EHR migration pays big dividends for Oak Orchard Health

EHR migration pays big dividends for Oak Orchard Health

Oak Orchard Health in Brockport, N.Y., continues to grow during the COVID-19 pandemic. In July 2020, it acquired a three-office private practice that was using a different EHR (Medent) than Oak Orchard’s eClinicalWorks platform.

To enable a rapid post-acquisition transition, Oak Orchard retained the practices at Medent and implemented procedures and workflows to be able to resolve differences. The goal is to provide a consistent patient experience across the entire organization.


“We quickly discovered that we had to implement many procedures and workflows to complete patient visits,” said Jason Kuder, chief information officer at Oak Orchard Health. “The first was when staff used Medent for a daily visit. From then on, every visit Each patient will be manually created in eCW so we can file a claim immediately.

“So an active patient would essentially have two accounts: one in Medent for patient charting and one in eCW for billing,” he continued. “The longer we lived with two electronic medical records, the more we realized that no matter how many procedures or workflows we implemented, the three offices would be siled. We no longer had the flexibility to use our resources across the organization .”

He added that for providers who are busy seeing patients, mastering Medent and eCW is an impossible task and a support nightmare. Over the years, the group became insular. Recruitment is made more difficult because providers are often not trained in either EHR.

“We also had problems with day-to-day reporting, but more importantly, it made reporting to UDS more difficult,” Coude explained. “FQHC health centers have to submit every February, which is a major hurdle for us.

“Since the acquisition, retrieving data from both EHRs and merging the data sets to be able to report for UDS has been a significant undertaking,” he continued. “Patients may be in both systems at the same time, or they may be in just one system. The way they are recorded is very different, resulting in longer data verification sessions, which is a huge improvement to our organization’s operations.”


Financially, Oak Orchard Health can’t put any more effort into solving this problem. To make matters worse, employee morale is at an all-time low. Due to significant changes in senior leadership, the new CEO made it a top priority to bring the three sites of the new business into eCW along with the rest of the organization.

“We thought if we could get everyone on the same electronic medical record, we would speak the same language,” Kuder said. “We would have an easier time implementing new technologies, company-wide procedures and workflows.

“Having multiple medical records platforms impacts everyone in the organization—from how we route inbound calls to how we document in patient records,” he adds. “Having everyone working from the same EHR will allow us to provide a more consistent patient experience.”

face the challenge

Kuder noted that when health IT professionals talk about migrating to a new EHR, most focus on the data that needs to be moved from one location to another.

“It’s more complicated than that,” he said. “The hardest part, in my opinion, was trying to train staff on the new EHR. For example, it wasn’t as easy as where to record a patient’s height and weight. The entire patient appointment workflow had to change.

“The analogy I used in this project was trying to replace an airplane’s engine while it’s flying,” he continued. “Patients don’t stop seeing patients just because the EHR is changing. We had to develop a plan to train all staff, configure new facilities in eCW, and migrate data from Medent to eCW without disrupting patient schedules arrange.”

From the data side, staff must work with Medent to provide Oak Orchard with all patient data in the EHR. The staff then had to provide this to eCW so they could provide Oak Orchard with a map of how the data was ingested.

“Because the EHR used different terminology, it was a daunting and tedious task to go through every attribute line by line from Medent to eCW,” recalls Coode. “Once this part is complete, we will perform a test migration in a test environment. We will then check hundreds of patient charts to ensure that the migrated data has been placed in the correct location in eCW.

“While that team works on the data side, there’s another team working on the training side,” he continued. “We started by enrolling all employees in the three offices into eCW University online courses based on their role. This enabled them to receive some initial training at their own time.”

Oak Orchard has recruited a number of eCW Super Users to deliver hands-on training at the new practice location. It also sent staff from the Medent site to the Oak Orchard site to learn about eCW’s work on-site.

“Once we verified that the data looked good and training was complete, we planned to get the data from Medent over the weekend and move it into our eCW production environment,” Kuder explains. “Employees last used Medent on Friday and started using eCW on Monday. All this occurred without the office being closed.”


One of the main successes is employee satisfaction. For three years, Oak Orchard has been doing the same thing over and over again. Front desk staff in these offices now do not have to enter data into two electronic medical records. The finance department does not have to pull information from one electronic medical record and enter it into another to process claims.

“Most importantly, we have been able to reduce operational costs associated with duplication of work,” Kuder reports. “We have been able to help reduce employee burnout because our staffing is flexible and we can deploy them wherever we need them. place without having to worry about which electronic medical record is being used.

“The transition to eCW allows us to become a unified system and share information in a more efficient way, ultimately saving time and providing better care for patients,” he continued. “We now speak the same language and use the same procedures and workflows in all our offices. This alone allows us to introduce new services such as self-check-in.”

Oak Orchard is also currently implementing kiosks at all of its locations. Kuder added that none of these things would be possible if there were still two electronic medical records.

Advice to others

“If you’re in an acquisition situation and you’re bringing in facilities on different EHRs, I recommend migrating those new offices to the existing EHR as part of the acquisition,” Coude said. “The time you’re trying to maintain two electronic medical records The longer it goes, the more difficult the transition will be. Most importantly, the patient’s experience will be affected twice instead of just once.

“Planning for a project like this takes more time than you think,” he continued. “Since the EHR is the provider organization’s first port of call, ensuring you have completed all due diligence will make the migration smoother.”

When validating data, give it as much attention as possible, he added.

“A single patient has hundreds of different attributes, and the more people you can verify to make sure the data migrates correctly, the more complete the picture will be,” he concluded.

Follow Bill’s HIT coverage on LinkedIn: Bill Siwicki
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