How to Successfully Navigate the EHR Landscape
EHR migrations are among the most demanding initiatives healthcare organizations face. They extend well beyond technology, reshaping workflows, operational processes, and the daily routines of clinicians and staff. While every migration is different, the organizations that navigate them successfully share the same foundations: strong planning, experienced guidance, and a clear understanding of the complexity involved. At Keena, we’re here to help simplify that complexity.
Part 1
Setting Goals & Outlining Strategies
As healthcare delivery continues to evolve, many organizations are taking a step back to evaluate system gaps and define what they truly need from a new EHR platform. Input from end users plays an important role in this process, helping shape the clinical, financial, operational, and technical criteria that guide evaluation and selection.
Throughout the journey, it’s equally important to revisit organizational goals and ensure the long-term plan supports an efficient, competitive network. For many provider organizations pursuing EHR change, common challenges emerge along the way—often creating operational strain and avoidable costs if they aren’t addressed early.
How Far Along Are You in the Migration Process?
We’ve found that provider organizations needing migration support generally fall into one of three categories, each with its own challenges and complicated processes to manage.
01
Pre-Implementation: Selecting Vendors & Planning Resources
02
Implementation: Migrating Data & Initiating Go-Live
03
Post-Implementation: Evaluating Performance & Optimizing Systems
Do You Have a Plan for Addressing Resource Challenges?
Resource constraints are a common challenge throughout the EHR migration journey, regardless of where an organization is in the process.
Even in the best circumstances, recruiting and retaining skilled health IT professionals can be difficult. Add the demands of an EHR migration, and organizations often find themselves needing access to experienced resources and effective training programs to keep critical IT initiatives moving forward—on time and on budget.
At the same time, internal teams are frequently pulled into planning and implementation work, leaving day-to-day EHR operations stretched thin. Many organizations address this by bringing in experienced healthcare consultants who understand the pressures of large-scale system transitions and can help support teams through the process.
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Early Planning Is a Powerful Tool for Success
Early planning around key data elements—such as PAMI (problems, allergies, medications, immunizations) and ROI rules for reconciling outside information—can save significant time during migration. This is the time when organizations should address decisions about what data will be used and how it will be structured upfront.
Note that only a subset of data can be brought into Epic through CCDA files, while other information—such as histories, vitals, and results—may require HL7 interfaces or flat files that meet Epic specifications. Be sure to anticipate data clean-up. data clean-up and have the flexibility to accommodate errors.
Simplify Your EHR Migration with Guidance from Keena
Migrating to a new EHR system can be complex. Download our EHR Migration Guide for guidance on how to navigate the transition smoothly and streamline the process from planning to go-live optimization.
Get Expert Help
Schedule a 45-minute discovery call to kick-start you EHR migration or contact us for personalized assistance.
Part 2
Selecting Vendors & Planning Resources
As you begin the process of selecting a new EHR, you’ll need to make several critical decisions about your budget and operations.
How Do You Find the Right Platform to Suit Your Needs?
As healthcare delivery continues to evolve, many organizations start the migration process by stepping back to assess where their current systems are falling short and what they truly need from a new platform. Input from end users plays an important role in shaping the clinical, financial, operational, and technical criteria used to guide evaluation and selection.
Throughout the selection and planning process, organizations often revisit their goals to ensure the long-term strategy supports an efficient and competitive healthcare delivery network.
In working with provider organizations considering EHR platform change, common challenges tend to emerge—often creating operational strain and avoidable costs if they are not addressed early.
Talent Gaps Are Slowing EHR Initiatives
With ongoing staff shortages and some organizations lacking the specialized skills required to manage projects of this scale, many EHR initiatives are delayed. Project teams are often forced to move forward with limited resources, which can lead to difficult tradeoffs, extended timelines, and rising costs. In other cases, an unexpected urgent IT project pulls staff away from evaluation efforts, creating interruptions and additional delays.
When experienced staff are drawn into EHR planning and selection work, day-to-day EHR operations can also begin to feel the strain, leaving support teams stretched thin.
Building the Right Team for Complex Migrations
Managing an EHR planning and selection effort in today’s tight labor market often requires timely access to experienced resources and proven project frameworks. Organizations that assemble the right mix of skills and expertise are often better positioned to move through the process efficiently and keep critical projects on track.
