The last couple of decades have seen a significant shift in the healthcare world. Clinical and financial systems are switching from paper to electronic, and hospitals that can’t keep up will be left in the dust. This electronic health record (EHR) conversion can be difficult for a hospital if they are not prepared.
What is an EHR Conversion
An EHR is an electronic health record. A crucial development for healthcare providers over the last sixty years, they help practitioners better track patients’ health data. EHRs allow for better analysis, diagnosis, and treatment of patients, making them an integral part of a modern healthcare organization.
EHRs have not always been the modus operandi for doctors. For thousands of years, doctors had to track health records by hand on paper. With the development of early primitive electronic records in the 1950s, the first hospitals started converting to paper records. They found the process time-consuming and costly, and many healthcare organizations opted to stay with what they knew worked. But legislation passed by the second Bush administration forced more hospitals to consider EHRs and EMRs (electronic medical records). Successive administrations have continued to push healthcare legislation that have made paper records obsolete.
If a conversion does not go smoothly, a hospital can find themselves years behind, and leaking millions of dollars.
Additionally, hospitals that converted decades ago are left with legacy software that no longer meshes with other hospital software systems or handles the high-tech world of today’s healthcare world. While technology has progressed exponentially, a smooth implementation process has not developed as quickly, and today hospitals still face the arduous conversion process they did in the 1950s. If a conversion does not go smoothly, a hospital can find themselves years behind and leaking millions of dollars. This makes a successful conversion a priority for healthcare systems.
EMR vs. EHR
Before we list some steps that a hospital can take to prepare for a successful EHR conversion, it is essential to note that EHRs and EMRs (electronic medical records) are different. Imagine a patient in an old hospital. At the foot of his bed is a clipboard that doctors and nurses take notes on. These notes include his medication, what doctor is assigned to him, the dates of different procedures, and more. That clipboard stays at that hospital. If the patient returns five years later, the hospital can go into their records and find his old information, using it to diagnose and treat him more effectively. An EMR is akin to that clipboard, but instead of a paper record, it is a digital record. An EMR has all of a patient’s information from their visits to that doctor or hospital; however, it is almost exclusively in-house. It doesn’t get shared with other healthcare organizations that he may visit but stays solely with that hospital. If he sees another medical organization, they will not have access to that EMR.
What you get from an EHR vendor is much more comprehensive and holistic. It is shared across almost any health-related medical practice the patient may visit. It includes all legacy data as it tracks every medical procedure, appointment, medication, or illness a patient has. Its data is not just from hospitals, but across any healthcare organization a patient visits from a dentist, to a physical therapist. This all-inclusive patient record makes it easier for clinicians to diagnose and administer treatment. It also is vital for hospitals struggling to stay compliant with the various Medicare and Medicaid regulations. Because of this, more hospitals are converting to EHRs every single year.
Where EHR conversions go wrong
Whether your hospital is considering going paperless, going from an EMR to an EHR, or even upgrading from an old EHR to another new EHR system, there is a lot to consider, because unfortunately, the process is not easy. Things that hinder a successful conversion include:
- Failure to integrate with current hospital systems
- Non-compliance with Medicare/Medicaid regulations
- Lack of personnel who understand the new system
- Security failure
- EHR data gaps
- Billing office miscommunication
- Lack of pricing transparency
- Inability to include legacy data
- Failure to have functional workflow during the integration process
- Losing HIPAA compliance during the migration process
Mistakes like these can cost healthcare providers millions in revenue every single year, affecting your bottom line and stopping you from doing your job of providing invaluable care to your communities. With our experience in implementing successful EHR conversions, we’ve put together a list of things to consider if your healthcare organization is considering an EHR conversion.
Steps to prepare for a successful EHR conversion
Implementation is not a day-trip to the beach; it is a month-long process. Converting to a new system on your own will take months or even years of preparation time before you go-live with the new EHR system. Reconciling old paper records and legacy data takes time. Even after the new EHR is online, there will almost assuredly be missing data, resulting in missed charges and lost revenue. Without outside help, your bottom line will go down. The question is not how much revenue you will lose, but how long until you can return to your previous baseline. The answer to that question depends on how well you can follow these guidelines.
1: Build a team:
The first step to prepping for an EHR conversion is building an in-house team. This team should know your healthcare system inside and out, with an understanding of finances, clinical data, billing. They should also have some experience in implementing new systems in your hospital. All areas of a hospital will be affected, but in particular, your IT department, your finance department, and your billing department will bear much of the responsibility, so the conversion team should pull heavily from those departments. They will have to work closely with your physicians to ensure that every treatment, medication, doctor, and nurse is represented correctly in the new EHR. This means individually spending hours every day focused on the conversion, instead of their regular work in finance, billing, or IT.
2: Organize data:
The team’s first job is gathering and organizing the current data. This means examining what records system your healthcare organization currently uses. If you are already live with an EHR system, and you’re updating to a modern one, this shouldn’t take too long because the data already exists in an EHR format, albeit slightly dated. If you’re converting from paper or an EMR system, this part of the conversion process alone could take months. EMRs are digital like EHRs; however, they don’t include all of the data that the more comprehensive EHRs require. And if your hospital is unfortunate enough to use paper-records, your team will have an even more demanding task on their hand as they manually dig through your old hospital record-storage.
