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Transition to Electronic Health Records

Joyce A. Coleman

University of Cincinnati Clermont

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Abstract

With the ever changing medical field the conversion to the electronic health record is a must. This paper

will outline a plan for the conversion from paper health record to the electronic health record. While no

conversion will be perfect there are steps that can be taken to attempt to make the conversion as easy

and productive as possible.

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Transition to Electronic Health Records

There is no one size fits all plan for converting a healthcare facility from paper health

record to electronic health record. A few things can be done prior to the implementation of the

conversion and after the conversion to make sure the facility is staying on track with its goal.

Prior to the conversion or switch to the electronic health record healthcare facilities

should consider these few things:

Workflow level that is needed to be converted

The information needs for providing care
What historical information needs retained, how long to keep historical data

available, and how long to retain historical data. They type of patient and type of

care will help decide this information.

Options and best choice for converting this information into the electronic health

record
Role of printing during the conversion. Should it be allowed or not. How paper

records will be used during conversion.

Will the conversion be implemented by big bang or staged? Big bang is when

all the practice goes live all at once. Staged is when the conversion is

implemented in stages.

When deciding which of the conversions to go with, staged or big bang, a healthcare

facility will need to consider:

All staff needs training. How is this to be handled

Staff scheduling

Patient appointments scheduled during the conversion

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How to resolve issues that happen during the conversion

A timeline for implementation

Patient complexity

Amount of historical information to be converted prior to conversion and how to

make it happen

How to handle the records that still need converted

How to handle divisions that are still using paper records until they are converted.

The healthcare facility will need to compile a multidisciplinary team comprised of

representatives from each discipline. These people are picked to provide input about the

conversion and let it be known if needs are not being met. The IT department needs to be part of

this multidisciplinary team so they are able to access request and analyze the feasibility of

implementing a plan to correct any issues. Key issues such a patient safety needs to be monitored

to ensure that alerts or warnings are in place for any issues that could compromise the patients

treatment, such as allergic reactions to medications and such. No matter if it is still in paper form,

the conversion state, or total electronic health record the security of the information must be

maintained at all times.

Healthcare facilities need to understand that the whole conversion process will be labor

intensive and needs to pay attention to solid data validation and quality control of things such as

key patient demographic data, problem list, historical procedures, allergies, current medication,

sources and follow-up, medical devices/implant information, immunizations, pediatric patient

growth charts and legal documents. Records that have already been converted can be destroyed

since there is no standard guidelines for keeping converted records.

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Steps on how to implement electronic health records

1. Do an assessment of the facility to determine if the healthcare facility is ready to

convert to electronic health records

2. Planning Use the information gathered in the assessment phase to outline an

implementation plan.

3. Explore and select and electronic healthcare program to use.

4. Determine the training plan for the staff.

5. Achieve meaningful use for Medicare and Medicaid Electronic Health Care incentive

programs.

a. Meaningful use is grouped into 5 patient-driven domains

i. Improve quality, safety, and efficiency

ii. Engage patients and families

iii. Improve care coordination

iv. Improve public and population health

v. Ensure privacy and security of personal health information

6. Continue to evaluate the system to ensure needs are still being met and upgrade as

required.
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References

AHIMA. "Migrating from Paper to EHRs in Physician Practices." Journal of AHIMA 81, no.11

(NovemberDecember 2010): 60-64.

"How to", (n.a). (2014). How to Implement EHRs Retrieved from

https://www.healthit.gov/providers-professionals/ehr-implementation-steps/step-1-assess-

your-practice-readiness.