We asked Keena’s conversion experts to compile advice and tips from experience with 50+ Epic Conversion & Archival Projects to help you prepare for your conversion project.

With increased regulatory and reporting requirements, a push for true interoperability, and the need to better engage with patients, many of our clients have been considering a move to a new EHR- and specifically to the market-leading Epic platform. Industry statistics indicate that 46% of EHR conversions and implementations in 2021- 2022 were headed to Epic. Clients have pointed to stability and reliability as leading factors in their purchase decision.

01Data Elements Selection

Deciding which data elements to move from your existing EHR is at the heart of every conversion project. Here are some factors to consider when determining which data elements to migrate to Epic.

Key Patient Identifiers
Demographics such as name, address, date of birth, are typically a core part of any conversion.

Structured, Discrete Clinical Data
Medications, allergies, and lab results offer the potential of being moved directly into a new EHR database—which provides the advantage of being incorporated into clinical decision support processes.

Continuity of Care Documents (CCD)
CCD’s are useful for both summary data and discrete elements. This is because the underlying structure is based on the CCDA (Consolidated Clinical Document Architecture) standard. CCDAs can be used to generate historical PDFs for longitudinal view of the patient’s chart. It also contains all the discrete data needed for most clinical conversions.

Progress Notes and Other Relevant Clinical Documents

This data has important historical reference value. When considering notes and clinical documents look to balance providers needs vs wants to avoid cluttering your new EHR.

03Data Mapping

The data mapping effort is almost always underestimated by an organization but is critical for a discrete data conversion and crucial to keeping to your planned project timeline. For example: some items might not be codified, or they may not be in the required coding system. These situations require a lot of communication, vetting, and signoffs.

A Few Suggestions for a Successful Data Mapping Project:

• Identify coding set mapping requirements upfront
• Determine the volume of data you have that is not codified
• Prioritize by instance count Example: For medications: determine how many are prescribed and then prioritize accordingly
• Give extra time for basic data formatting of key elements. Example: Time, language, gender, and demographics
• Make sure you have the Epic Dictionaries map from source codes to Epic Codes

04Data Grouping / Sets

It’s important to define and build meaningful practice identifiers to ensure patients and their data can follow the provider. Consider what needs you may have for identifying patients/groups from a legacy perspective up front in your planning process. If you want to know which patients are affiliated with specific practices in your network, you’ll need to define and build meaningful Practice Identifiers. These identifiers can then be used during the conversion from the legacy system(s) for various conversion data set(s). If you’re planning to use the legacy practice level OID – having complex, or inconsistent rules can reduce or eliminate your ability for some practice level reporting, export utilities, or straight-forward conversion tasks.

05Archiving vs. Conversion

It may not be practical or possible to convert all the relevant clinical and financial data from your old systems to your new one. Yet it’s crucial for patient care, collections, and legal compliance that you “leave no data behind.” Consider having a comprehensive legacy system data archival plan to provide easy access to a full view of all archived clinical and financial data from older platforms. There’s no need to keep your legacy EHR or PM systems running along with the maintenance and licensing expenses that go along with that alignment. A user-friendly, flexible archive solution can be configured to operate as a module inside most leading EHR and PM systems. Thus, avoiding the need for clinicians and back-office staff to log into multiple systems to access historic patient information. There are several ways to make historical charts readily available for providers without integrating the data into the new platform. For problematic data, this is a compelling alternative. Balancing what providers want and need with what is possible, is critical to achieving success at a technical and user level.

How Much is Too Much?

The benefits of archiving data are huge and often pushed aside in the initial stages of planning. Consider planning ahead for release of records and legal data storage requirements. Avoid filling your new Epic system with poor quality data or data with minimal access requirements. The financial and operational benefits of planning your data archival strategy up front are significant.

How Much is Too Little?

It is also possible to err on bringing in too little data during a conversion. Patient safety can be threatened from limiting access to legacy records. When deciding how many years of patient data to bring into Epic consider that if a patient does not exist within Epic you will not be able to use single sign-on from within EPIC to the Archive for that patient. The user would have to manually login to the Archive and search for the patient which can dramatically reduce the value of the Archive, and in user adoption.