Planning for your EHR-S Data Conversion

The first steps you need to take when preparing for your EHR-S data conversion include taking an inventory of your current electronic sources for client and provider related data. Then determine which ones you will need to import into the new EHR-S and which ones can be archived and eliminated. Keep in mind that converting data can be tedious and expensive, so determine your alternatives and the cost versus value for each.

For example, let's say want to import all your existing client's past claim information, so that you have all past units of service in one system. The cost to do this might be significant if the data is not all in one place, accurate, and in the same format. Your vendor can give you a price based on the volume of records and a sample of what the data looks like. The value will be in having financial reporting available all in one system. If you do not import this data, you will need to merge data from your existing system/source and the new EHR-S in order to provide a report across the time frame before and after your EHR-S go-live date. An alternative might be to import only the data to create one fiscal year in the EHR-S or to manually enter the data using data entry staff.

You also need to consider whether you really need an ongoing data interface to or from the EHR-S. A typical example of this is your HR system where you collect provider name, NPI #, credentials, etc. The EHR-S needs this data also, so you are best served by entering the data once in the HR system and then importing it into the EHR-S nightly to keep it current for billing ad service recording. Your EHR-S vendor can give you a price for this custom interface, based on the HR system you have, what format the data is in, and what data elements you want to import.

So, to get started, take the following steps:

1. Inventory all databases you have or use to enter client or provider related data.
2. Identify which ones can be eliminated.
3. Identify which ones you want converted into your EHR-S and which ones you want an ongoing interface to (which direction?)
4. Identify what data elements you want imported
5. Identify time frame for data to import

Do some homework on the options in order to make the best and most cost effective decision for your organization. Some considerations are:

• Who will do the work, what will it cost?
  – vendor can do almost all of the work
  – or, you can hire a programmer to do most of it
  – or, you can share the work
  
• What data do you need in the EHR-S? What are the costs and workflow trade-offs?
  – just enough to deliver new services?
  – to avoid frequent access to charts?
  – to enable a full electronic audit?
  – to enable consolidated service reporting in the past?
  

You can think of the amount and type of data you need in Levels. Each Level representing a strategy for your conversion and workflow / reporting. Several vendors price their data conversion services in fixed price levels.

Maybe Level 1 is just enough data to deliver new services when the EHR-S goes live, e.g. client appt. scheduling, next service recording, and billing. For this strategy, the data you will need should include:
– Provider name, NPI, taxonomy code etc.
– Client name, primary Dx,
– Service facility info., e.g. address,
– COB payer paid amount
– Other: (S' for Local Plan Contract Providers, 1-plan Medi-
Cal claim. 'T' for Local Plan Contract Providers
Medi-Medi claim; 7-byte A/N character DMH client ID (MIS#); charge amount; place of service code; delay reason code)

This strategy can be developed by using the LA DMH Companion Guide for the 837's you will need to submit.

Level 2 might be to also enable avoiding frequent access to hardcopy charts. For this approach you may need at least:
– Tx plan
– Past Progress Notes
– Medication History
– What else?

Level 3 might also include enabling a full electronic audit and the following data elements:
– Signature forms
– What else?

And Level 4, to enable consolidated reporting:
– Past services/claims history
– What else?

Now once you have decided your approach and budget for the conversion, you can begin preparing your data, including the following:

1. Create a data map. You need to map your source data to the EHR-S tables. Each data element you want to bring over needs to map to a data element in the EHR-S tables. For example, if you import something called LName (last name), but the EHR-S calls it LstNm, you need to establish this mapping. Your vendor will help you with this.
2. Import source data into EHR-S table templates. Your vendor will give you some form of a template to facilitate the import, mapping, and cleaning of your data. You will need to:
   i. Identify misplaced data
   ii. Identify missing data
   iii. Identify data with no home
   iv. Identify data errors
3. Correct the source data and the mapping
4. Repeat #2 and #3
5. Test using real scenarios. Test your data conversion using real client and provider scenarios.

The typical datasource is the LACDMH SIFT data, which is your data you have been entering into the DMH IS. You should download that soon and review it to see how accurate it is and determine how much 'cleaning' will need to be done during your conversion. As you find issues, don't forget to re-train your data entry staff as necessary to keep your source data clean, by entering into the DMH IS accurately. The simple example I always use is to look at the client address field and see of the apartment numbers are in the apt. field or in the street field.