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hi thank you for joining us today today we're going to talk a little bit about data conversions and Xbox on a very high level this is a very in-depth complex process and each unique situation should be treated as such for those of you who are able to join us a couple weeks back around a young did take us through the process of analyzing and the decision-making process that should be taken into account when looking at possibly going to another application or possibly pulling up application for the first time we're going to take it a step further and take a look at the process to extract and put the data into a new version or joining practices going to the first part of this process of determining what goals and what the providers requirements are going to be some of the main key areas to take a look at is you want to make sure of course is the information within the old application is brought over to the new one and that specific data points are addressed this may or may not be the entire application one of the biggest misconceptions when going from through a conversion process is that you're going to just take all of the information from an application and dump it into a new one and there's some issues with that process that we're going to talk a little bit about so that may not be the best approach to actually take we want to make sure that through this process and while going live on the new application they were able to maintain providers productivity and of course probably the most important is maintaining patient safety during this time I want to keep in mind one of the reasons that we're going to be transitioning and making sure that we're actually driving utilization and option of the new HR system the very first part of the process of course is defining scope clearly outlining what will be converted and how we encourage you to engage both clinical people in this process as well as business office leadership and determine the scope as they will have very different motivations then the you need to take a look at each data element that will be converted and how it can be converted what the information sits in the one application and how it will then convert over to the new application and display and I have a dramatic effect on the bit of extract as well as if the information even has a place to go within the new application determine how far back you will pull data you may have been on the old application for a very long period of time and so it may not be practical or even pragmatics could pull data back from the beginning of time we also see practices change and evolve quite a bit over the years so as it becomes more sophisticated with the application the old data in the system may not be something they want brought over into the new one I also determine what patients will be converted you might want to discuss things like deceased patients or patients that have no longer been in the practice for multiple years whether it is worth the effort and time required in point all those patients over and then once these data elements and these patient's items have been determined you want to make sure that you have consensus within the organisation and understanding of the scope and that everybody is engaged in this process so the first part of process understanding the data source and destination of information this is a very complex subject and will vary depending on the legacy EHR and the new EHR depending on how the information is stored it may be displayed as in different formats within different applications and pulling it over from one EHR to another do not mean a direct one-to-one mapping so a provider might have seen lab results in one format in one application pulling it over to another one where possibly it's more condensed they may not see the same type of information or in the same format this may lead to modifications in workflow or changes of how the information has been brought over as a result it should also be taken into account whether there's information source for where the information is going to go within that new application unfortunately there is no single source of requirements for information within FDA hrs so you can have information you were able to put in one application and no longer a source to put it within the new one these decisions should not only be included on a clinical level including providers understanding where the information is going to and what is available but also technical resources and analyzing what format the information is displayed in it is also important to take a look at what the process will be to extract and convert the data be it flat-file hl7 C CDs each one of these have different impacts on the end users and may require manual entry process of the results a period of time should be taken to actually validate the quality of data and the legacy system as I mentioned before I longer you're on an EHR the more sophisticated providers do to come depending on the type of conversion that you are performing it makes a dramatic difference if you are going from one system into a brand-new completely clean system possibly merging multiple processes together and then initial time should be taken to see what repercussions of these will have if you're going from a multiple practices into one will there be patient overlaps and if so what will be the primary source of information for any discrepancies the shelfs will be discussed whether time will be spent to validate the information to make sure that is coming out the information coming over to the new system is clean and accurate they should be very candid conversations and should always include key stakeholders consideration of stuff like patient safety risks should be taken into account for this process because the new system will hold all data and we consider the true existing data source and after a period of time providers may not have the old system to go back to and reference where the information came from then of course we get to the actual data mapping so forget where the information is coming from and where it's going to you should keep a detailed requirements list for this this could be extremely important of course in the validation process but during the go-live process where providers are getting used to the new system it is often that expressed that information is missing and the receipts have requirements list of what the information is being converted to this can greatly help to determine if the information is actually missing or the provider is just not looking in the right place first let me get to the testing and validation period once the information has been mapped you should import into a non production environment first we all know of course that it will need to get into the production environment and an initial reviewing of information is absolutely critical during this phase we do encourage writers to select a key set of patients through this process ones that they're familiar with their charts and include more than one provider or subject matter expert in this process the reason for this an advantage to it is once the data has been imported into this non production environment the providers are going to quickly notice what information that they are not seeing and that will greatly help with the validation process in addition to these providers our subject matter expert teams validations should also be performed by the IT converted version team as well making sure that the information comes over with no fail let's give tested that and it's been successful both from the technical aspect as well as the provider sign-off a planned production conversion can take place key consideration should be put into the plan for the timing of the production conversion how far back you will go will have a dramatic impact how long it will take to convert the data and therefore we do encourage people to consider a what we call a catch-up conversions or incremental conversions the reasons for this is depending how long you are on the old system it may take multiple hours to possibly days to pull in all the informations so a conversion over a weekend may not be possible having a clear plan of how far back in which patients will be included and possibly incremental those can very much help with making a strategic approached patching up the new system with all the patient information you plan to bring over this can be done various ways we've often seen it based off of scheduled patients seen within the past six months or possibly patients seen within the past year and then these catch-up conversions can be performed on incremental timelines until all the data that you want to bring over to the new system has been pulled in you want to do a final test of the files and any clamps that you found as issues from the initial testing load prior to the production conversion and then once the conversion has taken place there should be a plan in place to archive or remove any patients from the old system once the conversion is complete that is a very high-level conversion process as I mentioned at the very beginning each conversion is unique depending on what applications if you are starting from and of course where you're going if there are going to be a multiple practices merged together if there's any duplication of information across the EHRs so there's an absolutely vital when adapting a new system and converting over information you follow very strategic steps in the data validation process prior to conversion the longer you have been on the old system the more chances for needing data cleanup to occur will be present and it's important to do very thorough data evaluations before the integration happens and it's extremely important to include the practices and providers being involved in this process they are the kind of the frontline people and therefore are going to be dramatically affected by this process so we used to help ensure success with the conversion is including them and it's not only the decision making process but having a clear communication of what information will be converted how it will be converted and where it will be converted to greatly affect the success of a goal I've thank you all for joining me here today I appreciate you allowing me to kind of walk through a very high-level data conversion and the steps that you should take in considerations you should take into account when going from a legacy system into a new application if you have any questions specific to your unique situation please feel free to email us or give us a call we'd be happy to walk through and get you started on a clean path or your HR conversion