In 2004 an executive order was enacted to define HIPAA regulations regarding the development of health information technology tools. The EHR incentive program began under the Obama Administration, and healthcare professionals were incentivized for implementing and demonstrating meaning use of and EHR (EMR during these early years). The health information technology industry has witnessed a steady increase in the number of healthcare professionals adopting EHR and companies selling health information services and products have grown significantly.

The rapid growth in EHR needs birthed many startups and forced existing giants in healthcare tech to enter the space. Some of these companies are still in business, others are not. All over the country, single practice clinics and large medical groups have had to face the unfortunate reality of having to deal with EHR companies going out of business or being sold. EHR comprises complete long-term data that includes not only a patient’s medical history, but also detailed demographics, insurance, and other sensitive healthcare data. As you can imagine learning the EHR vendor you have been with, sometimes over 5 years, is sun-setting can be a stressful situation.

If you find yourself as one of the healthcare professionals whose EHR vendor is being sold, there are a few areas that should be addressed to ensure the transmission is successful.

What Happens to The Data?

EHR is server-based or cloud-based. Most EHR systems such as CareCloud, or EHealthline’s Phoenix are cloud-based due to the strict HIPAA regulations regarding server security. Most EHR systems have practice management and medical billing systems integrated as part of the EHR platform. In most cases, the data will not only comprise historical healthcare data, but also the payer (insurance), and patient demographics and other personal information. Data migrations can prove to be a complicated task, not only regarding HIPAA violations but also effective mapping and the need for validating systems.

Data Migration

EHR systems such as CareCloud (a practice management and medical billing solution) gain terabytes of cloud-based electronic health records data. Health data can quickly balloon, as a patient’s data matures to include PACs images, many lab results, and detailed charting notes. Patient data also includes payer information and demographic details. After an EHR acquisition, you should contact your current vendor and ask them what data migration plan they have in place or plan to implement. Most EMR software contracts include a data transfer clause that specifies what processes take place in situations when you, as the healthcare provider, need to migrate data. The data migration cause will define what format and how and when the vendor must get you the data.

Cloud-based electronic health records data migration always poses the risks regarding data loss or corruption. EHR data, unlike billing data, is not standardized. Unstandardized data means EHR software developers choose different ways they store data and different ways data is moved around. When migrating EMR software data from one system to another, the mapping process is usually a considerable hurdle. One potential area of concern when migrating data fields within the patient health record may not be recognized or lost during the process.

Let’s say, for example, John Doe has a peanut allergy, and this information is stored as part of the patient’s health record on the current EHR system. CMS has different levels of certification with specific details on how data is stored and depending on which certification your new EHR has the peanut allergy may not have a field to accept this critical information. A situation like this can pose serious threats to a patient’s health.

While EHR data is not standardized, there is a standard in place for data transferring called CDA (Clinical Document Architecture). All EHR must be able to produce and accept data in CDA format. It is essential to understand CDA is only used with current patient data; historical data will have to be obtained in other formats and possibly entered manually.

Another file standard is .csv, which is an accessible format used when data is imported or exported. The problem with .csv files is additional fields may have been added, which may not be imported correctly in the new EHR system.
It is safe to assume, in most situations, when importing data into a new EHR; there will be some data loss or not transitioned as smoothly as we would like. It’s important to come to this realization and focus on making this transition as less disruptive as possible.

Clinic Workflow

When transitioning data to a new EHR, it is paramount to focus on data critical to your current workflow. Focusing on workflow when moving data will minimize the disruption to your staff and clinic.

Create a Transition Team

Once data is migrated, it needs to validate, and any pertinent information that is missing needs to be addressed. A transition team job will be to focus on ensuring the data transition process is moving in the right direction.

Prepare for a Learning Curve

You and your staff will have to adjust to the new system, and this may take time, some longer than others.

Medical Billing…

If your EHR vendor announces they are being acquired, there are a few areas of concern you should be aware:

Medical Billing Data

Medical billing data is HIPAA standardized and typically should not be a significant issue during the migration. The standardization of billing data allows for more options to customize it during the migration process. You should be able to receive billing data that includes patient demographics along with payer information or without. Other billing options are patient demographics with payer information and outstanding balances.

HIPAA

HIPAA is in place as a safeguard to protect and maintain the integrity of patient data. It is imperative to find out how your new EHR vendor handles HIPAA protected data; this is especially true dealing with foreign countries who don’t have our regulation standards.

Customer Service

Customer service is vital. This is especially true with EHR vendors. The often fast-paced nature of modern healthcare presents the need for real-time customer service when the inevitable issue occurs. If you are currently when your current EHR vendor is being sold, they may already have a backup system ready to use and the data migration may have taken place. All the details regarding vendor acquisitions and data handling should be outlined in the contract between you and the vendor. Here at MCC we have heard clients tell us when a tranisition occured, their customer service was shipped to another country. Please be aware of how this will affect your U.S. based practice.

MCC is here to help

Dealing with the transitional processes after an EHR vendor is bought out can lead to a stressful situation and there will be challenges ahead. Contact us today to speak to an MCC team member.