate EHRs? Are we going to continue to acquire new practices or hospitals? Are we struggling with a plan for handling and storing the data? Do our providers and staff function out of more than one system? Does our EHR have capacity we are not using? Does our legacy system require internal experts? Do we have specialties, such as Obstetrics Gynecology or Pediatrics, that are required to store data for longer periods of time? Do we have more than 30,000 records we need to convert? If you answered yes to any or all of these questions, an automated EHR data conversion might be a good fit for your healthcare organization. After identifying your fit for this effort, it is important to take the following steps: 1. Identify a leader and entrust him/her to make decisions that align with the best interest of your healthcare organization. 2. Work with organizational leadership to identify goals for the project. 3. Put together a Physician Advisory Committee (PAC) to guide clinical decision making. 4. Enlist the help of an experienced EHR data conversion partner and consultant. Page 6

7 What Should You Ask Potential EHR Data Conversion Partners? There are many partners available to help with the ETL process, but it can be difficult to decide who is the best partner for you. Sometimes, being armed with questions is best, because knowledge is power. Below are some questions you can ask potential vendors to help narrow down your choices and find the right fit: 1. Can you accomplish this in the timeframe I have laid out? As health IT grapples with interoperability concerns, and health administrators work to find the best EHR fit for their team, many health systems and practices are converting their data to new systems. There are many vendors available to help with that conversion. Not all vendors have equivalent skills, experience, and processes/systems. Additionally, the growing amount of work may make them unable to complete the conversion by your deadline. Be sure to choose a vendor who is available to start working with you when you are ready and can lay out a plan with checkpoints to ensure that your conversion is completed and data is available when you need it. 2. What is your experience in EHR data conversion? When picking a data conversion vendor, it is important to consider the experience and knowledge the company has in EHR conversion and systems. That being said, a strong data architect is not necessarily a specific system expert. Nor is he/she a specialist, in any specific system s operations, usability or recommended workflows. Data architects are experts in extracting data out of ANY system using whatever means necessary for that system. In turn, he/she will become an expert in the specific needs of your organization and the systems you use. Page 7

8 What Should You Ask Potential EHR Data Conversion Partners? (Con t.) 3. Do you have the necessary expertise? A data architect serving a health client needs to have specific expertise in HIPAA and other healthcare regulations. While conversions happen in many industries, government regulations and sensitive health information make it important that a data architect serving healthcare have a very specific expertise. Furthermore, the vendor you choose should have programming ability in order to create an automated process specific to your needs and the EHRs with which you are working. 4. How do you monitor success? Data loss is a very serious concern in an automated data conversion. Any vendor you work with should be willing to acknowledge the risk and have a plan and systems in place to mitigate it. Your vendor should monitor total errors, parsing errors, mapping misses, percent complete, date/time to finish, and success rates. Along with monitoring, the vendor you work with must have a remediation plan. 5. Can you help me? You want to be sure that the data conversion vendor you choose is comfortable working with you. Are they comfortable with the size of your health system or medical practice? Do they have geographic limitations? Are the goals for both sides clear, and have both parties agreed to them? Finding the right fit for you and for your vendor will make the process smoother and more successful. Page 8

9 What Might Potential EHR Data Conversion Partners Ask You? An EHR data conversion partner will need to assess several factors related to your environment, plan, and needs in order to determine what will be converted, how much it will cost, and how long it will take. In an attempt to move the process along more quickly, it will be helpful for you and your partner to consider the following questions: EHR Systems What are your source and target systems? Where are these systems hosted (on-premise, vendor hosted, cloud)? What version are you using of each system? Quantity How many practices/locations are involved in the conversion? What is the size of each location? How many patient records and categories are you planning to convert? What is the number of charts to be transferred? Page 9

10 What Might Potential EHR Data Conversion Partners Ask You? (Con t.) Timeline What is the deadline for completion? If there are multiple practices involved, is there a priority sequence or timeline for each location? Patient Demographics What socio-demographic information must be converted? What types and quantities of services are provided? Regulations Are you currently using your EHR to attest to Quality of Care measures? If so, which diagnostic tests are captured? If so, which lab results are captured? If so, what procedures are captured? Page 10

11 EHR Data Conversion Process After you have selected a partner who will best meet your needs, you will begin the following five steps of the EHR data conversion process. 1. Discovery During the discovery phase of the process, your team will play a large role. An EHR data conversion vendor will ask internal IT staff to extract all data from the current system. Working together with your internal designated leader, IT staff, and Physicians Advisory Committee (PAC), the data conversion vendor will work to identify how much data is available, what data needs to be converted, and the accuracy of the legacy data. 2. Scope Definition The scope definition phase of the process is the point at which both parties come to an agreement on which portions of the data need to be converted, the method of the conversion, and the prioritization of the data. During this time, the two teams should schedule time to review the records, format them to meet the new formatting requirements, and set the processes to update record fields not available in the conversion. 3. Testing Once the scope has been fully defined, and the formatting requirements are completely understood, the primary responsibility of the conversion then shifts to the vendor. Based on the input gathered during the scope definition step, the data architects working for the vendor will map the data fields and formatting from the old system to equivalent data fields and formatting in the new systems. After the map has been created, the data architects upload the test conversion data to a testing environment. 4. Validation This step is a shared responsibility between you and your EHR data conversion vendor. Once the data has been loaded to the test enviornment, the data architects validate the data. Then, your team reviews the content, validates the records, and signs off on the final data set. This step may require several cycles and is imperative for the success of the conversion. 5. Migration Once the data has been validated, the vendor will execute the final migration. While the data is migrating, the vendor s conversion utility should be monitoring total errors, parsing errors, mapping misses, percent complete, date/time to finish, and success rates. When all the data is converted and migrated to the new system, your new EHR will go live! Page 11

12 Conclusion As the healthcare industry prepares for the aging population, a shortage of providers, increased need for chronic disease management, and financial pressures, technology and data are becoming ever more important. As a result, healthcare organizations that take steps to prepare for these changing demographics, prioritize physician satisfaction, and utilize systems to improve care coordination, will require a strong IT partner. EHRs have already proven that they have a positive impact on patient care. However, many providers have expressed dissatisfaction with their current EHR provider. Furthermore, the industry is experiencing a merger and acquisition movement. These two trends are driving the need for EHR data conversion services for many healthcare organizations. Not all EHR data conversion vendors are the right partner for you. It is important that you find a partner who values your data, can meet your needs, and will deliver a successful conversion. Page 12

13 Innovating for Healthcare & Senior Living To learn more about using technology to improve patient care, cost, and experience, visit us at keystonetechnologies.com or contact us via the address or phone number below. (314) Hwy 109, Eureka, MO