Slideshow 11 pitfalls of an EHR conversion and how to avoid them

  • March 10 2016, 2:02am EST
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11 pitfalls of an EHR conversion and how to avoid them

Researchers in the healthcare industry say conditions are ripe for providers to consider replacing electronic health records systems. Providers considering an EHR conversion face potential problems, says Hayes Management Consulting, and the firm suggests watching out for 11 common pitfalls of a conversion.

Lack of executive sponsors or champions

Any substantive change must start with commitment from senior executives; an implementation can’t be driven by the project team. Executive champions set the tone for change and outline benefits. In addition, the executive sponsor must ensure the project team has the resources and tools to carry out the change.

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Organizational resistance to change

Even if you can show users that change will lead to better efficiency and make their jobs easier, there is often hesitation to leave the familiar. Having a change management plan in place as part of the project can help. The plan can communicate clear change goals and their importance; assemble and empower a team to lead change; implement training plans; listen to and address objections; and develop an atmosphere of trust and cooperation.

Exclusion of outlying staff

In most organizations, the bulk of legacy system knowledge resides with certain key players. But sometimes users operating on the edges of the systems have valuable insight that can be overlooked. For example, you might have people who aren’t doing data entry, but they regularly pull reports from the legacy systems. Failing to include these individuals can cause critical knowledge gaps. It’s important to gather input from anyone who interacts with the system.

Not providing enough resources

It’s easy to underestimate the number of people needed to handle a conversion; assigning one person for each process area usually isn’t sufficient. Include not only your superusers, but also other key players who have experience with the systems. You can solve this dilemma by engaging outside interim management or temporary additional staff to manage your legacy system during the conversion.

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Failure to appropriately plan for data conversion

The process of extracting, moving, manipulating and repopulating the extremely large volumes of data into a new system is very complex. Data errors that occur during the transfer could impact compliance as well as patient care and safety. An experienced team is needed to complete the conversions. You can start with qualified internal staff but also consider partnering with a seasoned third party.

Moving bad data

The data conversion process can leave you with duplicate or obsolete entries that result in populating your new system with bad data. Focus on cleaning up the databases before you begin transferring data. Limiting the amount of data you move by date range can risk not moving some essential data. The best way to preserve data integrity is to do a merge and/or review before transfer begins to thoroughly clean the data. This takes significant dedicated time and will hold up a project if not given priority.

Delegating the conversion completely to IT

Data conversion problems can arise when the task is left strictly in the hands of the IT department. While IT controls the data and will play a role in moving it over to the new system, it shouldn’t choose which data to move. To ensure the right data is transferred, involve the people who use the system on a day-to-day basis.

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Underestimating the process of converting future scheduling

Moving future scheduling data from the legacy system to the new system digitally involves extensive setup work and developing scheduling criteria in the new system. The systems may not be compatible when it comes to schedule formatting so you could end up needing to make significant corrections once the data is transferred. In most cases, it can be more effective to simply load all future schedules manually.

Not converting all key data

Another issue is not moving all relevant documentation into the new system. Physicians will need access to historical clinical content for treating patients, and failing to move this critical data will result in a continued dependency on your legacy system. Certain data has legal requirements, so it must be moved into the new system. Make sure all data fields are reviewed and understood prior to transfer and that you have included all areas of the organization in the process.

Poor testing

A common pitfall is having the same people on the build team also act as testers. Although it sounds logical, this may not be the best practice. Many times builders will recycle the same patient test data over and over again. This randomly selected data may have no clinical or business reasoning behind it. It’s more effective to write test scripts based on real-world scenarios that can be validated before end-user testing takes place. Have a clear way to communicate those results back to the project team and ultimately the vendor. Include multiple rounds of testing aimed at different objectives.

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Waiting too long to plan for archiving

Plan for archival of historical records early in the process. Waiting too long to make the decision can mean paying full service maintenance fees and incurring hardware and software expenses related to your legacy system even though it’s only being partially used. While you’re waiting to archive, you’ll also be paying people to keep the legacy system up and running. Determine how long you’re going to need the data from your legacy system and how best to store it.

In conclusion

Any system conversion presents challenges. Being aware of them ahead of time and planning ways to overcome them will ensure the best chance of a successful transition. This means developing a firm plan, scope projections and resource requirements. With proper preparation, you can avoid these common pitfalls and give yourself the best chance of success.