Six things to consider before switching EHRs

John Meigs Jr., MD, FAAFP, a family physician in Centreville, Alabama, and president-elect of the American Academy of Family Physicians, will get a new electronic health record (EHR) system sometime next year. It will be his fifth EHR.

He’s getting a new system at his practice, Bibb Medical Associates, as part of an upgrade initiated by his parent healthcare system, Bibb Medical Center, as it aims to move all its facilities onto a single system.

Meigs along with Derek Kosiorek, CPEHR, CPHIT, principal consultant at MGMA Healthcare Consulting Group, and Steven E. Waldren, MD, director of the American Academy of Family Physicians’ Center for Health IT, recently recommended tasks for any practice prior to switching to a new EHR.

Determine customization needs.

Many practices have unique ways of handling certain tasks, so they often tweak, or customize, software to meet those distinctive workflows, Waldren said. If that’s the case in your practice, decide what customizations you want and contract for those software upgrades before switching over to the new system, so the customized workflows are ready as soon as you go live with your new EHR.

Plan for data transfer.

Transferring data from the old into the new system is a time-consuming and potentially costly endeavor, and it’s nearly impossible to transfer every piece of data, Waldren said. So determine what patient data you need and then work with your new EHR vendor and your tech support to establish a timeline for transferring information and figuring out how the transferred data will appear in the new system.

Determine how to maintain access to old records/system.

At the same time, determine how you’ll maintain access to information not imported into the new EHR, Waldren said. You may need that information at some future point; at the very least you need to maintain patient records for a period of time as set by state laws. “I know some doctors who have printed out all the records, filed them and then put them in to a secure archive; others might maintain the old system just for access,” Waldren said.

Adjust your schedule.

Although many vendors offer pre-implementation training, Meigs said you should still scale back on appointments or plan for more work after clinic to accommodate the additional time it will take to learn the new system; expect your productivity to go down for the first three months to six months after going live with the system, Meigs said.

Consider other upgrades.

You might need to upgrade other parts of your IT stack when you switch to a new EHR, Kosiorek said. Consider, for example, whether you have enough network bandwidth and Internet speed to handle the capabilities of the new EHR, whether your Wi-Fi is sufficient in all areas of your building and whether all existing pieces of hardware and software are compatible with your new EHR.

Plan your exit.

At some point, your new EHR will be outdated, so plan for that now, Kosiorek said. “You need to write things into the contract [such as] how do you get the information out and how do you move that information into the next EHR,” he explained. This is particularly important if your new EHR is cloud-based, Kosiorek said.