10 Steps to Smoothly Switch EHR Vendors

Healthcare organizations may need to replace their electronic health record (EHR) systems for any number of reasons, whether it’s because of a recent merger, to get access to the latest features, or to take advantage of the cloud computing model. Regardless of the reason, switching out such a core system is never easy. The intention of this article is to provide a blueprint that healthcare organizations can follow to ease the transition and potentially maximize the benefits.

Why Switch EHR Vendors?

Switching EHRs certainly isn’t the path of least resistance. Clinicians and support staff will have grown accustomed to the legacy system, even with its imperfections. But in many cases healthcare organizations have no choice.

Healthcare provider mergers often require organizations to choose between different incumbent EHR systems or move to another, more modern system. In other instances, a healthcare organization may find that its incumbent EHR vendor can’t support its plans, either because the vendor isn’t innovating quickly enough or because the system can’t scale to the extent the organization needs. Or its existing EHR system may simply not interoperate well enough with its patient portal, life sciences, lab, worker scheduling, finance, or supply chain systems—or other EHR systems.

10 Steps for a Smooth EHR Vendor Switch

Healthcare organizations can make switching EHR systems easier by following a handful of common-sense steps, such as involving the right stakeholders, defining objectives for the new system, formulating a budget, and undergoing a thorough vendor assessment. Read on for more on these and other key steps.

1. Create a dedicated EHR transition team

   Your EHR transition team should include key people from across the organization, including physicians and nurses, support staff, administrators, and representatives from finance, HR, and IT. Remember that different groups have different priorities based on their responsibilities. Ensuring that all their viewpoints are heard is crucial.

2. Assess current EHR system limitations and identify challenges

   Conduct a detailed assessment of why a change is needed; this account will inform the list of RFP requirements for the new system. Does your current EHR system make it difficult to input new information, resulting in a lot of “pajama time” for clinicians, which can contribute to burnout? Can your current system scale adequately to accommodate the growth your organization envisions? Does the vendor’s product roadmap align with your organization’s strategic vision? (For example, if your organization wants to take advantage of new technologies, such as AI for transcribing doctor-patient conversations, does the vendor’s product roadmap include adding this type of feature in the near future?)

3. Define clear objectives and set goals for the new EHR system

   In addition to performing the gap analysis in step 2, members of the transition team should spend time researching current EHR best practices to help ensure that the new system not only addresses current needs but is also likely to meet future ones. For example, will the new system interoperate with your organization’s finance, HR, and other business applications? Will it support mobile clinical interventions?

4. Plan your budget and financial resources for the transition

   Your organization should be clear-eyed about the cost of a new EHR system. A major consideration is whether your organization would be better off moving the expense of the new system to an operating budget line, as with a cloud or hosted service, rather than a capital line, as with an on-premises installation that requires an up-front investment in servers, networking, storage, and other equipment, as well as ongoing IT support. Recognize that the transition itself will cost your organization time as people evaluate and learn the new system, as well as the opportunity costs of lost productivity as users get fully acclimated to the new system.

5. Conduct thorough vendor research and selection

   Designate select IT, business, and clinical staffers to do extensive research on different EHR vendors and their offerings. Conduct a thorough comparison. Ask current users of those EHR systems—and not just the references supplied by each vendor—about their experiences with implementation, training, features, updates, and ongoing support. Eliminate from consideration vendors that make it difficult to interoperate with systems from other vendors. Your organization may want to consolidate its EHR system and use only one vendor, but the reality is that it may still need to rely on niche vendors for certain workflows and functionality, such as for behavioral health or oncology. Invite vendors to present their systems and press them on factors such as their interoperability, scalability, and product roadmap. Be as certain as possible that your vendor has the same vision for the future as your organization.

6. Standardize workflows

   Modern EHR systems run in the cloud, either hosted by a cloud provider or as pure software-as-a-service (SaaS) offerings. Such systems build in industry best practices for caregiver and administrative processes, reducing or eliminating the need for heavy-duty customizations. Your organization may, however, want the ability to “extend” its out-of-the-box cloud application—for example, to configure unique workflows and approval processes, tailor the user interface at the field, menu, and page level, or create new dashboards for the organization or specific teams or individuals. The best EHRs allow for these kinds of extensions while letting business users create more complex ones using low-code development tools.
   
   Hosted solutions allow for a greater degree of customization than SaaS solutions, and they also relieve your organization’s IT staff from having to maintain and upgrade the system as new innovations become available.

7. Migrate data

   In addition to adopting new interfaces and workflows, your organization will also need to transfer the data from the legacy system to the new one. Different organizations tend to name data types differently, especially when using heavily customized systems, so this process often involves recategorizing or relabeling data according to the new system’s taxonomy, which should be based on industry best practices.

8. Implement, test, and prepare for system launch

   Work with your vendor (and your implementation partner) to implement the new EHR, potentially in phases. Initially, basic system functionality will be tested using hypothetical data, but ultimately it will have to be tested using actual patient data, which is where most of the errors will be discovered. Pilot programs help determine whether a new EHR is viable in real-world situations, while trial programs test the implementation approach. Create a schedule for the rollout and training, and enlist stakeholders and power users to extensively test the new system. Begin preparing staff for a cutover.

9. Conduct staff training

   First identify who will be using the EHR and determine which parts of the system they’ll have to be trained on based on their roles. Then start identifying the users who are most comfortable with technology so they can become power users and later help train their colleagues. Your organization can draw from a variety of training regimens, including online tutorials, in-person hands-on training by the system vendor or implementation partner, and interactive group sessions, so employees can learn from both experts and their colleagues. Eventually, transition training into the hands of power users who know how things were done previously and what might be especially confusing or disorienting to their colleagues.

10. Offer post-implementation support and continuously optimize the system

    Getting user buy-in is crucial to the success of any EHR implementation. Hopefully, the initial consultations with stakeholders will have resulted in an EHR that satisfies the business requirements of all parties, but even in the best of cases, new systems require staff to learn new processes and force them to break old habits. Plan on having onsite vendor support for a few weeks and ongoing support from your organization’s power users for at least a couple of months, until users become fully acclimated to the new system. Vendors should offer long-term remote support as well.

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Switching EHR Vendors FAQs

What is an EHR migration?

An EHR migration is the process of switching from one electronic health record system to another.

What is the most common rationale for changing EHR vendor platforms?

Most healthcare organizations switch EHR platforms because their current system is too costly to maintain. Another reason is to consolidate platforms following an acquisition.

How long does it take to transition to a new EHR?

Depending on the size of the organization, it can take anywhere from eight months to almost two years from when a contract is signed to the implementation of the first phase of a new EHR.

^{*The content is intended to outline our general product direction. It is intended for information purposes only and may not be incorporated into any contract. It is not a commitment to deliver any material, code, or functionality, and it should not be relied upon in making purchasing decisions. The development, release, timing, and pricing of any features or functionality described for Oracle’s products may change and remains at the sole discretion of Oracle Corporation.}