A well-prepared team can also help reduce the risk of costly missteps, allowing organizations to make informed decisions and maintain momentum throughout the migration effort.
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Parallel Track an Archival Project with Your EHR/PM Migration
Want to learn more about how the decision to run your conversion and archive project in parallel can save you time and money? Review OrthoCarolina’s case study “A Mission-Critical Data Migration and Archival Project.”
Successful Conversion and Data Migration
A dedicated integration team is critical for a smooth system migration. Partnering with an experienced third-party integrator—rather than managing it internally or relying only on your EHR vendor—helps prevent delays, control costs, and ensure accuracy. Involve your integration partner during vendor selection to define scope, timelines, and budget from the start.
Part 3
Migrating Data & Executing Go-Live
Data migrations are typically all-encompassing projects that can cause challenges in the even the most skilled IT departments. These challenges can trickle down to impact physicians, administrators, and other critical staff.
Are Data Issues Adding Pressure to Your Already Stretched Teams?
Several commons challenges tend to surface during this phase of an EHR initiative:
Helpdesk Services
Dealing with duplicate records, inconsistent patient information, and demographic data issues.
Legacy Systems
Determining whether to integrate, archive, or retire legacy platforms.
Data Elements Selection
Determining which data should remain structured versus discrete—such as CCDs, progress notes, and other clinical documentation—while avoiding over- or under-conversion.
Daily IT Operations
Keeping up with routine EHR/PM system management, ticket resolution, and ongoing system maintenance.
Project Staffing
Balancing internal teams, third-party resources, and cross-department stakeholders while managing competing priorities.
Implementing Migration Strategies
We’ve identified migration strategies and processes to help healthcare organizations navigate EHR/PM platform transitions while minimizing disruption, maintaining project timelines, and managing budget expectations.
The following eight steps can be a helpful guide when planning and executing your EHR migration initiative.
Step 1
Scope the Project
The first step is all about knowing what you need related to data (elements/quality), project staffing (leadership/multidisciplinary teams) and timeline (realistic project plan/optimal time of year).
Step 2
Select a Conversion Specialist
Almost every organization is going to need additional expert resources for this project. Look to third parties with experience, ETL workflow tools, references, and reasonable pricing.
Step 3
Build Migration Plan v1.0
As with most complex projects, the plan will be dynamic even as work begins. Be sure to address the following important plan elements:
- Identify data for conversion
- Plan and schedule approach
- Establish resources and responsibilities
- Define plan iterations
Step 4
Get Connected
Project managers are often surprised by how difficult it can be to enable third party specialists to gain/maintain access to legacy infrastructure. Plan ahead with required legal paperwork and provide internal staff support as needed.
Step 5
Sample, Test, Validate, Iterate – Repeat
Placing your patient data in the right location in your new system is a dynamic process that will take several iterations to perfect. It is very likely that the ultimate conversion profile will emerge out of this process. Be patient and work closely with your conversion specialist.
Step 6
Connect Extract with Import
Your conversion specialist will prepare an extract file for your EHR vendor to import.. Import requirements vary between EHR vendors, so communicating the detailed export specifications is very important.
Step 7
Don’t Forget About Workflow
In the end, getting a practical perspective on how the conversion project impacts daily activities—from scheduling and check-in to visits, ordering tests and more—is essential. This means you need to understand the work of the staff that fulfills these functions – not just the physicians.
Step 8
Go Live!
Going live is the culmination of the implementation team’s plans and collective effort. On one level it’s like another testing iteration conducted in a production environment and a final chance to refine workflow anomalies missed during testing. Be sure your implementation team is on-hand to help during this final step in the process.
Want more details? Check out our white paper, “8-Steps to a Successful Conversion Project” where our conversion team shares Keena’s proven process for successfully managing hundreds of conversion projects.
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Access All the Data You Need for an Epic Conversion
An EHR conversion is a complex and challenging project requiring a unique mix of technical deployment and carefully considered collaborative planning. To ensure a successful migration, a build-out of your data plan should be your first priority. From data elements selection and data quality to data grouping, mapping, and more, read the following white paper to discover important strategies for your successful Epic migration.
