Transitioning from a legacy EHR to a commercial, vendor-supplied, EHR: one academic health system's experience

Describe the planning, decisions, and implementation results experienced during the large-scale transition from one EHR to another throughout a large academic health system, which occurred simultaneously throughout both in-patient and all ambulatory settings.

Review of internal decision-making documents, interviews with key participants, and data from conversion software.

Over 7,000 unique users caring for a population of more than 1.2 million patients in both inpatient and outpatient venues and distributed across two states were successfully transitioned to a new EHR simultaneously. Challenges in data conversion were encountered resulting in more work for end-users than desired or anticipated. Users continued to access older information (principally schedules) in the legacy EHR one year later.

Data conversion from one EHR to another can be unsuccessful due to differences in how EHR's structure data obtained from underlying feeder applications or databases. Abstraction of only the pertinent clinical content is difficult in the context of transitioning to a new EHR. Clinicians require facile access to legacy content that can be achieved by implanting CCOW compliant solutions.