There will come a time when any practice considers changing its EHR software. The desire for change can either be motivated by ongoing frustration or an interest to improve practice performance even further, but whatever the case may be, the decision to switch is usually a matter of “when” and not “if”.
To practice owners unfamiliar with the change process, there are a lot of important dynamics to consider—so much so, in fact, that they can be intimidating to a point where some practices will stick with an underperforming software solution rather than endure the seemingly painstaking process of transition. Leaving behind an EHR is a considerable process, but it isn’t nearly as arduous as one might think. The basic dynamics of transition between EHR systems can be generally summed up in three major topics.
Sunsetting and starting up
Costs are an important factor during transition, and without adequate visibility into what sort of costs should be predicted, practices are likely to encounter a lot of surprises. To that end, it is important to think about any contractual obligations that might affect the process. If the existing contract with the old vendor must be terminated, be aware of any penalties that may have been agreed to in the terms and conditions. Know the vendor’s points of contact for any questions that might arise, and don’t be caught off guard.
Practices should also budget for the nominal first-year costs when starting up with a new vendor. These costs typically cover training, customer support, and any other onboarding programs or services intended to help practices reach autonomy with the new product.
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Data migration
The practice is legally the owner of the data, but the fact that the data lives in vendor-owned systems can create some friction during the exit process. Depending on the technology used by the vendor, getting data out of the current EHR can be a difficult endeavor. For example, if a vendor isn’t using discrete data stores, completing an export might require the participation of data analysts and architects—often a time- and cost-intensive proposition.
Migrating data is not a simple matter of moving it from one place to the next. In general, no two database systems are exactly the same, so the chances of perfect cross-compatibility are slim to none. The extracted data will most likely need to be cleaned and reconstituted for the new system, and may require some form of technical support to usher it in. Depending on the new vendor’s service agreement, it might be a good idea to anticipate charges for data services. Vendors usually consider this part of the process an extra service because the additional time and resources they must devote incur costs that need to be covered somehow. Again, having a good understanding of the contract will help practice owners know what to expect in advance.
Time and productivity
Changing EHRs takes time, for reasons both technical and industry-specific. New systems require training, so a ramp-up period while staff become accustomed to new features and functionality is to be expected. Staff productivity will inevitably increase as the practice becomes familiar with the new EHR system, but it is nevertheless worth considering how the intervening period will affect revenue.
Also note that EHR solutions with integrated billing systems will need to have pending transactions closed out completely before fully sunsetting the system, which could take at least three months (if not more). Simultaneously, new transactions will be entered into the new system. The management of two EHRs can be awkward and demand extra time from staff, but is a necessity in creating a timely transition between systems.
When it comes time to change EHR systems, understanding the dynamics involved will help practices evaluate the best possible solution for their unique needs. Accounting for the costs, time, and required data services will allow practices to more carefully budget the process and conduct a smoother transition.
