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Right through the COVID-19 pandemic, Oak Orchard Well being, based totally in Brockport, New York, was once rising. In July 2020, it got a non-public observe that consisted of 3 places of work, that have been the use of a unique EHR (Medent) then Oak Orchard’s eClinicalWorks platform.

To allow the short transition after the purchase, Oak Orchard stored the observe on Medent and carried out procedures and workflows with the intention to paintings across the variations. The objective was once to supply a constant affected person enjoy around the group.


“In no time we found out we needed to put in force many procedures and workflows simply with the intention to entire a affected person seek advice from,” stated Jason Kuder, CIO at Oak Orchard Well being. “The first actual one was once whilst group of workers used Medent for the on a regular basis seek advice from. Every affected person that was once noticed from that time on at each come upon would manually be created in eCW so lets get claims out the door.

“So, an energetic affected person would necessarily have two accounts: one in Medent for the affected person chart and one in eCW for billing,” he endured. “The longer we stayed with two EHRs, the extra we discovered regardless of what number of procedures or workflows we installed position, those 3 places of work can be remoted. We have been now not in a position to flex our assets throughout our group.”

To be talented in each Medent and eCW was once an inconceivable activity for suppliers busy seeing sufferers – and a make stronger nightmare, he added. Through the years the group become siloed. Hiring become harder since suppliers have been regularly now not skilled in both EHR.

“We additionally bumped into issues of on a regular basis reporting, however extra importantly, it made it much more tough to file out for UDS,” Kuder defined. “FQHC well being facilities are required to publish each February, and this was once a big hindrance for us.

“Retrieving information out of 2 EHRs and mixing the knowledge units with the intention to file for UDS has been a big fight each and every yr since acquisition,” he endured. “Sufferers might be in each programs, or in only one. How they’re documented may be very other, leading to lengthy information validation classes – an enormous operational elevate for our group.”


Financially, Oak Orchard Well being may just now not throw to any extent further our bodies at this downside. Worse than that, group of workers morale was once at an rock bottom. With a big turnover in senior management, the brand new CEO made it the No. 1 precedence to get the brand new observe’s 3 websites onto eCW with the remainder of the group.

“We felt if lets get everyone onto the similar EHR we might all be speaking the similar language,” Kuder stated. “We might have an more uncomplicated time enforcing new applied sciences, companywide procedures and workflows.

“Having a couple of clinical document platforms impacts everyone within the group – from how we path the inbound calls to how we record in a affected person’s chart,” he added. “Having everyone running from the similar EHR would permit us with the intention to supply a extra constant affected person enjoy.”


When well being IT execs discuss migrating to a brand new EHR, maximum focal point at the information that must be migrated from one location to the opposite, Kuder famous.

“It’s way more complicated than that,” he said. “The toughest section individually is attempting to coach group of workers at the new EHR. It wasn’t as simple as the place to record a affected person’s top and weight, for instance. All the affected person appointment workflow must trade.

“The analogy I’ve used for this venture is attempting to switch out an aircraft’s engine whilst it’s in flight,” he endured. “The sufferers don’t prevent desiring to be noticed simply because you’re going to trade EHRs. We needed to paintings on a plan to coach all group of workers, configure new amenities in eCW, and migrate the knowledge from Medent to eCW, all whilst now not interrupting sufferers’ schedules.”

From the knowledge aspect, group of workers needed to paintings with Medent to supply Oak Orchard with the entire affected person information that was once within the EHR. Personnel then had to supply it to eCW so they might supply Oak Orchard with a map of the way the knowledge can be ingested.

“For the reason that EHRs used other terminology, this was once a painstaking and tedious activity, going line through line for each and every characteristic from Medent to what it is named in eCW,” Kuder recalled. “As soon as this portion was once finished, we then would carry out a take a look at migration in a take a look at atmosphere. We then would undergo masses of affected person charts, ensuring the knowledge that may be migrated was once put into the proper places in eCW.

“Whilst that workforce was once running at the information aspect, there was once some other workforce running at the coaching aspect,” he endured. “We first began through enrolling the entire group of workers of the ones 3 places of work into eCW College on-line categories in line with their position. This allowed them with the intention to get one of the vital preliminary coaching after they had to be had time.”

Oak Orchard enlisted a few of its eCW tremendous customers to trip to the brand new observe’s websites to supply hands-on coaching. And it despatched group of workers from the Medent websites to Oak Orchard websites to peer how eCW works reside.

“After we validated the knowledge appeared excellent and that coaching was once executed, we deliberate for a weekend the place we might take the knowledge from Medent and migrate it into our manufacturing atmosphere of eCW,” Kuder defined. “Personnel necessarily used Medent for the final time on a Friday and started the use of eCW on a Monday. All of this took place with out places of work final.”


One of the crucial primary successes has been group of workers pride. For 3 years, Oak Orchard have been duplicating paintings. The entrance table group of workers in the ones places of work now don’t have to go into information into two EHRs. The finance division doesn’t need to take data out of 1 EHR and enter it into some other to get claims out the door.

“On best of that we have got been in a position to cut back our operational prices related to this duplication of labor,” Kuder reported. “We now have been in a position to lend a hand cut back group of workers burnout as a result of we’ve received the versatility with our staffing in that we will be able to deploy them any place we’d like them to be with no need to fret about which EHR is getting used.

“The transition to eCW has allowed us to grow to be unified as a machine and percentage data in a extra environment friendly model, which in the end saves time and offers sufferers with higher care,” he endured. “We now are speaking the similar language and dealing the similar procedures and workflows throughout all of our places of work. This by myself has allowed us to release new products and services like self-check-in.”

Oak Orchard is also now within the means of enforcing kiosks in any respect of its websites. None of these items would had been imaginable if it have been nonetheless on two EHRs, Kuder added.


“In case you are ever in an acquisition scenario and you might be bringing on amenities on a unique EHR, I’d advise migrating the ones new places of work on your present EHR as a part of the purchase,” Kuder stated. “The longer you attempt to deal with two EHRs, the tougher it is going to be to transition. On best of that, sufferers’ studies can be impacted two times as a substitute of simply that one time.

“Plan extra time than you assume you wish to have for a venture like this,” he endured. “For the reason that EHR is the No. 1 utility for a supplier group, ensuring you will have executed your whole due diligence will permit for a smoother migration.”

When validating information, get as many eyes on it as imaginable, he added.

“There are masses of various attributes for a unmarried affected person, and the extra folks you’ll validate to verify the knowledge migrated appropriately, the extra entire the charts can be,” he concluded.

Observe Invoice’s HIT protection on LinkedIn: Invoice Siwicki
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