EHR Data Migration: Strategy, Compliance, and Risk Reduction

Why EHR Migration Demands Strategic Planning

Migrating to a new EHR is no easy feat. Migration requires a thoughtful strategy throughout every step of the process, from preparation and execution to post-migration and beyond. There are also important considerations such as the data type and volume, file format, security and compliance, and the impact on workflows.

The migration process isn’t only about moving data from one system to another. Rather, there are 3 major phases: pre-migration planning, migration, and post-migration validation, all of which have their own set of best practices that must be followed to ensure success. For example, before embarking on a new migration, it’s important to know the scope and the goals of the project, choose the right platform according to the organization’s unique needs and requirements, and clean and prepare the EHR data.

Something healthcare leaders may not realize is that these projects usually include the main EHR as well as several ancillary systems, such as those for radiology. Their interconnectedness adds another layer of complexity that requires expertise.

We also find that clients who think about the conversion at the same time as the archival, and have a plan for how both will be executed either concurrently or sequentially, are more successful.

Healthcare Data Migration: More Than Data Mapping

Data mapping, the process by which two or more similar sources of data are matched in order to successfully extract legacy application data and convert it into the current EHR, is an important part of any migration project.

Data mapping is not as easy as simply matching fields, and healthcare leaders often underestimate what’s involved. One reason is that the data isn’t always a 1:1 match. Any time there was a free text field available where a user could enter any data, at some point in history, they did. As a result, issues often arise, such as delays, additional staff burden, impacts on operations, patient care, and compliance, as well as increased costs.

By implementing the right strategy for accurate data mapping and gaining a thorough understanding of current workflows, EHR data migration projects can be completed on time and within budget. This approach also mitigates compliance and patient safety risks while ensuring the migration is both accurate and complete.

Understanding the Full Scope of EHR Migration

Healthcare data migration projects are complex, nuanced, and rife with challenges such as data quality issues, compatibility problems, and security risks. They require a strategic approach to prevent errors, lost data, and a negative impact on the clinical, operational, and financial areas of an organization.

Identifying All Clinical, Financial, Historical Datasets

Successful migration projects require identifying and understanding all of the sources of data and the applications using the data. Some EHRs are not designed in a way that makes data extraction easy. Therefore, an organization may need to consult with its legacy system vendor to ensure every data source is identified and accounted for, and nothing is overlooked. Additionally, an organization may need to consult with internal IT resources to fully understand how systems within their legacy environment are interconnected and interfaced together. A complete understanding of the legacy architecture and dependencies is a crucial part of a successful migration strategy.

Aligning Key Stakeholders

Before launching a new project, organizations must ensure buy-in from all stakeholders to ensure a smooth, efficient process and successful execution. Early planning can help to ensure the right stakeholders are at the table to weigh in with subject matter expertise about nuances, workflows, and other key areas, and provide oversight. Stakeholders can include clinicians and subject matter experts from finance, revenue cycle management, IT, HIM, and legal.

Risk Reduction: Avoiding Common Pitfalls

EHR data migration requires significant time and investment, so getting it right is key. When not well planned, organizations can experience operational disruptions, patient safety risks, reputational damage from security breaches, and financial losses. One common pitfall I have seen is organizations struggling to split their time and effort between the implementation of a new EHR and the migration of an old EHR. Focusing on the new EHR is a top priority for every stakeholder in the organization. That is why selecting the best migration partner is absolutely essential in order to successfully navigate all the conversion and archival work in parallel, alleviating the burden on staff.

Legacy Data Migration

Replacing legacy systems is complex. Since each application has its own unique data structure, the transfer of data must be complete and accurate to prevent data loss or corruption. EHR conversion and archival processes, therefore, are critical and require careful data extraction, precise data mapping, and thorough data validation.

Legacy data migration also requires planning to minimize inevitable downtimes. This includes a phased approach, in which parts of the application are gradually migrated, and robust backups and contingency plans are in place to address potential downtime if applications go offline. Developing Standard Operating Procedures (SOPs) is another critical step before a data migration, helping to ensure the new EHR’s capabilities align with the organization’s goals, and any gaps are addressed ahead of time.

Data Validation Before Go-Live

Data validation is a critical last step in the process, but something to keep in mind is that this should occur both before the go-live of a conversion project and an archived data project. Data validation prevents errors, ensures accuracy, confirms assumptions, and prevents rework that can affect the timeline and budget. Data validation requires a comprehensive approach and includes several steps such as randomized record sampling across key domains, match-rate and field-level integrity audits, and format consistency checks, among others.

Active Archiving: A Case Study

After recently implementing a system-wide implementation of Epic, the University of Mississippi Medical Center (UMMC) was looking to decommission its mainframe-based legacy systems. They partnered with MediQuant and selected the DataArk® solution, an active archive solution that enables data archiving for accurate, compliant, and secure access to legacy data— allowing the health system to decommission the legacy EHR system and save on IT costs.

To ensure that the transfer of data was secure and compliant, MediQuant validated the clinical and financial data and ensured the extracts were accurate and complete. MediQuant also conducted a thorough review of the data from any system with a process that involves nearly 450 scripts on active and static data to identify variances that can be fixed before the migration. The project successfully resulted in 950,000 distinct medical records and eight million patient accounts being migrated.

Closing the Gap Between EHR Data Migration Strategy and Execution

Healthcare data migrations require a comprehensive, well-planned strategy. As a leading provider of enterprise data management solutions with 20+ years of experience, our experts have successfully extracted and mapped millions of records from hundreds of legacy clinical, financial, and ERP applications.

MediQuant’s data migration solution enables hospitals and health systems to extract, structure, and map data from retired systems. Our subject matter experts perform an initial validation to identify the types of data that should be seen and how the EHR system should function, which allows for a better user experience and reduces timelines. We have worked with more than 500 hospitals and health systems and our solutions have effectively reduced expenses by up to 80%.