5 Tips to Ensure a Smooth EHR Replacement Process

By: Rahul Kumar on October 11, 2018

Are you using an outdated EHR system or dissatisfied with your existing one? Or perhaps, the existing EHR is not suited for your practice specialty, or the vendor remains unresponsive to your requirements?

Whatever the reason maybe, you’re not alone. Countless medical practices are looking for a solution to replace their EHRs for reasons such as:

  • Low user satisfaction

  • Lack of system functionalities

  • High operational costs

  • Failure to reduce physician workload

  • Lack of data exchange ability, i.e., interoperability

Dissatisfaction with your existing EHR system could lead to even bigger problems such as low—or, no—[patient engagement](https://www.softwareadvice.com/medical/patient-engagement-comparison/). Because if you’re not satisfied with your EHR, you can’t engage with your patients effectively.

In this article, we’re listing five tips for small practices like yours to follow during the EHR replacement process.

Here are the 5 tips we’ll cover:

1. Involve Your Staff in the Process

2. Search for an EHR That Meets Your Specific Requirements

3. Ensure You Achieve Your Data Migration Priorities

4. Schedule Deadlines and Stick to Them

5. Secure Your Patient Data During the Transition

1. Involve Your Staff in the Process

As we mentioned above, low user satisfaction is one of the main reasons medical practices want to replace their EHRs. That’s why you need to involve your physicians and medical staff at all stages of the selection process. Take their feedback into account when you shortlist new vendors, attend product demos and discuss data migration priorities with your old and new EHR vendors.

Here are few steps you can take to engage your physicians and staff:

  • Send a clear message in the very beginning. To ensure transparency to your staff, inform them of the decision to replace the EHR as early as possible. Hold town hall meetings with your physicians and medical staff or email a survey to gather their opinion and advice.

    Ask them about the functionalities that the old EHR lacked and their expectations from a new EHR. This process will not only make them feel involved in the EHR selection process, but also help you gather critical inputs on selecting the new EHR.

  • Create a physician engagement plan. Along with regular communication, involve your physicians in the process through a well laid out plan, such as:

  1. Identify early EHR adopters or EHR champions from among your physicians, and offer them this leadership role opportunity.

  2. Involve physicians in the decision-making process related to new clinical workflows, interface customization or quality improvement initiatives.

  3. Let physicians know that the EHR replacement process is more of a physician-led initiative rather than a management-led one.

  • Engage physicians and staff through adequate training. Training should begin as soon as possible before the new EHR’s go-live date. Start by training staff in their respective areas, for example, patient charting for physicians and patient scheduling for front-desk staff.

    Schedule one to two hours of training per week, along with designated practice time. Spreading the training out this way will avoid the burnout that can occur with one long training session. (Read our “Five Best Practices for Training Staff on Using a New EHR” report for more on training your staff on a new EHR.)

These steps will make your physicians and staff feel at ease with the new EHR, and you’ll gain their support in the entire journey of EHR replacement.

2. Search for an EHR That Meets Your Specific Requirements

EHRs should ideally make your practice more efficient. They should also add value through time savings and help you avoid physician burnout.

One 2018 study found that practices will replace their EHR systems even if there’s no quick return on their investment. This means that, though this transition can be expensive, a lack of functionality and inefficient workflows will push practices to search for another option.

So, as you search for an EHR system, it’s vital that you prioritize finding a system that meets your physicians’ needs and supports your practice’s growth plans. Here are some steps for selecting a new replacement EHR:

  • Shortlist the most suitable EHRs. Thoroughly discuss all costs involved and all feature offerings with each shortlisted EHR vendor. Consider whether you want cloud-based or on-premise software based on your needs and the costs of each option.

    While cloud-based software usually involves a monthly fee, on-premise software usually requires an upfront license fee for use of up five years. Also, cloud-based systems don’t require additional hardware, while on-premise systems do. As a result, cloud-based systems are considered an operating expenditure and on-premise systems are a capital expenditure.

  • Set up demos for the shortlisted EHRs. When you shortlist prospective EHR systems, set up demos for each system, either in-person or online. The demos will help you compare your old system with the new options. Ask vendors to demonstrate how their EHR will address your current challenges and the additional benefits it will offer.

  • Connect with current clients. Try to connect with medical practices that use the EHR you’re considering. Search on physician forums or communities (SERMO or American Medical Association) and read software product reviews on our EMR market webpage. Real user feedback will help you understand an EHR’s performance. You could also ask these practices if they’ve ever replaced their EHR to get their input on the whole process.

These steps will help you improve your search process to find the most suitable EHR software for your small medical practice.

3. Ensure You Achieve Your Data Migration Priorities

In this section, we’ll offer advice on how to proceed with caution regarding data migration and to reassess your data mapping needs.

Let’s take a look at a real-life case story to understand what kinds of data migration challenges you might face during EHR replacement.


Emory Health Network’s EHR Replacement Data Migration Challenges

Daniel Goodman, M.D., a solo internist at Emory Health Network, Atlanta, GA, bought his first EHR in 2012. But he had to replace it after only three years, as the first one wasn’t able to support the other systems on Emory’s network.

During data transfer to the new EHR, Goodman noticed that some of the patient data was transferred smoothly, but the remaining data wasn’t transferred as expected.

Here are all the challenges Goodman faced:

  • During data transition, patient names got duplicated and in some instances, the first and last names were interchanged.

