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Clinical System Replacement & Decommissioning: Migrate or Archive? – Tackling EHR & EMR Transition Series

Posted on September 21, 2016 I Written By

clinical-system-complexity
(See Full Healthcare Data Archival Infographic)

A Maturing Healthcare IT Landscape
If 2010 was the year of EMR implementations and optimization driven by initiatives like Meaningful Use, the ARRA, and Obamacare, then 2015 might be known as the year that clinical application retirement became a prevalent topic for many mature healthcare organizations.

Application retirement is nothing new. Large organizations both inside and outside of healthcare have had application retirement strategies in place (typically doled out by expensive consulting companies with fancy matrices, methodologies, and graphs in tow) for a decade or more. Anytime an organization outlives a large IT system (or, in many cases, that system’s vendor), retirement becomes a pressing need. In the case of healthcare, the two largest driving factors forcing clinical application retirement are the consolidation of organizations into large integrated care delivery networks, and replacement of existing electronic healthcare record systems due to poor usability or inadequate functionality.

Migration and Archival – Not Migration Versus Archival
One question that often comes up early on in the process of clinical application retirement is whether it’s necessary at all if the data in these systems is also being migrated into a new EMR. Conversely, the question of whether the cost of a migration is worth it if the archival solution being considered supports some sort of continuity of care solution like seamless single sign on from the new EMR. In most cases, it turns out that the ideal approach is migration and archival.

Just Migrate?
The process of EMR data migration almost always results in some fairly fundamental alteration of the legacy EMR data. The data models used by different EMRs are typically quite different, and it’s not a matter of export/import. Instead, it’s a true ETL process – extract, transform, load.

The shape of the data is changed. Sometimes data types undergo conversions, such as a number to a string, which if done poorly can result in loss of precision. Data sets, such as order codes, result codes, diagnosis categories, note types, and various other types of dictionaries are mapped from the values in the legacy EMR to the values used by the new EMR. Fields that have no apparent corollary in the new EMR are often just dropped entirely. It’s frequently not possible to know for sure what the data actually looked like in the legacy system once this process is complete and the legacy system is actually retired.
legacy-ehr-archive
Not only that, but from a clinical perspective, it’s probably not useful to take 15 years of legacy data and load that directly into your new EMR. Most organizations opt for something more likely to be relevant, while still remaining safe; perhaps 3 to 5 years of data. While the state and federal requirements for archival are clear on how long you need to preserve data (from 6 years to forever, depending on a variety of factors), they aren’t nice enough to say that the data you need to preserve is limited to what’s usually currently clinically relevant. In other words, that 10-year-old test result is still, technically, part of the legal medical record.
legal-medical-record-and-continuity-of-care
Some EMR vendors will even outright limit the mechanisms for data import to something like a CCD (clinical continuity document) import, which inherently limits the scope and quantity of available data that can be preserved.

Just Archive?
Ok. You give up. Obviously a migration isn’t going to cover us, and if the archive has everything we need legally and clinically, let’s skip that time consuming and expensive migration and just archive. Well, you can do that, but just archiving means that your organization is abandoning millions of dollars of hard won documentation and all the automation and analytics that goes with that.

An EMR is a lot more than a place to store clinical documentation. Virtually all modern EMRs have substantial functionality surrounding clinical decision support, health maintenance planning, and quality reporting. They also often are crucial source of data for analytics suites that are the pillars of population health management. In short, not migrating this data means you should have just stuck with paper charts until your latest and greatest EMR was available.

It’s certainly possible to bring over data in a manual, piece meal fashion as patients are seen or based on some other reasonably predicable event whose workflow can be augmented. This will, eventually, patch up the gaps in data that not performing a migration results in. If your organization is willing to suffer the significant, but probably short to medium term repercussions of temporarily losing this data in your EMR and related operational data repositories, then migration might not be necessary.

Not All Archives Are Created Equal
Inside the world of data archival, there are nearly as many different types of archives as there are vendors. Many of the existing archival solutions that have gained popularity with large healthcare organizations are ones that are also frequently utilized by other sectors and often claim to be able to “archive anything”. This can be very appealing, as an organization going through a merger will often retire dozens or even hundreds of systems, some clinical, but most only tangentially related to the delivery of care. HR systems, general ledger financial systems, inventory management, time tracking, and CRMs are just a few of the systems that might also be slated for the chopping block. The idea of retiring all of these into a single logical archiving is very appealing, but this approach can be a dangerous one. The needs of healthcare are not necessarily the same as the needs of other sectors.

