One of the harsh realities of EMRs built on proprietary databases is that it's often tough and expensive to migrate from one system to another.
EMRs are supposed to keep an audit log of when, by whom and what data fields have been modified, but sometimes audit files don't survive the transfer, reports Technology for Doctors, a publication of Canadian Healthcare Technology. "The EMR systems in place today all track this audit information, but older legacy systems may not have had this feature. And even if they do, the audit files may be overlooked when patient records are moved to the new EMR," says Sid Soil, president of document storage vendor DOCUdavit Solutions. "These files are lost forever when the old computers are wiped clean like you're supposed to do to dispose them."
Audit files generally don't contain patient data, so they're unnecessary for patient care, but they are very necessary should a question about privacy or unauthorized access arise. "If there's a problem, then you need to be able to refer to the old audit record," Soil tells the publication. DOCUdavit, based in Toronto, helps healthcare providers through the transition by converting old audit logs to searchable PDF files.
This is an important issue in Canada, particularly in Alberta, where the provincial government is offering funding to physicians who switch to one of three "provincially qualified" EMR vendors. But it also could apply in the U.S. because federal health IT subsidies only apply to those providers able to demonstrate "meaningful use" of certified EMR technology. In both countries, a legacy system might not qualify.
"We're not seeing this in Alberta, but there's sometimes a significant cost to converting their data. In many cases, doctors are surprised they're being charged for this service in leaving one vendor for another," Soil says. "So doctors who don't like their EMR vendors should find out how much it will cost to get their information out of their current EMRs before they make decisions."
To learn more:
- take a look at this Technology for Doctors story