The number of ambulatory providers dealing with legacy EMR and PM systems is growing; with some practices dealing with multiple legacy systems.  Different organizations deal with legacy medical records (ePHI) in very different ways, for some organizations they see HOPE as the best and most economical strategy.  They simply let the system sit in a closet or rack, and HOPE they can retrieve the records when needed.  This is in essence the lack of is a strategy, and is fraught with problems.  The other ill informed strategy is to purchase a image extract from a hosted EMR vendor, typically a CD or DVD containing PDF files, and just keep them on a shared drive in the practice.  We have even seen them uploaded to an unsecure Internet accessible shared drive, where everyone in the practice can access the records whenever they need them.  This seems like a salient solution, but the problem is, this method is NOT HIPAA compliant.   

When deciding on a strategy for EMR/PM system retirement define some guiding principles at the onset:  1) How long is the practice required to maintain the records, and how long does the practice intend to maintain the records.  2) Is the practice interested in structured data or simply an image of the legacy record.  3) What are the expected uses of the information, is it for patient care reference or is it for potential retrospective research?  Is the practice open to a hosted data archive, or only an on premise solution? 4) Does the practice want to have any clinical data imported into the new system, and if so, what data.  Typically, demographics, medications, allergies, problems and immunizations are the first wants, and then can expand to include nearly every element of the medical record. 

Once you have these guiding principles in place, selecting a solution is relatively simple —  select the solution that meets the defined needs at a reasonable cost.  Importing discrete or structured data beyond demographics becomes expensive quickly because of the necessary translations and validation between system.  An image or unstructured data archive or data migration is much more cost effective. 



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