The Ins And Outs Of Upgrading Your Practice's Electronic Health Records

How EHR Systems Stay Current

Electronic health records (EHRs) have become indispensable for healthcare providers. But how do these complex systems stay up-to-date as technology rapidly evolves? What steps should practices take when upgrading platforms?

This comprehensive guide breaks down everything you need to know about optimizing electronic records. Whether you currently use an EHR/EMR or are considering adopting one, this article provides invaluable insights. 

Learn best practices for system upgrades, new functionality, vendor options and more.

Assessing Your EHR and Planning Updates

A thorough assessment of your current EHR system is crucial to determine where upgrades or changes may be beneficial. This involves taking a critical look at what is currently working well, along with identifying any pain points, inefficiencies, or desired new capabilities.

Start by gathering comprehensive feedback from all your EHR users, including physicians, nurses, administrative staff, and other healthcare providers. Survey them to gauge satisfaction levels with the system and have them detail specific issues or desired improvements. Also review usage data, metrics, and analytics to spot any trends.

Develop a detailed update plan that covers:

1	Scope	Outline the goals, target areas, and extent of changes to implement. Prioritize updates that will have the biggest impact or address the most urgent needs.
2	Timeline	Create a phased rollout schedule, factoring in complexity and availability of staff for testing and training. Build a buffer room for unexpected delays.
3	Testing	Design thorough testing protocols to validate new workflows, functionality, integrations, etc. before deploying updates. Appoint user groups to test different aspects.
4	Training	Develop training programs to educate all staff on impending changes and how to use new features or workflows. Combine classroom and online learning as needed.
5	Support	Have dedicated help desk resources ready when updates are rolled out to assist users. Also create user guides, knowledge bases, and FAQs.
6	Review	Schedule regular check-ins after launch to gather feedback, address issues promptly, and refine as needed.

It's also essential to involve your EHR vendor early in the process. Review proposed changes and determine if any software upgrades, additional modules, or modifications may be required.

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EHR Vendor Software Upgrades

EHR vendors like Calysta EMR continually release enhanced software versions to fix bugs, improve performance, and add new capabilities. It's essential to keep your system up to date through these upgrades to:

• Maintain security and address vulnerabilities
• Access the latest features and functionality
• Meet changing regulations and compliance criteria

Major version upgrades require more intense preparation. But modern EHRs aim to limit legacy system disruptions during incremental changes. Stay current and avoid technical debt down the line.

EHR Certification Requirements

Government standards like the ONC's 2015 Edition Cures Update establish baseline EHR capabilities and data formats for improved nationwide interoperability. Vendors must meet new certification criteria through software updates so customers can participate in programs like Promoting Interoperability.

Don't get left behind on requirements that impact compliance and reimbursements. Continually updating your certified EHR ensures you can leverage new standards that support better data exchange and patient access.

Creating Patient-Specific Guidelines

Electronic health records (EHRs) have the capability to automatically generate personalized health maintenance reminders and screening guidelines for patients based on key demographic and clinical factors. Some of the variables that can be used to tailor recommendations include:

Age

Screening tests and health maintenance often depends on the patient's age. Mammograms, colonoscopies, lipid panels, and other preventive care can be prompted based on age-specific guidelines.

Gender

Certain conditions and tests are more relevant for either biological males or females. Prostate cancer screening for males and cervical cancer screening for females are examples. EHRs can account for gender in determining appropriate reminders.

Medical Conditions

Underlying medical diagnoses, such as diabetes, heart disease, or asthma, may necessitate additional screening tests or more frequent monitoring. Patients with these chronic diseases can be flagged for condition-specific care.

Family History

A family history of certain illnesses, like breast cancer or colon cancer, can trigger earlier or more frequent screening in patients at higher risk.

Medications

Prescribed medications may require periodic lab tests to monitor for side effects or therapeutic drug levels. EHRs can prompt physicians to order appropriate follow-up based on the patient's active medications.

Immunization History

Reminder alerts can be generated to advise patients when they are due for recommended vaccines based on prior immunization records.

Social History

Factors like smoking or alcohol use may influence screening recommendations for conditions like lung cancer or hepatitis.

By continually updating the EHR with new patient data from each encounter, the system can leverage this information to provide timely, individualized, evidence-based guidelines to standardize and optimize preventive care across the practice. 

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Transitioning EHR Systems

Changing platforms entirely involves systematically transitioning data, workflows and capabilities to the new system. Meticulous planning minimizes disruptions and ensures continuity of operations throughout the transition.