Some factors that make healthcare different include:

  • The highly complex data models used by electronic healthcare record systems.
  • The common need for specialized user interfaces to properly visualize the data.
  • The continuing need for clinicians to seamlessly access the archived data with minimal workflow interruption.
  • The incredible variety of source systems that are in need of archival.
  • The lack of data format standards to make it easy to determine what needs to be archived.
  • The need for HIPPA and HITECH compliance (think encryption and auditing).
  • The massive size of the data to be archived, the need to constantly add new sources of data to an existing archive as the organization expands.
  • The frequent need to rapidly produce specific subsets of archived data during an eDiscovery proceeding or other legal compliance scenarios.

Summary:

  • There must be a clear distinction made between “migrated” or “converted” data and archived data, as the drivers and considerations for each are different. Retiring a legacy application and housing the data in an archival solution has markedly different requirements than migrating data from an existing clinical application to another.
  • Retiring legacy systems typically do not necessitate changing the “shape” of the data to fit a particular model. A data archival solution facilitates legacy system retirement, providing a storage solution for clinical data archival in compliance with state and federal regulations for protected health information (PHI).
  • With EMR migration, data typically needs to be mapped and translated to facilitate proper import into the target system. This is critical for the clinical impact and workflow integration required to support a discrete clinical data migration.

Download the full archival whitepaper to evaluate available EMR data migration & EMR data archival options and processes critical to EMR replacement and legacy system decommissioning.

About Robert Downey
Robert is Vice President, Product Development, at Galen Healthcare Solutions. He has nearly 10 years of healthcare IT experience and over 20 years in Software Engineering. Robert is responsible for design and development of Galen’s products and supporting technology, including the VitalCenter Online Archival solution. He is an expert in healthcare IT and software development, as well as cloud based solutions delivery. Connect with Robert on LinkedIn.

About Galen Healthcare Solutions
Galen Healthcare Solutions is an award-winning, #1 in KLAS healthcare IT technical & professional services and solutions company providing high-skilled, cross-platform expertise and proud sponsor of the Tackling EHR & EMR Transition Series. For over a decade, Galen has partnered with more than 300 specialty practices, hospitals, health information exchanges, health systems and integrated delivery networks to provide high-quality, expert level IT consulting services including strategy, optimization, data migration, project management, and interoperability. Galen also delivers a suite of fully integrated products that enhance, automate, and simplify the access and use of clinical patient data within those systems to improve cost-efficiency and quality outcomes. For more information, visit www.galenhealthcare.com. Connect with us on Twitter, Facebook and LinkedIn.

10 Reasons for Full EHR Data Migration – Tackling EHR & EMR Transition Series

Posted on September 7, 2016 I Written By

top-10-reasons-for-ehr-data-migration

(Check Out the Full Top 10 Reasons for EHR Data Migration Infographic)

At Galen Healthcare Solutions we’ve found some important considerations and benefits during EHR data migration, including:

  • Legacy application licensing, and on-going support & maintenance.
  • Avoidance of data redundancy and improvement of data integrity.
  • Productivity and efficiency gains through enhanced clinical decisions support and consolidated clinical data access.
  • Enhanced regulatory reporting with programs including PQRS & PCMH.

When undertaking an EHR replacement project, there is a general misconception that the all of underlying patient clinical data is migrated systematically with ease. However, due to cost and complexity constraints, in most cases only patient demographics and basic clinical data elements are migrated to the new EHR system. In these cases, the legacy system is left operational in a read-only capacity; used as “system of record” for compliance, audits and responses for requests for information. Contrary to popular thought, this approach can actually end up being costlier than pursuing EHR data migration and archival, especially considering clinical efficiencies and patient care benefits associated with each of the latter.
legacy-ehr-data-migration
Understanding available EHR data migration & EHR data archival options and processes are vital to EHR replacement. Not doing so potentially leaves providers and staff inaccurate, unusable or missing data at go-live, compromising patient care. It’s important to evaluate scoping considerations, including options for import of discrete and non-discrete migrated data the new EHR systems provides, expertise of internal or external resources to migrate the data, and data retention requirements. Typically, the data elements & amount/duration of data to be migrated vs. archived is driven by organizational requirements related to continuity of care, patient safety, and population-based reporting requirements. Further, care needs to be taken to ensure data integrity when migrating clinical data – mapping nomenclatures and dictionaries where possible to avoid duplication, and facilitating reconciliation of the data to the existing chart in the target system.

