Whether an ambulatory practice is pleased or unhappy with its electronic health records system, few understand that there are outside forces at work that will compel buying another EHR sooner than anticipated.

Being ready for the change is the focus of an education session at HIMSS14. The change could come when a hospital acquires a practice, or an accountable care organization commits to using a single EHR platform, or a practice merges with another, or a vendor stops trying to comply with Stage 2 meaningful use requirements, says Barbara Drury, president at Pricare Inc., an ambulatory-based consultancy in Larkspur, Colo.

To be ready, practices need now to look at their EHR contracts to see what happens if they have to exit the contract without cause. They may be required to return the software to the incumbent HER vendor along with the manuals and could lose the ability to retain their electronic medical records-and metadata—and port them to the new EHR. Many vendors will work with migrating clients to retain their application, data and metadata, but not for free, Drury says.

Contracts also may have “timing triggers,” which could force a practice to stop using its incumbent EHR software within 30 days of informing the vendor that the practice will be switching products. Or contract language may consider a practice to be breach of the contract if it disclosures the data structure of the incumbent product to a new vendor. “You really need to play with both vendors above the table,” Drury adds. “You need to develop an exit strategy before you sign an entrance strategy.”

Consequently, it is important for a practice to understand now what the options will be if it must adopt another EHR before it expected. And don’t think it can’t happen to anyone. Drury presently is working with a practice that is on its third EHR in the past two-and-one-half years after the first two products were sunsetted.

Education session 174, “EHR Expiration Dates: Why and What’s Next?” is scheduled at 11:30 a.m. on Wednesday, Feb. 26.

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