EMR Migration Guide | medicalrecords.com

Installing or upgrading to a new EMR system requires careful planning to migrate your data and make sure your office workflow is either properly supported or that needed changes are identified.

Successful migration to a new or upgraded EMR system will depend on careful and individualized analysis and planning, which will need to be re-visited and updated as implementation progresses.

Integrating an EMR system into your office starts with an appraisal of current workflows. There are numerous formal methodologies which can help, ranging from Six Sigma (made famous initially by General Electric) to Total Quality Management. While documenting your current workflow in its entirety-from patient scheduling to the completion of a patient visit-is a start, identifying possibilities for a re-design of workflow elements is the goal. Migration to an EMR may eliminate steps in patient check-in, or as if often the case, allow for patients to schedule a visit and complete the check-in process almost entirely without staff intervention.

Key workflow elements to consider, among others, are:

• Patient visit scheduling, which can include automatic allocation of time blocks depending on the nature of the visit, for instance.
• Tracking a patient’s status as they move through your office.
• Review of a patient’s chart, and reference to patient data during a visit.
• Updating of patient charts.
• Patient follow-up.
• Lab results.
• Rx transmission.

This is a recursive process that should involve all staff members. While time consuming, long run efficiency improvements and cost savings can be substantial.

Plans need to be made for migrating from paper based patient records to electronic storage. There are a variety of paths here. Many providers end up using a hybrid system, where new patient encounters are recorded and stored electronically, with older data kept in their original paper format. This saves the time and expense of converting paper records to digital format, but reduces savings from eliminating the expensive need to store and access paper records.

Others pay up front to have all or the majority of records digitized, since space dedicated to file storage can be reduced dramatically and personnel dedicated to filing and retrieving paper records can be used for other tasks. Moving to digital storage involves two tasks: preloading, and scanning. Pre-loading is the more labor intensive and time consuming, as it involves manually reviewing and coding information from previous patient encounters and clinical notes. This is often done selectively, with critical data such as immunizations, drug allergies, and recent vitals entered. Other, less critical data can be scanned and converted to images, which is a fairly mechanical process. Regardless of what you choose, a fully paperless office is unlikely: you will still have to support working with other providers and with patients who use paper records.

All providers and staff will require training in the use of a new EMR system, with particular emphasis on HIPAA privacy and security regulations as they relate to EMR systems.

Takeaways

Successful EMR implementations are time intensive, and require careful workflow analysis as a starting point.

A paperless office is an unrealistic goal for most providers. Paper based and computerized records will co-exist. Cost and efficiency considerations will vary by practice.