At the heart of the EHR data migration process, it’s important that clinically driven workflows across various user roles are supported, transitioned, and maintained to the greatest extent possible. EHR data migration and archival allows for successful retirement of antiquated legacy applications, and ensures seamless and successful transition to the new EHR system.

Evaluate options, define scope and formulate a strategy for EHR data migration by downloading our EHR Migration Whitepaper.

About Justin Campbell
Justin is Vice President, Strategy, at Galen Healthcare Solutions. He is responsible for market intelligence, segmentation, business and market development and competitive strategy. Justin has been consulting in Health IT for over 10 years, guiding clients in the implementation, integration and optimization of clinical systems. He has been on the front lines of system replacement and data migration and is passionate about advancing interoperability in healthcare and harnessing analytical insights to realize improvements in patient care. Justin can be found on Twitter at @TJustinCampbell and LinkedIn.

About Galen Healthcare Solutions
Galen Healthcare Solutions is an award-winning, #1 in KLAS healthcare IT technical & professional services and solutions company providing high-skilled, cross-platform expertise and proud sponsor of the Tackling EHR & EMR Transition Series. For over a decade, Galen has partnered with more than 300 specialty practices, hospitals, health information exchanges, health systems and integrated delivery networks to provide high-quality, expert level IT consulting services including strategy, optimization, data migration, project management, and interoperability. Galen also delivers a suite of fully integrated products that enhance, automate, and simplify the access and use of clinical patient data within those systems to improve cost-efficiency and quality outcomes. For more information, visit www.galenhealthcare.com. Connect with us on Twitter, Facebook and LinkedIn.

Decommissioning Legacy EHR systems with Data Archival – Tackling EHR & EMR Transition Series

Posted on August 25, 2016 I Written By

EMR Data Archival

In their latest infographic (Check out the full infographic), Galen Healthcare Solutions provides critical information and statistics surrounding EMR data archival including:

  • Healthcare Data Growth
  • Healthcare Data Archival Drivers
    • Mergers & Acquisitions
    • Legacy System Retention Requirements
  • Healthcare Data Archival Benefits
  • Average Patient Digital Footprint
  • Industry Leading Archival Solution

Healthcare Information Technology leaders face challenges in keeping pace with new initiatives and consequently, managing a growing collection of legacy systems. With drivers including mergers & acquisitions, vendor consolidation, application dissatisfaction and product sunsets, it’s estimated that 50% of health systems are projected to be on second-generation technology by 2020, according to the IDC. As these new systems are implemented, multiple legacy systems are left behind, requiring healthcare IT staff to provide support and maintain access.

The strategy of keeping a patchwork of legacy systems running in order to maintain access to data is risky, resource intensive and can be quite costly given licensing, support, and maintenance needs. Decommissioning legacy systems with a proven archival system reduces cost and labor, minimizes risk, ensures compliance, simplifies access and consolidates data.

  • Reduce Costs: Streamlining the long-term storage of historical PHI now will save money in the long-run. Not only will it reduce costs paid for the support and technical maintenance of the legacy system, but it will also save on training new staff on the new system over the next 7-25 years. In addition, incorporating data archival efforts with a discrete data migration provides significant economies of scale.
  • Minimize Risk: Preserving historical patient data is the responsibility of every provider. As servers and operating systems age, they become more prone to data corruption or loss. The archiving of patient data to a simplified and more stable storage solution ensures long-term access to the right information when it’s needed for an audit or legal inquiry. Incorporating a data archive avoids the costly and cumbersome task of a full data conversion.
  • Ensure Compliance: Providers are required to retain data for nearly a decade or more past the date of service. In addition, the costs of producing record for e-Discovery range from $5K to $30K/ GB (Source: Minnesota Journal of Law, Science & Technology). Check with your legal counsel, HIM Director, medical society or AHIMA on medical record retention requirements that affect the facility type or practice specialty in your state.
  • Simplify Access: We all want data at the touch of a button. Gone are the days of storing historical patient printouts in a binder or inactive medical charts in a basement or storage unit. By scanning and archiving medical documents, data, and images, the information becomes immediately accessible to those who need it.
  • Consolidate Data: Decades worth of data from disparate legacy software applications is archived for immediate access via any browser-based workstation or device. Also, medical document scanning and archiving provides access to patient paper charts.

Because the decision to decommission can impact many people and departments, organizations require a well-documented plan and associated technology to ensure data integrity.

Download the full archival whitepaper to understand the drivers that impact archival scope specific to both the industry and your organization.

