Do you find yourself in a position of switching EHRs and having to migrate some of your legacy data to a new target system? If so, you’re probably trying to decide which types of information (results, notes, PAMI data, scans, etc.) are most important to migrate for continuity of care. You might have a situation where critical information is stored as a scanned document in your legacy application and needs to be migrated to the new system. Now, you just need to figure out which types of scans should be migrated and how to actually migrate the scans from one system to another. Easy-peasy, right? While there are many different types of data migrations from one EHR to another, a scanned document migration can be the most challenging. Through multiple articles, I’ll discuss the ins and outs of a preparing for a scan migration, the typical process, and other considerations throughout the project.
The first step, which can also be the hardest, in any data migration is deciding on scope. This process usually involves soliciting feedback from your end users, physicians, and specifically with scans, getting your HIM team involved. It can be difficult to involve many people in the decision process but having more input up front will help reduce scope changes later in the project that could result in time extensions or extra costs.
One important concept to understand before getting into detailed scoping discussions, is to understand the difference between your scanned documents (scanned images) and your textual notes (transcriptions, office/progress notes, etc.). If discussing migrating “documents” with your scoping committee or a vendor your contracting with, make sure you clarify what “documents” refers to as sometimes it can be both scans and notes, or just one or the other. Scanned documents are typically migrated differently than you would convert a textual note. Often scans will be imported into a DMS (document management system) and have hyperlinks in your EHR that open the image. Or, depending on the EHR and setup, they can be directly imported into the EHR, but the migration formatting is still different than what it would be for textual notes.
Another consideration is that depending on the format of your textual notes in the legacy EHR, you may need to convert them to PDFs and import them into the new system as a scanned document. Sometimes this is necessary based on how textual notes are formatted or stored in the legacy system or because they have embedded images in them. This is something that would need some analysis ahead of time and you would want to discuss with the vendor helping you with your migration.
Once you’ve defined what will be migrated as a scanned document, there are multiple ways you can limit the scope. Extracting a list of scanned document types from the legacy system would be a great place to start. You may decide that you are only going to migrate specific scan types based on how clinically important they are.
- What types of documents do your physicians and end users need quick access to?
- What documents are important enough to have in the EHR chart for your patients?
We often see people concentrate on documents such as advance directives, consults, discharge summaries, ER documentation, etc. I recommend reviewing the list of scan document types with your lead end users and HIM to determine which documents are essential. As you are reviewing the scan document types, it’s also good to consider the time-frame in which you need these documents. You may decide you only need consults done in the last two years, but you want all advanced directives. You may also decide to migrate images of driver’s licenses and insurance cards, but only need them from the last year since you re-scan them every year.
While it’s tempting to include as much as possible or just say migrate it all, it is important to put some restrictions around your scanned document migration. Scanned images can take up a lot of space which often you need to pay for in addition to the migration and they can also take a long time to extract and import into the new application. Depending on your timeline and budget you may need to restrict your scan migration to a small amount.
The main takeaway here is that it’s never too early to start planning and scoping out your scan migration. A scan migration can be much more complex than you originally expected. In the next few articles, I’ll be reviewing some of these complexities such as:
- How to analyze your legacy EHR and prepare the extraction
- Whether you should use your DMS for the migration
- How to prepare and setup your target system
- What your validation process should entail
These are just some of the many considerations that go along with a scanned document migration.
Please contact us to leverage our expertise and experience as you shape your strategy for data migration.