The Great EHR Migration: Why Two Organizations Made the Switch

More than one in six providers currently using an electronic health record system has plans to change vendors within the next year.

Many of these providers are physician practices upgrading to meet meaningful use requirements or replacing a poorly-functioning system, but hospitals have increasingly been switching to new vendors as well. The financial and labor outlay required to change EHR systems is no small matter — meaning the hospitals contemplating a switch have very good reason to do so.

"There were a lot of outside forces that affected our decision," says Lisa Moffett, health information manager of UHS Delaware Valley Hospital in Walton, N.Y., of her hospital's decision to change EHRs in its physician practice. For example, Medinotes, the initial EHR system at UHS Delaware, didn't meet meaningful use criteria. "Like every other hospital, we have those incentives on our minds," she says, as well as the looming threat of noncompliance penalties.

The most compelling reason to find a new system, however, was news of Medinotes' acquisition by first Eclipsys, and then Allscripts. "We were soon informed they were sunsetting our system," says Ms. Moffett, meaning Allscripts would no longer provide support services for the EHR. The situation is not unique: "It's something that's happening more and more in the industry — these bigger companies gobbling up the smaller ones," she says.

When deciding on a replacement EHR system, Ms. Moffett looked not only at the systems that met meaningful use standards, but also at what the other primary care practices in the UHS system used. "Everyone we work with uses NextGen," she says. Moving to that vendor made it easy to share patient data, including laboratory and testing results, throughout the system.

"It was the path of least resistance," says Ms. Moffett, and ultimately of least cost. "This should keep us from having to switch EHR vendors every few years."

The desire for a common EHR throughout a health system is becoming increasingly common as hospitals consolidate and acquire physician practices. "Currently, we have five or six EHRs in our organization, and it's affecting the ability of our physicians to operate like a cohesive, multispecialty practice. We have a health information exchange, but it's not the same as having everyone on the same platform," says the CIO of a large, four-campus system in Pennsylvania, who requested anonymity as the system's current vendors are unaware of the plan to consolidate down to one.

"It's becoming clear in the current accountable care environment that coordination between acute and ambulatory care is critical," he says. "And it's driving us to a single vendor to have that consistent platform for everyone."

In the years since the health system was first on the market for an EHR, what it's looking for has changed, he says. "When we bought our EHRs the first time, it was about feature functions rather than looking at accomplishing our goals and supporting our business strategy with the least amount of physician disruption."

The selected EHR will have to feature "full integration across the healthcare system, including the acute care setting, so we can tell the patient's complete health story, regardless of care setting," he says, as well as comply with meaningful use, accountable care, and current and future regulatory requirements and most importantly to facilitate transition of care across care settings. He also plans to limit modifications across the system as much as possible, to both standardize care delivery and allow for easier system upgrades.

He advises other hospitals to do the same — to focus less on what individual clinicians want in a system now, but rather what the organization will need the system to be able to do as healthcare reform takes shape, and be able to update and adapt without going through another EHR switch. "What your doctors want today is less important than what the healthcare industry will look like three or four years down the line," he says. "Focus on choosing an EHR that will improve your delivery strategy and put you in a place to succeed in the market."  

More Articles on EHRs:

Report: Cerner, Epic Acquired 75% of New EHR Hospital Business Last Year
MU3 Recommendations for Reducing Health Disparities Released by Consumer Coalition
Study: EHR Analytics Can Identify Diabetes Cases Earlier

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