About Justin Campbell
Justin is Vice President, Strategy, at Galen Healthcare Solutions. He is responsible for market intelligence, segmentation, business and market development and competitive strategy. Justin has been consulting in Health IT for over 10 years, guiding clients in the implementation, integration and optimization of clinical systems. He has been on the front lines of system replacement and data migration and is passionate about advancing interoperability in healthcare and harnessing analytical insights to realize improvements in patient care. Justin can be found on Twitter at @TJustinCampbell

About Galen Healthcare Solutions
Galen Healthcare Solutions is an award-winning, #1 in KLAS healthcare IT technical & professional services and solutions company providing high-skilled, cross-platform expertise and proud sponsor of the Tackling EHR & EMR Transition Series. For over a decade, Galen has partnered with more than 300 specialty practices, hospitals, health information exchanges, health systems and integrated delivery networks to provide high-quality, expert level IT consulting services including strategy, optimization, data migration, project management, and interoperability. Galen also delivers a suite of fully integrated products that enhance, automate, and simplify the access and use of clinical patient data within those systems to improve cost-efficiency and quality outcomes. For more information, visit www.galenhealthcare.com. Connect with us on Twitter, Facebook and LinkedIn.

EHR Data Migration – Tackling EHR & EMR Transition Series

Posted on August 10, 2016 I Written By

EHR Data Migration
(See Full EHR Data Migration Infographic)

In this infographic, Galen Healthcare Solutions provides critical information and statistics pertaining to EHR data migration including:

  • Healthcare Data Growth
  • EHR Data Migration Drivers
    • Mergers & Acquisitions
    • System Consolidation
  • EHR Data Migration Challenges
  • Industry Leading EHR Migration Solution

The demand for data migration within the U.S. healthcare market is growing exponentially. The increase in mergers and acquisitions is driving system consolidation as is the increasing number of HCOs seeking EHR replacements to address usability and productivity concerns. A recent survey by Black Book Rankings found that nearly one-fifth of large practices and clinics intend to undergo an EHR replacement by the end of 2016. In addition, a 2015 Kalaroma report shows that the EHR replacement market will grow at an annual rate of 7-8% over the next five years.

EHR Data Migration Process

The process of migrating from one EHR to another is among the most difficult technical and functional projects a healthcare organization will ever confront. The EHR transition requires vendor selection, assessment and scoping, legacy system optimization, data migration, legacy application support, data archival, and new system implementation. If organizations fail to address any of these components properly, their migration could leave healthcare providers without the information needed to make the best patient care decisions, and organizations without easy access to the historical data necessary for participating in quality reporting initiatives and other current and emerging value based care reimbursement methodologies.

Learn more about EHR transition, replacement and migration strategies, methodologies, tips & tricks, and best practices by downloading our EHR Migration Whitepaper.

About Justin Campbell
Justin is Vice President, Strategy, at Galen Healthcare Solutions. He is responsible for market intelligence, segmentation, business and market development and competitive strategy. Justin has been consulting in Health IT for over 10 years, guiding clients in the implementation, integration and optimization of clinical systems. He has been on the front lines of system replacement and data migration and is passionate about advancing interoperability in healthcare and harnessing analytical insights to realize improvements in patient care. Justin can be found on Twitter at @TJustinCampbell

About Galen Healthcare Solutions

Galen Healthcare Solutions is an award-winning, #1 in KLAS healthcare IT technical & professional services and solutions company providing high-skilled, cross-platform expertise and proud sponsor of the Tackling EHR & EMR Transition Series. For over a decade, Galen has partnered with more than 300 specialty practices, hospitals, health information exchanges, health systems and integrated delivery networks to provide high-quality, expert level IT consulting services including strategy, optimization, data migration, project management, and interoperability. Galen also delivers a suite of fully integrated products that enhance, automate, and simplify the access and use of clinical patient data within those systems to improve cost-efficiency and quality outcomes. For more information, visit www.galenhealthcare.com. Connect with us on Twitter, Facebook and LinkedIn.

Five Signs You Need a New HIE Solution

Posted on February 17, 2015 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

I’ve written a lot about the new EHR switching market. EHR implementation software has become quite mature and so we’re entering a new world where new EHR sales are going to come from hospitals switching EHR software. Yes, there are a few hospital EHR stragglers out there, but the majority of new EHR sales are going to come from switching.

