Transitioning EHRs Due to Sunsetting or Aging Products

November 2018

The healthcare information system (HCIS) landscape has been evolving for decades, with mergers and acquisitions often interfacing disparate systems together to form a complete EHR. With one system “bolted on” to another, one area (e.g. clinical, financial, HIM, ambulatory) of development halts or “sunsets,” as well as any support for those pieces. It then becomes critical for organizations to plan for the new system, as well as the support and accessibility of the old one.

Is your current HCIS aging (and possibly the reason it’s sunsetting)? Is your current HCIS being replaced due to a healthcare partnership, merger or acquisition? Is your current HCIS actually sunsetting? If the answer is yes to any of these questions, then there are steps to take to ensure the organization is positioned well to move forward.

  1. Assess the Current Landscape

Assessment of the current system strengths and weaknesses is critical to understanding your organization’s functional needs. Surveying the organization’s leadership and end users provides the perfect opportunity to get them involved right from the start and collect some baseline IT facts.

Once the assessment is completed it is time to analyze the findings. The needs and priorities should be used to develop the IT strategy that aligns with the overall goals of the organization to ensure optimal success. 

  1. System Selection, Costs and Implementation Considerations

Now that you know the system functional needs and priorities, you can develop a short list of vendors to be included in the selection process.  Vendor selection is a crucial stage in the HCIS process to ensure there are no gaps. Here are some considerations:

  • The HCIS vendor landscape is shrinking. There are some vendors that market to the critical access and small community hospitals vs. the larger vendors that are traditionally implemented in the larger medical centers.  Make sure you are including the right vendors that fit your situation in your selection process.
  • Costs vary widely in the HCIS vendor landscape.  Know your budget before engaging the vendors.  A request for information (RFI) may make sense so you understand the costs before you begin the selection.  Be careful not to look for a Porsche on a Volkswagen budget.  Selecting a system that you later learn you can’t afford will only frustrate the team.
  • Understand the implementation timelines and resource requirements for implementation and steady state staffing. Include resource costs, project management and consultant costs into your Total Cost of Ownership (TCO).
    • Determine whether there is “out of the box” standard content you can use to save time, or third party vendors that can supplement your HCIS with content and functionality.
  • Is your organization merging with another and utilizing their HCIS? If so, make sure you’re aware of what the other organizations have.  Can you move to their instance of HCIS and avoid a selection altogether?
  • What are the hardware options?  Does remote hosting or local hosting make the most sense for your organization?
  1. Interfaces

Don’t forget interfaces- these are often overlooked during the selection process.  Even the fully integrated HCISs on the market will still require interfacing to third-party applications.  In many instances, you may be interfacing in excess of 100 other systems to your HCIS.  The cost of the implementation can grow very quickly, costing upwards of $1,500 each, depending upon the vendor.

Ensure your interfaces are planned for, purchased, and tested thoroughly!

  1. Legacy Support

Ensuring that the current system is maintained during the new implementation process is another area that is frequently overlooked. Often the staff that are supporting the legacy systems are the same people involved in the implementation of the new systems. They can be stretched so thin that it’s difficult to do either job well. Consider bringing in backfill resources to support the legacy system. Interim resources are often capable of supporting multiple applications which can be cost efficient. This allows the current employees to get the education necessary to implement and eventually support the new system.

  1. Legacy Data, Decommissioning and Data Archive

What is your plan for the accessing the legacy data during the transition to the new system? Having access to the old systems is going to be critical to a successful transition.  The clinicians may need to access previous clinical data to safely care for the patients. 

What is the plan for the decommissioning of the legacy HCIS? In the case of the vendor sunsetting the product, this could dictate the organization’s timeline. It’s not the most ideal situation to be “forced” to make decisions you aren’t ready or prepared for.  

What are you planning on doing with the data?  Will you be purchasing a data archive solution to house your legacy data?  Typically the decommissioning and implementation of a data archive solution comes several months to years after your new system is LIVE and stabilized.  Archival systems are not cheap and need to be planned for and included in the TCO.  This is a large project in itself and needs to be carefully planned and executed.

I hope this post has helped ease the transition to a new HCIS. Feel free to reach out to us at should you require further expertise on transitioning your EHR.

About The Author: John Vergato has more than 10 years of implementation, optimization, and sales experience with healthcare information systems, specializing in numerous proprietary software vendors. He has a distinct understanding of the healthcare IT environment, assisting in the support and implementation of all sizes of organizations, from critical access hospitals through Independent Delivery Networks with as many as 14 facilities.  He has his CPhT Certification and has shared his knowledge through presenting at user conferences across the country.

Photo credit: Dawid Zawiła, Unsplash