Trying to map data out of one EHR and into another EHR is like take taking a square peg and trying to put it into a round hole. Your organization is preparing to change EHR systems, and you are faced with the problem of determining what to do with the clinical data in your legacy EHR. There are many options available to you and I’ll summarize them here and point out the strengths and weaknesses of each. The reality is that you will probably have a hybrid approach to this very significant challenge.
Here are the options to accessing the legacy EHR data:
• Put a hyperlink to the legacy EHR in the menus of your new EHR.
• Strengths: You will have access to the complete EHR and all the patient data.
• Weaknesses: Unless you have already implemented single sign-on across the two EHRs and have implemented patient context switching, then the provider will have to log into the legacy EHR and do a patient search on the patient, and then go swimming for the data. This requires you to keep the legacy EHR active for a defined period of time (See Data Archiving solution below).
• Install HL7 interfaces between the legacy EHR and your new EHR. More than likely you would use historical interface transactions, but that doesn’t help you for results directly entered into your legacy EHR. You could also extract the data out and build HL7 messages from the extract.
• Strengths: This approach gets the most discrete data into your EHR and makes it easily accessible.
• Weaknesses: Very costly in the amount of time it takes to make all the necessary mappings and testing to get the legacy data to map to the requirements of your new EHR. Odds are that your legacy EHR allowed extensive free texting in results and your new EHR is Completely table-driven. Some data simply cannot be mapped, which means it won’t get loaded into the EHR.
• Data abstraction from the legacy EHR into the new EHR.
• Strengths: Allows discrete data to be accessible in your new EHR.
• Weaknesses: Prone to error and takes a great deal of time.
• Creating patient summary reports from your legacy EHR and scanning or importing them into your new EHR.
• Strengths: Low cost.
• Weaknesses: Does not allow any discrete data to be available for import into your new EHR.
• Data archive solution for your legacy EHR. Arching your complete Legal Medical Record (LMR) into a hosted solution that allows viewing from the clinicians, from a link in the new EHR. The strengths and weaknesses to this are very similar with linking to your legacy EHR, with a few exceptions.
• Strengths: You’ll have access to most of the legacy EHR data. Allows you to retire your legacy EHR system.
• Weaknesses: While the data is discrete in the archival system, it is not discrete to the new EHR. Requires the clinician to branch out of the EHR to view historical data.
• Create Continuity of Care Documents (CCD’s) out of the legacy EHR and import them into your new EHR.
• Strengths: Probably the best all-around solution. Gives you the amount of data that you dictate out of the legacy EHR and allows some of the data to be reconciled into the patient chart, in the new EHR, as discrete data. For the data that cannot be mapped due to data issues, it is still imported, and allows the clinician to correct it during reconciliation.
• Weaknesses: Takes some time, but is worth the effort if done appropriately.