EHR migration delivers major benefits for Oak Orchard Health
During the COVID-19 pandemic, Oak Orchard Health, based in Brockport, New York, grew. In July 2020, it acquired a private practice consisting of three offices that used a different EHR (Medent) than Oak Orchard’s eClinicalWorks platform.
To enable the rapid transition after the acquisition, Oak Orchard kept the practice in Medent and implemented procedures and workflows to work around the differences. The goal was to provide a consistent patient experience across the organization.
THE PROBLEM
“We quickly discovered that we had to implement many procedures and workflows to complete a patient visit,” said Jason Kuder, CIO at Oak Orchard Health. “It was the very first time that the staff used Medent for their daily visits. Every patient seen at every encounter from then on was manually created in eCW so we could get claims out the door.
“So an active patient would essentially have two accounts: one in Medent for the patient record and one in eCW for billing,” he continued. “The longer we stayed with two EHRs, the more we realized no matter how many procedures or workflows we put in place, these three offices would remain isolated. We were no longer able to spread our resources across our organization.”
Being proficient in both Medent and eCW was an impossible task for healthcare providers busy treating patients – and a support nightmare, he added. Over the years, the organization became siloed. Recruiting became more difficult because healthcare providers were often not trained in both EHR courses.
“We also ran into issues with daily reporting, but more importantly, it made it even more difficult to report for UDS,” Kuder explains. “FQHC health centers are required to apply every February, and this has been a major barrier for us.
“Retrieving data from two EHRs and combining the data sets to report for UDS has been a major struggle every year since the acquisition,” he continued. “Patients can be in both systems, or just one. The way they are documented is very different, resulting in long data validation sessions – a huge operational lift for our organization.”
PROPOSAL
Financially speaking, Oak Orchard Health could not address this problem any further. Worse still, staff morale was at an all-time low. With high turnover in senior leadership, the new CEO made it a first priority to get the new practice’s three locations onto eCW along with the rest of the organization.
“We felt like if we could get everyone on the same EHR, we would all be speaking the same language,” Kuder said. “We could more easily implement new technologies, company-wide procedures and workflows.
“Having multiple medical record platforms impacts everyone in the organization – from the way we route incoming calls to the way we document in a patient’s chart,” he added. “If everyone works from the same EHR, we can provide a more consistent patient experience.”
MEETING THE CHALLENGE
When healthcare IT professionals talk about migrating to a new EHR, most focus on the data that needs to be migrated from one location to another, Kuder noted.
“It’s much more complex than that,” he said. “The hardest part, in my opinion, is training staff on the new EHR. It wasn’t as simple as documenting a patient’s height and weight, for example. The entire patient appointment workflow would have to change.
“The analogy I used for this project is trying to replace the engine of an airplane while it is flying,” he continued. “The patients no longer need to be seen just because you are going to change the EPD. We had to work on a plan to train all staff, configure new facilities in eCW and migrate the data from Medent to eCW, when this was not the case. interrupting patients’ schedules.”
On the data side, staff had to work with Medent to provide Oak Orchard with all patient data contained in the EHR. Staff then had to provide it to eCW so they could give Oak Orchard a map of how the data would be recorded.
“Since the EPDs used different terminology, this was a laborious and tedious task, going through line by line for each attribute of Medent to what it is called in eCW,” Kuder recalls. “Once this portion was complete, we performed a test migration in a test environment. We then went through hundreds of patient records and ensured that the data that could be migrated was placed in the correct locations in eCW.
“While that team was working on the data side, another team was working on the training side,” he continued. “We first started by enrolling all staff from these three offices for eCW University online classes based on their roles. This allowed them to receive some of the initial training if they had time.”
Oak Orchard has engaged some of its eCW super users to travel to the new practice locations to provide hands-on training. And it sent staff from the Medent locations to Oak Orchard locations to see live how eCW works.
“Once we validated, the data looked good and the training was done. We planned a weekend where we would take the data from Medent and migrate it to our eCW production environment,” Kuder explains. “Staff last used Medent on Friday and started using eCW on Monday. All this happened without the offices having to close.”
RESULTS
One of the biggest successes is staff satisfaction. For three years, Oak Orchard was duplicating work. The reception staff in those offices now do not have to enter data into two EPDs. The finance department doesn’t have to take information from one EHR and enter it into another EHR to get claims out the door.
“Additionally, we have been able to reduce our operating costs associated with this duplication,” Kuder reported. “We’ve been able to help reduce staff burnout because we’ve been given flexibility with our staffing in that we can deploy them wherever we need them without having to worry about which EHR is being used. used.
“The transition to eCW has allowed us to become unified as a system and share information more efficiently, ultimately saving time and providing patients with better care,” he continued. “We now speak the same language and use the same procedures and workflows in all our offices. This alone has enabled us to launch new services such as automatic check-in.”
Oak Orchard is now also implementing kiosks at all of its locations. None of these things would have been possible if it was still on two EPDs, Kuder added.
ADVICE FOR OTHERS
“If you are ever in an acquisition situation and you are bringing facilities into another EHR, I would recommend migrating those new offices into your existing EHR as part of the acquisition,” Kuder said. “The longer you try to maintain two EHRs, the harder it will be to switch. Furthermore, patients’ experiences will be affected twice instead of just that once.
“Allow more time than you think you’ll need for a project like this,” he continued. “Since the EHR is the No. 1 application for a service provider, making sure you have done all your due diligence will allow for a smoother migration.”
When validating data, make sure as many eyes as possible are on it, he added.
“There are hundreds of different characteristics for a single patient, and the more people you can validate to make sure the data has been migrated correctly, the more complete the graphs will be,” he concluded.
Follow Bill’s HIT coverage on LinkedIn: Bill Siwicki
Email him: bsiwicki@himss.org
Healthcare IT News is a HIMSS Media publication.