EHR Migration: Challenges and Mitigation Strategies

Approximately 78% of office-based physicians and 96% of non-federal acute care hospitals had implemented a certified electronic health record (EHR) by 2021. That demonstrates significant progress since 2011 when EHR adoption rates stood at 28% for hospitals and 34% for physicians.

Healthcare management systems become outdated over time, losing their effectiveness and efficiency. To ensure healthcare organizations can utilize medical records to their fullest potential, it is essential to conduct EHR modernization and migrate to a newer and more robust infrastructure. Discover how to perform EHR migration while minimizing risks and maximizing rewards.

The Limitations that Arise and Require EHR Migration

Electronic Health Records are crucial for enhancing patient care and operational efficiency. Yet, as newer systems emerge, organizations frequently face challenges with their outdated legacy EHR systems.

• Immature technologies had limitations: As a result, around 30% of hospitals in the 2000s switched from their existing EHR vendors or home-grown systems to vendor-provided EHRs.

• Meeting new regulatory requirements is essential: Outdated EHR solutions may not comply with the latest healthcare and data processing regulations. In such cases, migrating to a new EHR system provides a viable solution. The Meaningful Use (MU) program played a crucial role in motivating healthcare organizations to transition to certified EHRs, ensuring eligibility for MU incentives, or maintaining compliance.

• The absence of modern, advanced EHR functionality necessitates data migration to a system with improved features. Although it is feasible to incorporate missing functionalities into the existing system, the limitations of legacy software can pose significant obstacles.

• Acquisition by another company: The acquiring organization assumes control and establishes new protocols. In such cases, your entity may need to undergo EHR migration to align with the larger provider and establish a unified system.

Different Types of EHR Migration

Transitioning from a standalone EHR to an all-in-one healthcare platform

In certain cases, organizations opt to transition from a standalone EHR system to comprehensive healthcare software. The new software integrates EHR with extra functionalities like practice management, billing, telehealth, and more. That shift may also involve adopting a different technology stack.

Migration from on-premise EHR to cloud-based infrastructure

Healthcare organizations find cloud-based EHR solutions more appealing due to their scalability, accessibility, and cost-effectiveness. They choose to migrate their EHR data from local servers to cloud-based systems. That shift to the cloud brings several benefits, such as improved data sharing and collaboration, reduced dependence on in-house IT infrastructure, and increased flexibility. 

Some healthcare organizations even adopt a hybrid cloud approach when they keep certain data on-premises for quick access while storing other data in the cloud. That approach strikes a practical balance, combining the security and control of an on-premises system with the scalability and accessibility offered by the cloud.

Migration to new tech stack 

Instead of moving to the cloud, an organization can choose to modernize its applications by upgrading its tech stack. It means they are transitioning their tech infrastructure to a different set of tools, frameworks, or technologies. This modernization process could involve changing databases, programming languages, or other foundational technologies to achieve improved functionality and adaptability. 

By embracing a new tech stack, organizations aim to leverage the benefits of modern technologies and stay ahead in today's rapidly evolving digital landscape. How can it look? Let us consider the quite popular migration from .NET Framework to .NET Core. Here are some key reasons to make the switch:

• Cross-platform support: .NET Core is a framework that works on multiple operating systems like Windows, macOS, and Linux.

• Cloud-ready for Azure: .NET Core integrates seamlessly with Azure, Microsoft's cloud platform. Azure offers specialized services tailored for .NET Core applications, simplifying deployment, management, and scaling on the Azure platform.

• Faster performance: Benchmarks indicate that .NET Core applications can outperform equivalent .NET Framework applications, delivering improved speed and efficiency.

• Future-proof features: .NET Core offers advantages over the .NET Framework. It embraces a modular and scalable microservices architecture and integrates smoothly with containerization technologies like Docker and orchestration platforms like Kubernetes. It also provides modern development tools such as CLI tools and integrates well with popular IDEs like Visual Studio Code across different operating systems.

• Long-term support and security updates: Microsoft has declared .NET Framework 4.8 as the final major version. It means that future innovations and improvements will be focused on .NET Core and its successors like .NET 5 and .NET 6.

EHR Migration Challenges and the Strategies to Address Them

• Financial Challenges

Mitigation strategies: Explore consolidation with larger systems, plan for long-term costs, allocate budget for consultants, consider third-party migration, or utilize consolidated clinical documents (CCD).

• Technical Issues

Mitigation strategies: Budget for increased personnel costs, consider purchasing all-in-one EHR with ancillary modules, and ensure data integrity as part of the total cost of ownership.

• Personnel Challenges

Mitigation strategies: Provide comprehensive initial training to reduce ongoing support needs, and prioritize user satisfaction and efficiency to maintain a smooth workflow.

• Cybersecurity Concerns

Mitigation strategies: Allocate budget for IT personnel, conduct ongoing staff training, and regularly back up data. Consider establishing a cybersecurity task force and engaging 'white hat' hackers to test system security.

By employing these strategies, organizations can successfully navigate the challenges associated with EHR migration and ensure a smoother transition to a new system.