With Galen’s extensive experience in the EHR conversion space, one question we receive frequently from clients relates to the relative value of abstracting data versus the pursuit of a full-scale conversion engagement.  We typically find the solution slightly more nuanced than choosing one option over the other.  Oftentimes the best approach with data migrations combines both options in a manner considerate to the individual organization’s needs and timeline. In fact, some of Galen’s best work has come from helping clients devise the right combinations amid such challenging scenarios.  However, we also recognize that business needs dictate the formulation of some ‘soft rules’ that help us recommend comprehensive abstraction or conversion engagement in more clear-cut situations. Above all, it comes down to finding the sweet spot between efficiency and value for all involved stakeholders.

The 5/7500 Rule

Our objective and responsibility as consultants is to make the correct recommendation for each unique situation, and our work in conversions is certainly no exception. With this in mind, Galen most often recommends a conversion engagement for settings involving more than five providers or for a data set greater than 7500 patients. This governing principle is based on the intersection of efficiency and value we have achieved for clients amid some of our most successful projects.  For our partners, the choice between abstraction and conversion tends to first focus on the cost and time-intensive nature of abstraction before looking at alternatives. Put simply, is it worth it? Can we achieve our goals economically and on schedule? We have found that the cost of abstraction typically comes in around $10/chart, moreover $32/hour for the discerning oversight of an accredited clinician.  Knowing this, our partners face an important economic and strategic choice over which route to take, and turn to the Galen team for these pivotal business decisions.

Hybrid Approach: Planning is Key

Abstraction and conversion does not need to be an “either or” choice for our partners.  Prior to engagement, we often advise a hybrid approach that may involve abstraction of certain data elements while other aspects of clinical content may be reserved for the conversion effort. For this regimen, thorough attention to timing and strategy is essential for success. A set of important themes will dominate this discussion and help to shape a strategy.

1. State of the new production system – (Note: abstraction of charts typically takes more time than conversion of data. If the production environment is not available two months prior to go-live, it may be difficult to abstract the entirety of data in time.)
2. Staffing and training abstraction resources
3. Number of resources dedicated to abstraction
4. Choice of data elements for abstraction and conversion
5. Timing of abstraction relative to conversion go-live
6. Practice and “dry-runs”

Typically, our teams place heavy emphasis on aspects of preparation and timing ahead of conversion go-live.  It is important that conversion engagements are structured in a manner considerate to our partners’ business needs, especially in matters of staffing and effective time management.  This resource management dilemma becomes more prominent in settings where abstraction is being considered as both an adjunct or standalone solution. With this in mind, it is important to proactively and accurately forecast the use of time and money among resources that are qualified to shoulder the burden of abstraction.  These estimates will dictate whether or not conversion or abstraction is the correct solution for data migrations.

As with any large movement of data in healthcare IT, accuracy and integrity of the medical record is the essential pillar of a successful operation.  We hope this post helped to clarify a dilemma that many of our partners face in more ambiguous situations. In any case, we hope that you join forces with Galen’s best in KLAS team to ensure a seamless conversion or multifaceted approach for your organization.  For additional information, don’t hesitate to contact us!