While I’d seen this coming in the EHR market for a while, I hadn’t carried that over to the HIE market as well. In this case, I’m really referring to a private HIE that a hospital might employ versus a third party HIE provider. Is the HIE market in a similar “switching” market like EHR? I’d love to hear your thoughts on this.

This question came to mind when I found this eBook called, Five Signs You Need a New HIE Solution. It’s a free download if you want to check out the whole eBook. The 5 signs it suggests are worth some discussion:

  1. My data sharing solution isn’t meeting my needs, but the thought of replacing it is painful.
  2. My technology is old. We need an architectural update.
  3. I can’t access or share my data when I need to.
  4. I can’t make changes to my HIE solutions without my current vendor’s involvement. Plus, they take too long and charge too much.
  5. I don’t feel confident that my current HIE partner is well equipped to handle healthcare’s changes, challenges, and uncertainties.

It’s amazing how universal these signs are with any software. This list could have applied to EHR software as much as HIE. In the eBook, they discuss each of these in more detail. I’m sure that many of these issues resonate with readers.

As I look through this list, I wonder if switching software is the only way to solve the problem. I think in most cases the answer is that switching is the only solution. The reason many don’t switch is fear. Plus, that fear is exacerbated by colleagues from other organizations who have switched their system and not seen an improvement. That’s why so many organizations stick with The Devil You Know for much longer than they should. Hopefully the above list of signs will help people who are going through this evaluation. Just make sure that if you do need to switch HIE or other software that you take the time to make sure your new software won’t suffer the same issues.

Leveraging Vendor Neutral Archives Against EHR Vendor Lock In

Posted on October 3, 2013 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

I recently heard of a new strategy that some organizations are employing to be able to avoid EHR vendor lock in. I’m happy to support anything that prevents EHR vendor lock in. The fact that a hospital can switch EHR software, doesn’t mean they will. However, the ability to switch EHR software usually means that the EHR vendor makes more effort to make sure they’re meeting the customer’s needs. This is why I think that preventing EHR lock in is so important. I don’t like EHR vendors resting on their laurels because a hospital has no choice but to use that software.

The method I heard described was a hospital who chose to implement a vendor neutral archive (VNA) of their EHR data. We usually hear VNA’s applied to radiology, but I predict over the next 3-5 years every large organization will have an EMR VNA as well. In this case, the hospital chose to implement a VNA while they were on good terms with their current EHR vendor.

Most EHR vendors won’t facilitate a VNA if you’re leaving them. So, it’s important that this is done before you choose to leave an EHR vendor. We also shouldn’t start assuming now that everyone that has a VNA is getting ready to part ways with their EHR vendor. In fact, I’d love for an EHR VNA to become the standard in the industry. That way, if and when an organization chooses to change software vendors, they can do so without losing all of the important data they’ve been collecting and storing in their EHR.

Just remember that it’s too late to employ this strategy when you’re ready to switch EHRs. It takes a forward thinking organization and investment to do this while everything is going great with your EHR vendor. Consider the investment insurance for a rainy day to come. I assure you that day will come for most healthcare organizations.

Paper to EMR is Much Easier to Justify Than EMR to EMR

Posted on May 30, 2013 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

When I was last in DC at the Healthcare Forum, I heard hospital CIO Bill RiegerStep Out” and talk about some of the challenges he faces as a hospital CIO. One of the things he said in his talk really rang true to me and is going to become an increasingly important topic in healthcare.

His comment: The ROI from Paper to EMR is Much Easier to Justify than EMR to EMR

This is a powerful and challenging thing to consider. I’m sure those at Epic, Cerner, Meditech, etc are licking their chops knowing that it will take a hospital CIO with special leadership skills to overcome this challenge. Yes, from their perspective they have some incredible customer lock in. However, Bill went on to describe that it’s not impossible to lead such an effort. In fact, his hospital was switching EMR software shortly after I heard him speak.

The biggest challenge with this idea isn’t that there’s no ROI to switch from one EMR to another EMR. There can be a significant ROI, but most hospital CIOs are afraid to make such a call. They’re afraid to really dig in deeply to find out what a new EMR might mean for their hospitals. Sometimes this is because they were the one who implemented the first EMR. Other times it’s they’re too risk averse to take on such a challenging project. It’s often easier to sweep thing under the rug than it is to pull up the rug and really see what’s going on under the covers.

I’m of course not suggesting that switching EMR software is always the right decision either. One of the first lessons I learned out of college was that change doesn’t always mean better. In fact, a change can make things worse.

