Data Conversions: What About the Documents?

You may know this already but document management systems (DMS) can be a great add-on to your electronic health record (EHR). While a paperless environment is still the dream, paper still seems to show up at our hospital and clinic doorsteps. A variety of paper documentation related to patient care is still generated today. This happens both inside and outside of the patient health system and needs to be captured and organized electronically to ensure a longitudinal plan of care for the patient.

What about the electronic documents stored in multiple applications within your health system walls? Even with a single integrated record, this challenge is still relevant. One path forward is consolidating into a single document management system essentially the same strategy as a single integrated EHR.

But how to go about this?

With a current client, we are converting documents from six clinical systems to a new DMS. We are following steps similar to that of a discrete data conversion or legacy data archive project, with some minor tweaks:

Prepare – Solidify the scope, secured resources, engage the vendors (from both the legacy and new system), determine the volume of documents in each system and sign contracts/scopes of work.

Extract – Request full extracts to be pulled from all systems. The extracts should include all documents in the system and, in addition, a metadata file. The metadata file will contain discrete data, also known as keywords, attached to the document in the legacy system. Examples of metadata fields include patient name, date of birth, MRN, encounter number, encounter date, document Type, etc. The “document type” is the naming convention that details what is in the document, i.e., Pathology Report, Summary of Care, Consent, etc.

Design – Map your legacy system document types and keywords to the future state document types and keywords. The future state document type list should be consolidated and more streamlined so documents are easier to find. Work with stakeholders from the organization (physicians, HIM, IT, etc.), legacy system, the new DMS system and the EHR. Conduct planning sessions with the stakeholders and encourage discussions and discovery into legacy system documents to ensure the mapping makes sense.

Build – Build the future state document types and keywords in the test system. The DMS vendor will build the mappings into their import code for testing.

Test – Load test documents into the system and conduct rigorous testing. As issues are found and corrected, the have the vendor re-import the sample for verification of fixes.

Deploy – Once testing is signed-off by the stakeholders, production loads can begin. Ensure that the build in production is identical to the build and mappings tested in the testing phase. Plan out your bulk loads, and deltas (if applicable). If the systems are not read-only, delta loads, or catch up loads, can be used up until the systems is read-only meaning no more changes are being made to documents in the system.

Understanding the need for this process is the first step. The second step is timing, the ideal time being during an EHR conversion or implementation. We help our clients through the conversion process end- scoping, design, selection and implementation of solutions. Contact Impact Advisors if you’re interested in discussing how to make the next step in improving your patient satisfaction.