CC BY 4.0 · ACI open 2020; 04(01): e48-e58
DOI: 10.1055/s-0040-1710007
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Data Migration: A Thorny Issue in Electronic Health Record Transitions—Case Studies and Review of the Literature

Richard Schreiber
1   Division of Informatics, Department of Medicine, Geisinger Commonwealth School of Medicine, Camp Hill, Pennsylvania, United States
,
Lawrence Garber
2   Division of Informatics, Reliant Medical Group, Worcester, Massachusetts, United States
› Institutsangaben
Funding None.
Weitere Informationen

Publikationsverlauf

02. Dezember 2019

12. März 2020

Publikationsdatum:
26. Mai 2020 (online)

Abstract

Objective To review the existing literature regarding data migration during electronic health record (EHR)-to-EHR transitions and add two case studies on this topic.

Methods Very few publications exist that detail the processes and potential pitfalls of data migration during EHR transitions. One of the authors participated in a panel discussion at the American Medical Informatics Association symposium in 2015; at the time, only five empiric or experiential research articles on any aspect of EHR transitions were available. Of those, only two mentioned their experiences with data migration or conversions. A detailed PubMed and CINAHL (Cumulative Index to Nursing and Allied Health Literature) search in March 2019 yielded only one more article giving details about data migration.

Results The two new case studies contrast starkly: one relied on manual abstraction and data entry, whereas the other leveraged several electronic tools. The literature reflects this diversity of approach: no two sites have reported the same approaches. The authors identify nine domains of potential consequences of the currently available techniques and offer mitigating strategies.

Discussion Very little empiric information exists in the peer-reviewed literature regarding data migrations during EHR-to-EHR transitions; yet the case studies reflect that much remains suitable for a prospective study.

Conclusion This report adds two new case studies to the six already reported in the literature. There is a wide disparity in techniques of data migration, each with its own set of pros and cons, which sites must consider during an EHR-to-EHR transition. Such transitions would benefit from prospective research on evaluation and knowledge discovery.

Protection of Human and Animal Subjects

This study does not contain any patient information and was not research, and thus it did not require Institutional Review Board review.


 
  • References

  • 1 Gettinger A, Csatari A. Transitioning from a legacy EHR to a commercial, vendor-supplied, EHR: one academic health system's experience. Appl Clin Inform 2012; 3 (04) 367-376
  • 2 Abramson EL, Patel V, Malhotra S. , et al. Physician experiences transitioning between an older versus newer electronic health record for electronic prescribing. Int J Med Inform 2012; 81 (08) 539-548
  • 3 Zandieh SO, Abramson EL, Pfoh ER, Yoon-Flannery K, Edwards A, Kaushal R. Transitioning between ambulatory EHRs: a study of practitioners' perspectives. J Am Med Inform Assoc 2012; 19 (03) 401-406
  • 4 Bornstein S. An integrated EHR at Northern California Kaiser Permanente: pitfalls, challenges, and benefits experienced in transitioning. Appl Clin Inform 2012; 3 (03) 318-325
  • 5 Pfoh ER, Abramson E, Zandieh S, Edwards A, Kaushal R. Satisfaction after the transition between electronic health record systems at six ambulatory practices. J Eval Clin Pract 2012; 18 (06) 1133-1139
  • 6 MJH Life Sciences. 2015 Technology Survey Results. Available at: https://www.physicianspractice.com/technology-survey/2015-technology-survey-results . Accessed January 14, 2020
  • 7 Walsh B. Survey finds Allscripts top-ranked EHR, satisfaction increasing. Black Book Rankings 2015 Survey Results. 19 August 2015
  • 8 Saleem JJ, Herout J. Transitioning from one electronic health record (EHR) to another: a narrative literature review. Proc HFES 2018; 62 (01) 489-493
  • 9 Behlen FM, Sayre RE, Weldy JB, Michael JS. “Permanent” records: experience with data migration in radiology information system and picture archiving and communication system replacement. J Digit Imaging 2000; 13 (02) (Suppl. 01) 171-174
  • 10 Makar M. Dealing with Existing Data in Legacy Systems when Transitioning between Electronic Health Records in Three Swedish Counties [Master's thesis]. Stockholm, Sweden: Karolinska Institutet, Stockholm University; 2014
  • 11 Pageler NM, Grazier G'Sell MJ, Chandler W, Mailes E, Yang C, Longhurst CA. A rational approach to legacy data validation when transitioning between electronic health record systems. J Am Med Inform Assoc 2016; 23 (05) 991-994
  • 12 Camacho Rodriguez JC, Stäubert S, Löbe M. Automated import of clinical data from HL7 messages into OpenClinica and tranSMART using Mirth Connect. Stud Health Technol Inform 2016; 228: 317-321
  • 13 Bortis G. Experience with Mirth: an open source health care integration engine. Presented at the 30th International Conference on Software Engineering, Leipzig, Germany, May 10–18, 2008
  • 14 Yang YL, Zhang YH. Application of Mirth Connect interface integration engine in medical data transmission. Industrial Control Computer. 2016; 29: 112-113
  • 15 Lin J, Ranslam K, Shi F. , et al. Data migration from operating EMRs to OpenEMR with Mirth Connect. Stud Health Tech Inform 2019; 257: 288-292
  • 16 Howard P. Data Migration Customer Survey. Available at: https://www.bloorresearch.com/research/data-migration-customer-survey/ . Accessed January 14, 2020
  • 17 Noreen N. Data migration lessons learned: one facility relates hard-learned best practices after migrating to a new EHR. J AHIMA 2013; 84 (09) 40-42
  • 18 West S. Need versus cost: understanding EHR data migration options. J Med Pract Manage 2013; 29 (03) 181-183
  • 19 van Ooijen PM, Aryanto KY, Broekema A, Horii S. DICOM data migration for PACS transition: procedure and pitfalls. Int J CARS 2015; 10 (07) 1055-1064
  • 20 Agarwal TK. , Sanjeev Vendor neutral archive in PACS. Indian J Radiol Imaging 2012; 22 (04) 242-245
  • 21 Berkowitz SJ, Wei JL, Halabi S. Migrating to the modern PACS: challenges and opportunities. Radiographics 2018; 38 (06) 1761-1772
  • 22 Epstein RH, Dexter F, Schwenk ES. Provider access to legacy electronic anesthesia records following implementation of an electronic health record system. J Med Syst 2019; 43 (05) 105
  • 23 HIMSS Analytics. Electronic Medical Record Adoption Model. Available at: https://www.himssanalytics.org/emram . Accessed January 14, 2020
  • 24 Barnett ML, Mehrotra A, Jena AB. Adverse inpatient outcomes during the transition to a new electronic health record system: observational study. BMJ 2016; 354: i3835
  • 25 Garber L, Nicholas E. Davies Award of Excellence – Ambulatory Care Application – 2011. Available at: www.himss.org/reliant-medical-group-formerly-fallon-clinic-davies-ambulatory-award . Accessed June 13, 2019
  • 26 Graham J, Levick D, Schreiber R. AMDIS case conference: intrusive medication safety alerts. Appl Clin Inform 2010; 1 (01) 68-78
  • 27 Michel J, Hsiao A, Fenick A. Using a scripted data entry process to transfer legacy immunization data while transitioning between electronic medical record systems. Appl Clin Inform 2014; 5 (01) 284-298