Thinking of Switching EHRs? Read This First

Ronald B. Sterling, MBA, CPA


December 11, 2018

In This Article

Getting Your Current EHR Vendor On Board

Unfortunately, most EHR vendor contracts don't adequately provide for an effective exit and transition strategy to a future EHR replacement. In most cases, your EHR support and/or use can be terminated without providing adequate time for a transition, or even a commitment from the EHR vendor to support the transition.

Indeed, the Application Service Provider EHR vendor model is based on continuing payments to use their software and access your data. In more and more cases, EHR vendors are basing continuing use of licensed EHR software on continuing support payments.

This is not an academic discussion. The contractual relationship established in your legacy EHR contract will frame and control the vendor's relationship with your organization as you seek to transition to a new EHR. To set the stage for a transition process from your existing EHR, you need to work with your current vendor to support a test conversion as well as the final (go-live) conversion.

The conversion of patient information is a critical issue and challenge for your transition to a new EHR. It must be properly structured to support your implementation process.

Implementation and Training

You should plan the new EHR implementation to occur during the lower activity level of your practice's business cycle. For example, primary care practices should avoid flu season, whereas other practices may have a lower level of activity at the beginning of the calendar year.

Base the implementation process for a new EHR on experience with the existing EHR and include the following:

  • Map existing EHR use and features to the new EHR to help physicians and staff relate to the new EHR.

  • Inventory the new features to be used in the EHR.

  • Design a new clinical workflow to capitalize on the new EHR features.

  • Develop training materials that include where the existing EHR data will be stored in the new EHR as well as how to use the new system.

  • Verify the conversion of data from the legacy EHR to the new EHR for a test and final conversion. The test conversion helps verify the conversion process and avoid problems when go-live is imminent.

  • Train staff on the patient information to be entered on the first patient visit under the new EHR.

  • Define expectations for completion and signoff of EHR patient service items and notes. The strategy should include a daily process to verify that notes are signed and patient service issues addressed in a reasonable timeframe. For example, secure messages from patients should be answered within a specified number of hours.

  • Complete a new HIPAA Security Risk Assessment for the new EHR.

Your implementation plan will depend on the EHR vendor and your own organization. The vendor implementation plan will not necessarily address the practice issues that you need to manage for the implementation process. Practices or organizations should have their own list of implementation activities to ensure the practice can successfully implement and capitalize on the new EHR.

Your potential change to a new EHR system should be driven by needs and requirements that are significant enough to bring additional value to your practice, beyond the capabilities of the current EHR.

Once your organization has decided that the transition is worth the benefits of a new EHR, you will have to be actively engaged in designing, guiding, and verifying the transition of the existing data to establish a viable patient record in the new EHR and to also maintain the integrity of your patient records to improve patient service and clinical operations from the new system.

Ronald Sterling is a nationally recognized EHR expert and serves on the Medscape Business of Medicine Advisory Board.


Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.