The document discusses the necessity and challenges of data conversions in healthcare systems, highlighting issues like outdated technology and improper planning. It outlines various conversion options, their pros and cons, and emphasizes the importance of a systematic approach, including stages from discovery to go-live. Key considerations include data mapping, testing, and involving clinical staff to ensure successful implementation.

1. Data
Conversions
–
Convert
With
Confidence
Wednesday,
July
9,
2014
Disclaimer:
Nothing
that
we
are
sharing
is
intended
as
legally
binding
or
prescrip7ve
advice.
This
presenta7on
is
a
synthesis
of
publically
available
informa7on
and
best
prac7ces.

2. • Why
are
conversions
necessary?
– Lack
of
MU
Cer5fica5on
• Federal
Funding
– Improved
Performance
– Increased
Quality
of
Care
– Lack
of
Func5onality
in
Outdated
Systems
Introduc5on

3. • Why
are
changes
needed?
– Solu5on
does
not
meet
needs.
– Needs
not
adequately
assessed
when
original
implementa5on
occurred.
– Designed
not
suited
for
prac5ce
specialty
– Unresponsive
Vendor
Why
the
pain?

4. • Legal
Record
– Maintaining
pa5ent
records
for
legal
purposes
• Con5nuity
of
Care
– Easy
access
to
pa5ent
informa5on
– BeMer
Pa5ent
Care
• Proper
Planning
– Data
conversion
is
an
o=en
7mes
an
a=erthought
• Conversion
Exper5se
– Many
organiza5ons
are
not
familiar
with
the
data
conversion
process
– Suitable
op5ons
that
meet
specific
needs
Considera5ons

5. • Unsuccessful
planning
process
• Data
assessment
not
performed
• Lack
of
complete
tes5ng
process
• Not
involving
the
clinical
staff
• Timing
issues
• Conversion
size
considera5ons
• And
more.
Why
Do
Conversions
Fail?

6. • Leave
old
system
up
and
running
– Pros
• Don’t
have
to
dedicate
funds
or
resources
for
a
conversion
– Cons
• Ongoing
maintenance
and
support
costs
can
be
huge
• Risk
of
not
being
able
to
access
the
data
if
issues
occur
• Requires
physicians
having
to
log
into
another
system
and
search
for
the
pa5ent
You
Always
Have
Op5ons

7. • Manual
Entry
(Hand
type
data
from
old
EMR
into
new
EMR)
– Pros
• Enables
full
EMR
func5onality
on
legacy
data
• Ease
of
access
– Cons
• May
poten5ally
take
a
VERY
long
5me
and
is
resource
intensive
• Greater
chances
of
error
when
manually
entering
informa5on
Op5ons
to
consider

8. • Discrete
Data
Conversion
(Clinical
data
electronically
transferred
and
physically
resides
in
new
database
)
– Pros
• Enables
full
EMR
func5onality
on
legacy
data
• Legacy
data
is
easily
accessible
• Faster
implementa5on
5me
over
manual
conversion
• Less
resource
intensive
than
manual
• Higher
degree
of
accuracy
• Legacy
data
can
be
incorporated
for
clinical
intelligence
purposes
(i.e.
PQRS)
– Cons
• Can
be
cost-­‐prohibi5ve
for
smaller
prac5ces
• Requires
conversion
exper5se
• Garbage
in,
garbage
out
Op5ons
to
consider

9. • Summary
Report
Documents
(Summarized
documents
created
as
PDFs
and
physically
reside
in
new
EMR
database
)
– Pros
• More
cost-­‐effec5ve
than
discrete
conversion
• Doesn’t
require
logging
into
another
system
– Cons
• Hard
to
find
informa5on
quickly
in
large
summary
documents
• Does
not
receive
benefit
of
full
EMR
func5onality
on
legacy
data
• Cannot
report
on
the
data
Op5ons
to
consider

10. • Interface
the
data
during
transi5on
– Pros
• More
cost-­‐effec5ve
than
discrete
conversion
• Real-­‐5me
system
sync
– Cons
• Interface
systems
can
take
a
long
5me
to
create
and
test
• Certain
data
elements
may
not
be
interfaced
precisely
as
needed
due
to
vendor
system
inadequacy.
Op5ons
to
consider

11. Common
Conversion
Process
• 1)
Discovery
• 2)
Requirements
• 3)
Build
• 4)
Test
• 5)
Go-­‐live.

12. • Risks
– Make
a
list
of
risks
and
their
con5ngency
plans.
– What
would
jeopardize
your
deliverables
or
schedule?
• Service
Level
Agreements
– Agreements
in
place
for
quick
turn
around
on
decisions
Discovery

13. • Data
content
issues
– Plan
for
late
discoveries
of
data
content
issues
• Conversion
and
mapping
teams
– The
project
team
requires
a
combina5on
of
people
with
clinical,
technical
and
project
management
skills
Discovery

14. • Data
mapping
– Plan
to
deliver
the
EHR
build
based
on
the
schedule
needed
for
the
conversion
data
mapping
effort
• Documenta5on
– Document
everything.
– This
includes:
status
reports,
dashboards
and
other
visual
aids
Requirements

15. • Format
– Many
clients
have
standards
for
specifica5on
formats.
Since
there
will
be
many
specifica5ons,
it’s
important
to
enforce
a
standard
so
that
all
specifica5ons
are
consistent.
• Content
– Every
detail
must
be
defined
on
a
field-­‐by-­‐field
basis
Requirements

16. • Mapping
– There
will
be
mul5ple
versions
of
mapping
documenta5on.
It
is
important
to
manage
these
so
that
team
members
always
have
the
latest
version
available
to
them.
Build

17. • Conversion
design
– Demographics
• Determine
the
trusted
source
of
your
demographic
data
• Consider
how
new
and
updated
registra5on
data
will
flow
to
the
new
EMR
in
real
5me
once
the
ini5al
registra5on
conversion
is
complete.
– Encounters
• All
chart
data
that
gets
loaded
is
associated
with
an
encounter
or
“visit.”
• Pa5ent
contact
or
visit
entries
may
not
necessarily
be
an
exact
match
Build

18. • Full
volume
tes5ng
– Work
with
technical
support
to
plan
disc
space.
– Perform
incremental
tests
at
increasing
volumes
up
to
full
volume.
• Test
environments
– 2
are
necessary
– A
primary
test
environment
for
incremental
volume
tests
– A
secondary
test
environment
for
simulated
produc5on
Test

19. • Tracking
– Good
tes5ng
requires
good
tracking.
Use
tracking
tools
to
monitor
tes5ng
progress,
defect
countdown,
issue
resolu5on,
etc.
• Clinician
sign-­‐off
– Tes5ng
is
not
complete
un5l
the
clinicians
sign
off.
Test

20. • Bulk
and
gap
conversions
– Bulk
conversions
some5mes
take
days
to
complete.
– a
smaller
bulk
conversion
is
needed,
ofen
called
a
“gap
conversion”
• Big-­‐bang
vs.
rollout:
– If
the
go-­‐live
approach
is
a
“big
bang”,
the
legacy
system
must
be
locked
out
to
prevent
any
new
transac5ons
– If
the
go-­‐live
approach
is
a
“rollout”,
there
must
be
real-­‐5me
conversion
interfaces
that
transfer
all
new
manual
ac5vity
Go-­‐Live

21. • Dan.Holleran@quirkhealthcare.com
• Tamina.Vahidy@quirkhealthcare.com
Ques5ons?