I do believe that continuous improvement leads to beautiful results. Too many in healthcare IT are satisfied with status quo. If we’re going to continuously improve, one area we can start is to dig deeply into the ROI of going from electronic to electronic.

Accenture: Five Questions Hospital Boards Should Ask Before EMR Buys

Posted on January 24, 2013 I Written By

Anne Zieger is veteran healthcare editor and analyst with 25 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

As we’ve noted in the past, hospitals are on not only an EMR buying binge, they’re doing a lot of switching from one EMR to another. Check out these stats from Accenture:

Accenture research shows that 4 to 4.5 percent of hospitals plan to make an EMR buying decision each year. This
could exceed 110+ EMR contracts or 200 to 250 hospitals per year. This trend is expected to continue well into the
future. In fact, in 2012, 50 percent of EMR deals [were] replacements, up from 30 percent in 2011, according to KLAS Research.

Whether your hospital is a switcher, a late adopter or  planning some kind of EMR upgrade, it’s making a decision of grave importance. So what are some of the key considerations boards should bear in mind? Here’s Accenture’s list of five key questions boards should keep front and center as they consider (more)  big EMR investments and plan for the future:

*  Does your current system offer enough functionality to meet up and coming Meaningful Use requirements, such as the ability to make patient family health histories and imaging results available? Does your current or contemplated EMR vendor have plans in place to keep up with future requirements/changes?

*  Is the EMR vendor’s development strategy in line with your strategy? “Boards should ask of the EMR vendor: do they have adequate resources…to help complete the business roadmap on time and successfully?” Accenture asks. And just as importantly: “Can the vendor help ensure that future product functions are strategically aligned to the healthcare [system’s] key initatives?”

* Is your hospital currently on track to meet ICD-10 adoption and Meaningful Use Stage 2 requirements?  Is your vendor going to be able to help support you in these efforts as your hospital works to meet these multiple goals, or does it lack the resources to do so?

* If we decide to switch EMRs, do we have the internal resources needed to support such a bandwidth-sucking effort? Given competition for healthcare IT labor today, will you have the ability to hire on additional resources if needed? And while you’re at it, is your C-level and IT leadership solid enough to make such a treacherous journey?

* Can your hospital afford to switch EMRs, bearing in mind not only direct costs such as licensing, implementation and new technical support, but also ongoing support costs in the neighborhood of 20 percent per year?

To answer these questions, Accenture recommends you conduct an independent analysis of EMR vendors (presumably, rather than relying on analyst firms or peer feedback exclusively).  This sounds like a very good idea to me.

2013: The Year Of The EMR Switch

Posted on December 27, 2012 I Written By

Anne Zieger is veteran healthcare editor and analyst with 25 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

After years of ferment, it looks like this is going to be a year when many a hospital decides to rip and replace their system.

Pundits of various stripes like to dwell on the big-ticket installations — some in the many hundreds of millions of dollars — and yes, those folks are not very likely to back out. But those same pundits are beginning to note that a high percentage of hospitals (and doctors, by the way) are growing unhappy with the EMRs they’ve got.

What has so many providers in agreement that their system doesn’t cut it? Maybe it’s the pressure to meet Meaningful Use 2 standards. Maybe it’s a recognition that their system requires too much care and feeding. Or maybe,  just maybe, the fact that doctors hate the system they’ve got is finally filtering through.

Regardless, if there is a wave of hospital EMR switches, it could have a big impact on the EMR sales process:

Vendors will market their heads off:  With lots of new contracts up for grabs, vendors would be crazy not to spend on marketing like they never have before. But they’d better be selling confidence — think the “we’re the people you can trust” ads run by life insurance companies — or it won’t win a lot of fans.

Hospitals will be sadder but wiser:  All of that happy marketing stuff aside, hospitals will (hopefully) be harder to convince and clearer on what they want. That means doing some long, sober, careful analyses of what went wrong the previous time, but nobody will be rushing into things this time, so why not?

Alternatives (like open source) may see more momentum:  With hospitals having already sunk big money into products that didn’t make the cut, maybe this time they’ll give free open source EMRs and health IT infrastructure a chance.

New market winners and losers will emerge:  Right now, the same 10 or 15 players are usually turning up in EMR satisfaction surveys.  With a big switch going on, some may lose their pride of place and new winners may emerge. It would be pretty surprising if every hospital EMR switcher just jumped on the same products that already dominate the market.

Maybe this time, with Meaningful Use experience under their belt and some experience with a live EMR, the (re)selection process will go better this time. Let’s hope so!