- In many cases, an EHR replacement ends up being even more complicated than an initial implementation. Clinicians now have a laundry list of complaints about the first system and may be vocal in demanding specific changes that a new EHR must include. Administrators, feeling burned by the financial drain of low productivity and inappropriate software, may be leery of the promises of new vendors offering up different products. But perhaps the biggest challenges of replacing an EHR are ensuring access to the data an organization has compiled within its first system and migrating that data to a new EHR with a minimum of disruptions.
Unfortunately, many providers don’t anticipate the eventual need to change vendors, and may not pay as much attention as they should to the first contracts they sign. Last year, the Office of the National Coordinator (ONC) addressed this issue with a guide to EHR vendor contracts, but by that time, a large number of providers were already on board with their first vendor, and may have signed to terms that will end up being problematic.
A spate of data ownership disputes and access denials in 2013 turned the “Year of EHR Replacement” into the “Year of Nightmares” for some providers. Before you consider switching systems, make sure you take a hard look at the contract you have and be sure to consult legal experts if necessary. Does the EHR vendor claim to own all the data that resides in its system? Does it have a clear and standard method of data transfer? Do you need to pay extra for this service? How will you receive the data, what will the timeframe be, and will it be compatible with your new vendor of choice?
The ONC warns providers to pay attention to the dispute resolution clauses in their contracts, as well. Oftentimes a provider will refuse to keep paying for services that are not being performed by the vendor, but non-payment may entitle the vendor to cut off access to your patient records until the legal wrestling match is resolved. To ensure continuity for patients, providers should scrutinize the language of the contract and plan accordingly.
“There are many reasons you may find yourself transitioning from one EHR technology developer to another, but you are likely to need assistance from your current EHR technology developer regardless of the circumstances,” the ONC guide points out. “It may be impossible to predict exactly what these transition services will involve, but it is important to at least obtain the EHR technology developer’s general agreement to assist.”
The guide suggests that providers ensure contracts address the right to continue using the software throughout a stated transition period for an established fee. The EHR vendor may wish to require a minimum period of notice from the provider or limit the number of hours that it will commit to the transition process, all of which may be negotiated.
Despite the fact that more and more EHR vendors are embracing technical standards, converting data from one system to the next isn’t always as easy as plugging in a USB drive and hitting “import”. While no vendor wants their customers to leave for a new company, many are cognizant of the fact that it will happen. It is in everyone’s best interest to ensure that the process is as painless as possible, many vendors have told EHRintelligence.
“We give people full access to all their records, and we’ll do an export of their data if they want to leave Practice Fusion,” says Emily Peters, VP of Marketing Communications at Practice Fusion. “It’s many DVDs full of data, and it’s kind of a big process for us, but we will absolutely let anyone have their records if they want to leave us. Thankfully, we’ve only had to do it a few times. But we see that a lot on the other side. We have a team of specialists here who are experts at getting the data out of other systems, especially when they’re not really set up to do it. The average turnaround time for an import is about two hours, because we’ve been able to crack the code for a lot of systems.”
“Data conversion is a big issue,” agrees VP of Corporate Communications John Hallock of CareCloud. “There are always these difficulties in getting information off one system and on to another. We’re working on ways to convert the data from one clinical system to ours. I think that’s a key trend that has to get easier and better. It’s a real challenge providers face. They need that information to do their work, to deliver patient care, and make sure they’re billing correctly and that the overall health of the business is there. And if we don’t do that, then we won’t be successful either.”