What About Your Legacy Data?

Over the last ten years, provider adoption of Electronic Health Records (EHRs) has grown significantly. Healthcare providers are expected to document encounters with patients to ensure a record of crucial information. However, just a decade ago around 90% of physicians still updated their patient records by hand. By the end of 2014, the tide had changed, and 83% of physicians reported they had adopted EHR systems. The combination of government incentives, advances in technology and improved outcomes and operations has fueled this growth.

While the last decade has witnessed significant growth in adoption, the need to change systems while maintaining the access to and integrity of data has also increased. The two largest reasons for EHR system changes for health systems, hospitals, and private practices are provider dissatisfaction and mergers and acquisitions. In preparing for these changes, providers and health administrators have been grappling with how to handle the data in the legacy systems.

When healthcare providers have access to complete and accurate information, patients receive better care and have better outcomes. EHRs improve providers’ ability to diagnose disease and reduce medical errors. EHRs further help providers meet patient demands, provide decision support, improve communication, and aid in regulatory reporting. Maintaining the data stored in the EHR is of prime importance.

Provider Dissatisfaction

By and large, providers recognize the important advances enabled by EHRs. According to Health Affairs, fewer than 20% of all providers said they would return to paper records.

Providers also noted negative effects of current EHRs on their professional lives and on patient care.  While excited about the possibilities provided by EHRs, providers have ultimately found poor usability that does not match clinical workflows, time-consuming data entry, interference with patient interaction, and too many electronic messages and alerts.

Mergers & Acquisitions

In the last twenty years, there has been significant consolidation among healthcare organizations. The Affordable Care Act (ACA) sought to eliminate duplication, standardize treatment protocols, and incentivize better utilization by encouraging mergers and acquisitions. As a result, there has been a surge of this activity in healthcare since the ACA became law.

In addition to encouragement from the ACA, hospital and health system leaders have turned to mergers, acquisitions, and other forms of partnerships in order to reduce costs, enhance competitive positioning, and pivot to a value-based business model.


Like the initial adoption of a system, changing systems is an enormous project. As these healthcare organizations work to adopt new EHR systems, patients continue to generate more and more data daily. In the US healthcare system, the volume of electronic data roughly doubles every two years. Determining how to maintain and store data from legacy systems while utilizing a new system can be extremely challenging. There are 3 different options to achieve this goal:

Archive Legacy Data

An archive system indexes data that is stored in disparate systems. Indexing creates a searchable list of what is stored in different systems. The power of indexing lies in the fact that files can remain separate from the new system, but still be discoverable and accessible from a single interface.

Archiving tends to be a cost effective way to store legacy data. However, it can be challenging for accessing historical patient information that, depending on the specialty, can be legally required to be maintained for up to 20 years This data is also needed to fulfill patient requests, is used in patient treatment, and remains imperative for various reporting needs.

Run Multiple Systems

While health systems, at times, choose to run multiple record systems in order to take advantage of various clinical specializations offered, there is an inherent risk when working out of more than one system. The risk further increases when attempting to run multiple systems within the same office in order to maintain legacy data. Those risks include issues related to maintaining patient safety and decision support, as well as, access to records and software usability.

EHR Data Conversion

Another option is to move all the data from the legacy system to the new system through data conversion. EHR data conversion is accomplished through a process known as ETL. During an ETL conversion, patient data is EXTRACTED from the legacy system, TRANSFORMED to align with the map created for the new system, and LOADED into the new system. EHR data conversion can be performed through manual data abstraction or automated data conversion.


Interested in learning more about options for your legacy data, read Evolution of EHR: Changing Systems Without Affecting Care or speak to a Keystone data expert today!

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