  • The old EHR vendor wouldn’t grant access to patient data unless Goodman continued with the subscription. He had to pay $3,500 extra to obtain some data, such as patient progress notes and consult notes. However, that data also didn’t sync with the new EHR as expected.

  • Ultimately, most of the patient data had to be manually entered into the new EHR.

  • The cost of data transfer increased with the degree of data mapping that Goodman needed, e.g, data from the old EHR that he wanted to be displayed in the structured fields of the new EHR. (Customized data mapping typically costs extra.)

  • The old EHR needed to continue being operational along with the new EHR until the full data transfer was done.

  • Productivity loss was high—the first week after replacing the EHR had zero productivity, while the next week saw only 50 percent productivity.

  • Overall, Goodman ended up paying $10,000 to 12,000 in EHR switching costs, in addition to the $3,500 to continue subscribing to the old EHR during data transfer.

To avoid similar challenges and ensure a smooth transition, you must be better prepared for the data migration process. Follow these steps to ensure this:

  • Connect with the old and new EHR vendors. Talk to your old and new EHR vendors upfront about data transition costs, data mapping costs (from old EHR to structured fields in new EHR) and any additional subscription costs for the transition.

  • Anticipate data mapping needs. Thoroughly plan the transfer of all your patient data into the structured fields of the new EHR. The new order should make it easy and quick for your staff to use the new EHR. You’ll also avoid spending extra on data mapping requests at a later time.

  • Use continuity of care documentation. Ask your old and new EHR vendors to use the continuity of care documentation (CCD), a standard used for exchanging patients’ digital health records among EHRs. It allows most EHRs to accurately read the exchanged patient data.

Note: CCD is a joint attempt by HL7 International and ASTM to encourage interoperability of patient data. It allows medical practices to share electronic medical data with other health care providers, without the loss of actual meaning.

All-in-all, a well-planned, well-paced approach will give you sufficient time to think in detail about each step of the transition process.

4. Schedule Deadlines and Stick to Them

EHR replacement is a time-consuming and complex process, and you should expect this and prepare your staff. Creating a long-term plan will make the transition easier for everyone.

It’s also critical to set deadlines for each stage of the EHR replacement such as communicating to staff, collecting their feedback, selecting the new vendor, going for product demos, discussing matters with the old vendor, migrating the data, implementing the EHR and training your staff.

Here’s an example timeline we’ve prepared that you can use as a model:

  • Nine to 12 months before new EHR launch: Start communicating with your staff; create a new EHR vendor shortlist, attend product demos and choose the new EHR vendor; set a timeline for implementation and staff/physician training.

  • Six to nine months before go-live: Appoint an internal EHR implementation project team and define their roles; prepare the data mapping priorities in consultation with old and new EHR vendors; prepare workflows for new EHR.

  • Three to six months before go-live: Evaluate the readiness of your staff and physicians (through tools such as online surveys, feedback forms etc.); create a training schedule for your staff and physicians.

  • One to three months before go-live: Test the new EHR interface and workflows; populate your patient records into the new EHR; prepare patient and staff schedules; communicate all the planned schedules to your staff and physicians.

  • One month before go-live: Customize the new EHR templates to your practice’s needs and brand; assess and recheck the new EHR workflows; meet with staff regularly to gather their feedback.

  • One to four months after go-live: Check with the new EHR vendor about any user concerns or bugs; gather feedback from your staff and physicians on suggestions for improving the EHR.

Setting a reasonable timeline is key to avoiding any pitfalls. Follow these tips to create a viable timeline:

  • Involve the old and new EHR vendors and get their estimates for end-to-end EHR replacement. They’ll know the exact time required for each step.

  • Talk to your physicians and staff on how the practice’s functions may be affected during the EHR replacement process. Ask for their estimates about training and adoption times, and factor these into the final timeline.

Remember that though timelines are necessary, they should be flexible for uncertainties such as physicians or staff members taking unplanned leave during training. It’s more beneficial to go live when your whole staff is fully prepared to use the new EHR than it is to just meet the deadlines.

5. Secure Your Patient Data During the Transition

Data security is vital, as you’re working with two external parties (the old and new EHR vendors). It’s necessary to ensure the safety of your patients’ medical data.

Consider the following tips to keep your data safe during the EHR replacement process:

  • Secure your medical archives. It’s important to understand the data import and export processes, which involves finding data formats that work on the old and new EHR systems. If you transfer only parts of your archives to the new EHR, ask your old vendor how your remaining data will be securely disposed. If they store the data, ask whether you’ll have access to it in the future.

  • Engage a dedicated data safekeeper. To not compromise data safety and privacy at any stage, make one of your physicians or staff the data safekeeper. The role requires overseeing the data migration process and keeping a close watch on how the data is transferred and stored by the old and new EHR vendors.

Conclusion and Next Steps

Replacing your existing EHR is not an easy task, and you can’t guarantee that it’ll be a smooth process. Therefore, medical practices need to make well-informed decisions during the entire replacement process. Follow the tips and advice we’ve given here to better understand and plan your EHR replacement.

And, if you haven’t yet decided on which new EHR system you’ll go for:

  • Call us at (844) 686-5616 for a free consultation with an EHR software advisor.

  • Fill out this short questionnaire to receive custom software details and price quotes in your inbox.