Data migration is one of the most complex undertakings. A study describes it as a “thorny issue” in the transition process. Leveraging an integration engine to synchronize and validate data across systems is advised over manual approaches. Prioritizing elements like patient demographics and medication lists can help focus mapping efforts.

Adequate training and post-go-live support ensures providers can fully leverage the new platform from day one. A phased rollout by location allows lessons learned to be rapidly incorporated across sites. Above all, include staff early and often to smooth the inevitable bumps.

Directly Editing Records

Electronic health records enable authorized healthcare providers to seamlessly edit and update patient records over time as more information becomes available. 

The structured data formats and use of standardized clinical terminologies in EHRs help maintain data integrity when applying changes to records such as:

• Correcting or updating demographic and personal details like name, date of birth, address, insurance information. This ensures accurate patient identification across all care settings.
• Revising or adding to the medical history with details of new diagnoses, procedures, hospitalizations, and more. A complete medical history supports clinical decision making.
• Updating problem lists and diagnoses as they are confirmed or ruled out. Structured problem lists make it easy to track diagnostic changes over time.
• Documenting medications, tests, referrals, and other treatments or orders in real-time as care is delivered. Treatment plans can be easily adjusted and optimized.
• Recording clinical notes, care summaries, and other narrative documentation from patient encounters. This provides valuable context and rationale underlying clinical decision making.
• Seamlessly incorporating data from labs, imaging, consults, and other ancillary services directly into the patient record. This facilitates test follow-up and care coordination.

Unlike paper records which are static, EHRs enable patient records to be living documents that reflect the continuum of care across all settings. Direct editing allows patient data to be kept up-to-date and accurate as clinical knowledge evolves over time. 

This supports high quality care delivery and care coordination across the healthcare ecosystem.

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Changing Data and Correcting Errors

Electronic health records must maintain high accuracy and integrity to support safe, effective care. Systems should provide robust tools to modify records while preventing the introduction of new errors. Key principles for proper data changes include:

1. Proper oversight and approval workflows for any modifications, following organizational protocols and regulations. Changes should require authorization from the original data source or an appropriate supervisor when possible.
2. Clear documentation of all changes including what was modified, by whom, when, and the rationale. Audit trails should track all changes to identify suspicious activity.
3. Alerting all providers who may have been impacted by changes, such as those who already viewed or acted on erroneous data. Notification enables them to follow up appropriately.
4. Strict controls around high-risk fields like allergies and medications to prevent accidental corruption that could endanger patients. Special workflows may be needed for managing complex data like consolidating medication lists from multiple sources.
5. Options to mark outdated or inaccurate data as superseded rather than deleting to maintain transparency. Deleted information should still be recoverable when necessary.

It is essential to ensure that these principles are consistently applied and that the tools provided by the EHR system are effective in maintaining data accuracy and integrity.

How to Ensure Data Integrity

A robust data integrity strategy is crucial for optimized electronic health record (EHR) systems. This involves implementing policies, protocols, infrastructure, and usability features that safeguard the accuracy and completeness of EHR data. 

Core elements of this strategy include:

• Advanced record matching algorithms that can effectively link health data across disparate systems
• Strong access controls such as biometrics to authenticate users
• Detailed audit logs that comprehensively track all changes made to records
• Emerging blockchain-based approaches that cryptographically seal records

Technology alone is not sufficient to fully safeguard EHR data integrity. Healthcare organizations must also foster an organizational culture centered on high-quality, accurate data entry and management in EHR systems. 

This requires extensive training on proper data handling, workflow optimization to minimize errors, and leadership emphasis on the importance of data integrity. With a multilayered approach combining technological safeguards and cultural commitment, healthcare organizations can enable confident clinical decision-making based on trusted EHR data. 

Comprehensive data integrity boosts patient safety, care quality, clinical research, billing accuracy, and overall performance for healthcare providers.

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Conclusion

Like any other software, EHR systems require constant updates and maintenance to protect against obsolescence. Follow best practices around assessments, planning and change management to smooth major upgrades. Monitor incremental improvements from your vendor to stay current.

Outdated EHRs put your practice at risk for non-compliance, compromised security and suboptimal care delivery. But optimized systems greatly empower providers with integrated, accurate data analytics. And emerging chronic disease management, medication safety and infection control capabilities on the horizon promise to further revolutionize population health efforts.

At Calysta EMR, we're pioneering these leading-edge innovations while providing a premium user experience at an affordable cost. Our fully customizable EHR platform is designed by clinicians, for clinicians. Contact us today to schedule a demo and discuss how we can meet the unique needs of your aesthetic medicine practice now and into the future.