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Implementing EHRs
Planning Your Approach

The Basics

The process of moving data from your existing paper records to your electronic health record (EHR) is called chart migration. Chart migration is a critical EHR implementation step, as it ensures that patient data will be available in the EHR when you go-live. Chart migration decreases the risk of lost productivity and helps avoid patient safety issues that can emerge when key patient data are not available.

Make a Plan

When preparing for EHR implementation, you should develop a plan for migration of patient data from the paper chart to the EHR. You should make sure to conduct chart migration before your go-live date. You should work with your vendor to populate electronic charts with clinical data from existing paper charts, so that providers do not have to start with a clean slate during their first electronic visit with the patient.

Key Factors to Consider

Consider the following questions when developing a plan for chart migration.

  • Assessment and Planning

    • What information from the paper chart is important to move to the EHR?
    • Where and how will the information be stored in the EHR
    • What is your go-live date? Will chart migration be initiated before the go-live date? Will your practice have a hybrid transitional plan where both paper and electronic charts will be used? What is the target timeframe for chart migration?
    • How many people will be supporting the process? How many workstations will be available?
  • Goal-Setting

    • What are your practice/hospital/health center goals? Do you want to become a paperless office? Or, do you plan to become an office with less paper?
    • Do you aim to interface with other organizations, such as labs, hospitals, or radiology specialists?
  • Scanning Specifics

    • What is your prioritization strategy (e.g. chronic patients, patients with upcoming appointments, alphabetical)? What data elements do you want to migrate?
    • Which parts of charts will be scanned? Scanned documents typically cannot be mined for data; they will appear as a picture in the EHR.
    • What is your indexing strategy and how will you maintain this strategy? You should define index terms and stick to your definitions when scanning documents.
    • Which parts of the charts will be manually back loaded? Back loaded data can be mined, but must be entered manually into the EHR.
  • Process

    • Who will oversee the scanning and manual back loading processes?
    • Who will scan the documents/enter the data into the EHR? Remember, these two tasks may require different skill levels.
    • What will be done with the paper charts once they have been migrated into the EHR? Will they be maintained on-site for a period of time in case a provider needs information that was not migrated?

Your Local Regional Extension Center Can Help

Your local Regional Extension Center (REC) can help you plan for and manage the chart migration process. RECs are located in every region of the country to help health care providers select, implement, and become adept and meaningful users of EHRs. Contact your local REC to find out if you are eligible for free or reduced-price local support.