3: Build a plan:
After the arduous challenge of tracking down and organizing the data, it’s time to build a plan of attack. No two healthcare organizations are the same, so every implementation plan should also be individualized. Self-analysis will be essential, and to help you understand your hospital record system, ask yourself questions like:
- What does this data say about us?
- How do we like to keep records?
- How do we implement this data so that all departments are integrated?
- Who was in charge of cross-checking clinical data?
EHRs are comprehensive, so a conversion requires a holistic approach. We recommend starting with the big picture; what is your vision and plan, and then working your way down to the smaller details. Define a big-picture vision, centered around why this EHR system, and how it will help your hospital, then work down into specific department integration aspects and then further delve into the details of how many records should be represented, which doctors will have access to what parts of the system, and who will be signing off on various updates. The more you have planned ahead of time, the easier the go-live will be.
4: Develop good sequencing:
A big part of this plan is the order of your steps. EHR implementation is a complex process, so knowing when to do each step will be critical. Your team will need to have an intricate understanding of the implementation and integration process so that every part of the process happens when it is supposed to. You will want to collect data first, and then build the right software framework for the EHR. Next, you will need to integrate it with existing core systems, and then gradually build outwards while continuously checking for data errors and gaps. If you are too hasty, then it will turn into a convoluted mess, as systems are not integrated correctly, and data is lost, costing your healthcare organization more money down the line. Take the time to do it the right way, in the right order.
5: Practice the go-live:
We cannot stress enough how important it is to practice practice practice. No go-live will be perfect. While the EHR has the potential to be a great aid to any healthcare organization, it also means that a lot can go wrong. It’s important to practice so your team will be prepared to respond to any problems from connected software system failure to clinical department data loss. Because of the holistic nature of an EHR, it touches almost every part of a hospital, meaning a lot can go wrong. We recommend regular dress rehearsals with the whole team to help them understand the new EHR system and also to train your team to react well under pressure so that when it’s time to go-live, they will know exactly what to do.
6: Support team:
Even after the go-live, you cannot be laissez-faire. You will need to retain a support team to monitor the new EHR continually. This team will not need to be as large as the EHR conversion team, but it should include IT experts, who have worked with the billing department, clinical department, and finance department. We recommend keeping the team assigned to the conversion for several months after the go-live and then gradually reassigning individuals as need decreases. This team will already have spent many months and even years working together on your EHR, so downsizing to a smaller support team should not be too much of a hassle. This team will be assigned to updating software, dealing with any problems that pop-up, and adding new data to the system as needed.
The EHR needs to be a tool, not an inconvenience for your hospital. It is there to serve you and make your clinicians’ lives easier. Building a dashboard is a crucial piece of the puzzle. Most EHR vendors will actually provide you with a customizable dashboard. If your computer science people who work on your website are in-house, tap them to help design the interface. If that’s not an option, the vendor will have resources you can lean on for your dashboard design as well. When thinking about what you want it to look like, consider who will be using it. Remember your EHR is comprehensive, so it will not just be IT professionals and accountants interacting with it, but also the medical practitioners as well. Your doctors and nurses are not software engineers, so a dashboard that is simple, intuitive, and easy to use will be essential.
Part of the support team’s role will be keeping a constant eye on the EHR for discrepancies and errors and updating it continually. As new drugs are added, new doctors are hired, and new treatments are administered, the EHR system will need to be regularly updated and integrated with the other hospital systems to ensure that correct treatments are recorded and charged for accurately, and no revenue is slipping through the cracks.
We know that is a lot, but in fairness, it’s only the beginning. You’ll also want to factor in other considerations such as compliance with state and federal regulations, company revenue compliance, and more. But these are a good start for a healthcare organization looking to make the switch to a new EHR system.
To follow those steps, a healthcare system needs the right personnel, the budget for an expensive conversion, a good understanding of system implementation, and knowledge of EHRs too. If that doesn’t seem like something you can do, there are other options. We recommend using an EHR conversion software and team to help simplify that process.
Benefits of using EHR conversion software
A successful go-live is tough and will take your hospital months and years, just to even get back to the pre-EHR baseline. This could mean millions of dollars in revenue gone just like that. But if you’re looking for a shortcut to save you time and money and aid in a smooth go-live, consider third-party conversion software. There are many firms and software development companies that specialize in working with hospitals for this specific reason. They can partner with your hospital and help ensure a successful conversion. This process will start with consulting but usually will come hand in hand with proprietary conversion software. The main issues a third-party can help address are intersystem communication, workflow, and leaking revenue.
If you use a partner to find lost revenue and maintain your bottom line, you can buy your hospital time to address other problems with additional conversion software solutions.
Software solutions and consulting can help address all of those problems, but revenue leakage is the most crucial to fix. If you use a partner to find lost revenue and maintain your bottom line, you can buy your hospital time to address other problems with additional conversion software solutions. Third-party EHR conversion software is a viable option for hospitals that don’t want to sacrifice several years and millions of dollars trying to go through a messy EHR implementation independently.
At Avelead, we have been helping healthcare organizations with implementations for years. We believe in taking the burden of EHR conversions off the hospital and empowering you to thrive. We have built many specific tools that address different parts of a hospital at different levels. With our expertise, we have helped hundreds of hospitals across the country successfully convert to a new EHR system on an aggressive timeline. Quite simply, our tools such as RevID, WDM, DCE, alongside our team of healthcare professionals, can save your hospital money and guarantee a successful EHR conversion.
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