Are There Benefits To Using An EMR Archival System vs. Continuing To Run Legacy EMRs?
A recent report by Black Book Research indicates that 30% of practices with a dozen or more doctors are expecting to replace their current system in the next three years. So, what’s a medical practice to do when they need to replace an EMR system?
There are many things to consider when moving to a new EMR. Among those considerations is what to do with the legacy EMR that’s being replaced.
When migrating to a new EMR (for whatever reason), there are only three choices you have to ensure you have access to all of your historical patient medical records. This article hopes to shed some light on the benefits of each so you can decide what the best option is for you and your practice.
As mentioned, you have three choices:
Migrate all (100% of the data and all associated documents) in the legacy EMR into the new EMR.
Operate and Maintain 2 EMR’s – The new system and the legacy system.
Adopt an EMR Archival System.
Let’s look at each more closely.
Migrating 100% Of Legacy EMR Data Can Be Difficult & Costly
At first glance, migrating 100% of the data sounds like the best and most convenient solution. But as we assist practices when moving from one system to another, we’ve found that, more often than not, there’s no easy way to transfer the data.
There are often technical limitations when moving one EMR’s data to another due to significant differences in the data structure. Plus, the cost to migrate all the data is exorbitantly high, so it doesn’t make financial sense even to try it.
For example, take the data structure of only a date field. There are many ways that a date can be written into a date field:
Month Day, Year (January 1, 2019)
There are more ways, but for the sake of this example, we’ve identified these four. If the legacy EMR requires date format number 1 (above) and the new EMR requires date format number 4 then there’s a massive translation that must occur. Then there’s the quality checking and validation that must be done before the data can be transferred into the new EMR.
All of this will drive up the cost for EMR-to-EMR migration. Now take that same thought process and apply it to codes, notes, etc., and the process can quickly escalate financially.
Not to say that this is impossible, because we’ve seen instances where the new EMR vendor has performed migrations with the same legacy EMR so they have a “script” that they can follow. In those instances, it’s both cost effective and efficient to maintain all of the historical and new patient record data.
Lastly, most EMR vendors don’t want the older EMR data migrated into the new system because they want it to be clean. Most like to start fresh with new data and not have their systems “clogged” with the older data from the legacy EMR.
Cost-effective when the new EMR vendor has a script they can follow.
Efficiency is gained only when using one system moving forward (the new EMR).
Start fresh with new “clean” data in the new EMR.
Can be very difficult to migrate all data.
Can be cost prohibitive.
Quality/Validation Control processes need to be strictly followed or inaccurate data can result.
Maintaining 2 EMR Systems Can Result In Extra Costs & Security Issues
Assuming that your old (legacy) EMR was running effectively before the new system was implemented, then you can keep the system running and, when needed, staff can access it to find historical data. In terms of simplest to implement, this is by far the easiest because there’s nothing to do. Also, training isn’t required because you already know how to navigate the legacy system.
However, this model can be challenging to maintain due to a number of reasons. It can drive up overall costs, complexity, and support.
A lot of EMR vendors are now charging for “read-only” licenses.
Underlying technologies (hardware, software, operating systems, etc.) need to be maintained.
Remote Access Technology (e.g.., Citrix, Terminal Services) must be updated and maintained.
Original system flaws and weaknesses are brought forward.
For example, some systems make it inherently difficult to print full patient charts — That same difficulty will still be prevalent going forward.
Securing an older system (possibly running on outdated technology) can be difficult.
If cloud-based, you will still be paying for hosting fees and support.
Users will need to access two separate systems:
The new EMR
The legacy EMR for historical lookup
Here’s a real-world example showing why operating two EMR’s may not be ideal:
A practice was running a new EMR and a legacy EMR for two years without issue. During that time, they weren’t paying for support from the legacy EMR vendor. All was fine until they had a hardware failure on the legacy EMR hardware platform. They thought they would be able to simply bring up another system and restore the legacy EMR data on the new hardware platform. However, when they tried, the system wouldn’t come up, indicating there was a licensing violation. They were stuck — They had to deal with the legacy EMR vendor who wanted to charge them a hefty fee to “true-up” their licenses.
While this model is by far the simplistic route since there’s nothing to implement, there are, however, many considerations that may not make this the ideal solution.
Simplest to deploy (There’s nothing to do since the legacy EMR is already presumably running.)
No additional training (Everyone should know how to use the legacy EMR already.)
License fees from EMR vendors
Technology maintenance & refresh costs
If technology can’t be or isn’t refreshed, then security will be an issue.
Existing flaws in the system are brought forward.
Cloud-based costs still must be paid.
Users will need to log in to two separate systems to access legacy patient charts.
EMR Archival Systems Are Cost-Effective & Can Easily Be Launched From Within A New EMR Solution
This solution has caught on over the past couple of years with all of the EMR migration going on. This is because an EMR Archival System is a cost-effective way to retire a legacy EMR.
The legacy EMR data is extracted from the system and housed in a self-contained, secure database. A simple web-based User Interface (UI) is then used to access the data. All the clinical data is extracted and stored in the archival solution, including all of the documents in each patient chart.
Today, most EMR archival systems can be implemented in a format that can be launched from within the new EMR.
For example, a doctor may be using EPIC as their new EMR and have an EMR Archival solution running in the background. With the patient chart in EPIC they can, with the click-of-a-button, pull up the historical patient information within the EPIC screen. This integration makes life easier for the doctor since he doesn’t need to log into two separate systems.
Meets legal requirements for the retention of patient information
Quality/Validation Control processes must be strictly followed to ensure all the data has been migrated.
Regardless of the path a practice takes when retiring their legacy EMR, each comes with its own set of pros and cons. Weigh the features needed, associated costs, risks, and requirements to make the best choice for your continued operations and legal requirements for patient information retention.
Click here to about the ChartViewer EHR Archival System.
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