Part 4
Evaluating Performance & Optimizing Systems
There are several critical factors to manage after Go-Live, and without a clear plan following training and implementation, even well-executed projects can begin to lose momentum. Reaching an EHR Go-Live milestone is a major achievement—and it’s natural to feel a sense of progress—but the work doesn’t end there. Continued attention, coordination, and oversight remain essential to keep systems running smoothly and to support long-term success.
Are You Prepared for Go-Live—And What Comes After?
When organizations move to a new EHR, much of the focus naturally centers on the Go-Live milestone. It represents the culmination of months—sometimes years—of planning and execution. But without careful attention to several key elements of post-Go-Live preparation, even well-planned implementations can encounter avoidable challenges, from operational disruptions to declines in morale and productivity.
Navigate These Critical Steps
Many of the organizations we’ve worked with have experienced the following challenges post-implementation. By planning ahead, you can avoid some of these common efficiency issues.
Post-Implementation Training and Support Gaps
Several common challenges tend to surface during this stage of an EHR transition. With thoughtful planning and the right preparation, many organization are able to anticipate these issues an reduce their impact.
Make sure you have an effective internal training team and structure in place, along with a sufficient external support team (your new EHR partner) at the ready to offer help.
Key Question
Do you have sufficient internal and external training and support teams in place to provide the resources required for the expected increase in initial needs?
Important Factors to Consider
- Timely resolution of open support tickets
- Completing user access and system provisioning processes
- Maintaining consistent communication as workflows are refined during the early learning period
Network Infrastructure Strains
As more practices and/or departments come on board and begin using the new system, your IT network may begin to strain with more frequent down time incidents and slowing system response times.
In fact, 23 percent of healthcare leaders worldwide have identified IT infrastructure as a leading roadblock to using data effectively.
Key Question
Have you done a thorough IT infrastructure evaluation and test before rolling out your new system?
Important Factors to Consider
- Work closely with EHR/PM vendor to understand the infrastructure requirements needed for optimal system performance.
- Conduct internal audit to ensure you have the technology required for a successful transition.
System Optimization Shortfalls
Once you’ve completed your initial training, department staff will likely start to notice reports and processes aren’t running as smoothly as with the previous system. There may be disruptions and/or errors in essential third party applications. These disruptions could be related to application incompatibility or interface/integration shortfalls.
Some third party applications and standard plugins may not be functioning effectively, and standard and custom departmental reports may not be capturing data required to make important clinical and business decisions. In addition, specialty workflows will likely need to be adjusted to leverage your new system.
Key Question
Have you taken third party application inventory and contacted your vendors well ahead of Go-Live to plan for potential failures? Have you done an interface audit and planned resources for supplemental post Go-Live testing, validation, and refinement?
Important Factors to Consider
- Establish a skilled and trained workflow team with a clear process for identifying and implementing new workflows.
- Maintain early and consistent communication with critical third-party vendors to ensure interface adjustments are completed ahead of migration.
- Ensure integration engine resources are available to address issues quickly and minimize workflow disruptions.
New Practice Integration Slowdowns
If your organization intends to maintain or increase some level of growth after your new system is live, you’ll need to plan for integration training and implement new processes to continue the efficient transition of new practices into your network.
At this point, new practice extraction/conversion integration processes will have changed and may not be running as smoothly as with the legacy system. This could impede system-wide growth initiatives.
Key Question
Have you worked with your new platform vendor to determine appropriate skills required or third party resources available to assist in new practice integrations going forward?
Important Factors to Consider
- Plan ahead to determine if you’ll need third party assistance.
- Audit your current team’s skillset and decide if they have time to work on the transition.
Consider Using a Third-Party for These Services
Simplify Your EHR Migration with Keena’s Guidance
Download our EHR Migration Guide for guidance on how to navigate the transition smoothly and streamline the process from planning to go-live optimization.
Get Expert Help
Schedule a 45-minute discovery call to kick-start you EHR migration your EHR migration or contact us for personalized assistance.
The Knowledge in this Guide was Derived From:
550
Data extraction and conversion projects
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40+
Health organizations that we’ve assisted with conversion to EPIC EHR
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75
Leading EHR and PM vendors converted to data
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300M
Combined healthcare chart converted
Best of KLAS
In recognition of our achievements Keena was ranked among the top-scoring vendors for Technical and Conversion Services in the 2024 Best in KLAS Awards: Software & Services Report.