Mariia Kovalova

The whys and hows of EHR migration to the cloud

August 12, 2022
By Mariia Kovalova

It seems that all the discussions about comprehensive health records gave rise to the theory about an upcoming era of the cloud among EHR software developers. Global Market Insights reports the global healthcare cloud computing market was valued at $20 billion in 2018 and is expected to surpass $55 billion by 2025.

Despite such an optimistic forecast, healthcare organizations can find it challenging to initiate the EHR implementation in the cloud or its transition there. This article will go over the benefits of a cloud-based EHR and draft a plan for doing so seamlessly.

5 reasons to go for a cloud-based EHR
Many healthcare organizations are struggling with maintaining on-premises EHR systems. Even when the software and infrastructure are up-to-date and their capacity is sufficient, there will still be reoccurring issues to deal with. Data volumes will continue to grow, demanding more resources. Computing environments, such as disaster recovery and tests, will need to be resized every three years, not to mention factors such as merges and acquisitions which may bring in extra resizing.

Cloud-based EHR software can offer a solution to these challenges as well as other valuable advantages:

1. Saving money and time. Cloud-based EHRs come as turnkey solutions, which means that healthcare organizations only invest in recurring subscription fees with the ability to cut costs on the hardware installations, licensing feed, updates and patching, and the IT support team.

2. HIPAA compliance and security. All data from the cloud EHR is stored in a private and encrypted data center, ensuring both compliance with the HIPAA regulations and increased protection against breaches.

3. Accessibility. Patient data stored in cloud-based EHRs can be created, updated, modified, and viewed from different gadgets, which offers the invaluable benefits of the connected care environment.

4. Scaling capabilities. Contrary to traditional on-premises EHRs, a cloud-based system supports dynamic resource management, which means more resources can be added if necessary.

5. Effective disaster recovery. Cloud-based EHR solutions typically go through automated vendor-initiated backups and updates. With consistent automated backups, cloud-based EHR solutions will be able to provide speedy disaster recovery with minimal downtime and service disruption.

Key steps of EHR migration to the cloud
1. Conduct preliminary analysis
Healthcare organizations need to study as many details about their current system in use as possible, including:

● Policies
● Security architecture
● Dependencies
● Compatibility
● User interactions

Without knowing their system in and out, the EHR owner can miss significant gaps and fail to plan the transition accurately.

For instance, a legacy on-premises EHR can contain a specific patient record with “seafood allergy” entered in plain text. To ensure the successful migration of each patient’s history into a cloud-based EHR, this “seafood allergy” record should be translated and codified according to ICD-10, referencing a specific shellfish allergy. At the same time, the plain-text record should be automatically deleted to avoid duplicating the information.

Without a proper translation and mapping of allergies to the new EHR, it won’t be able to trigger respective patient safety alerts, for example in case of drug allergies.

Additionally, the EHR migration team should be assembled according to the following criteria:

● It should be led by an experienced project manager and a business analyst.
● It should include health specialists who are the end users of the current EHR. They will be the early adopters of the new cloud-based system and help other clinicians become familiar with it.
● It should have a dedicated expert who will analyze the vendors according to their bandwidth requirements, SLA, and escalation policies for eliminating connection lags and downtimes during technical support.

2. Decide on virtualization
Virtualization is the method of delivering complex applications, such as EHRs, by offloading them into a virtual ecosystem that isolates and secures big data sets for performing big data analytics in the future.

● Application packages and streaming: The system is deployed to a server and streamed to the endpoint as a package. It allows tucking specific network settings, policies, and drivers into an application.
● Hosted applications: This option is similar to streaming, but a hosted application is deployed to a virtual server instead of a physical one. Hosted apps can feature complex architectures with shared secure access for a wide range of users.
● Virtual desktops: Here, specific solutions are deployed to virtual desktops with policy-based access, allowing system administrators to make user actions visible and controllable.

3. Ensure maximal data security and accessibility
The system must remain accessible during migration, otherwise, healthcare organizations risk their EHR productivity and even patient safety. The catch is that it’s impossible to move all the data at once during the transition for these three reasons:

● Big data migration is restricted by the network and hardware parameters
● Data becomes inaccessible during migration
● Data becomes vulnerable when in a state of transition

Accordingly, providers should consult with their vendors or IT teams about dividing data into manageable chunks for gradual transferring.

Data migration to the cloud might also require reconfiguring the network security. Additionally, most vendors choose to duplicate the environment for migration and work with a replica to avoid affecting the live system through compatibility issues or mistakes that result in data loss. Replication is also needed at the final migration stage. This way, if there’s a security breach or interruption, all the migrated data will remain safe.

Ready or not, the cloud EHR is coming
Migrating from on-premises software to a cloud-based EHR system can be intimidating yet rewarding. There are a number of compelling reasons to start planning the transition, from extra accessibility and painless scaling-up to improved security assurance, safeguarded HIPAA compliance, and reduced expenditures. The cloud allows healthcare organizations to withdraw from maintaining a complex IT infrastructure with servers and storage area networks as well as from staffing an extensive team for managing these resources.

By making progress one step at a time, investing in analysis, and consulting with experts, healthcare providers can make their EHR transition to the cloud secure and seamless.

About the author: Mariia Kovalova is a Healthcare Technology Researcher at Itransition, a custom software development company headquartered in Denver, CO. Having working experience with both healthcare and IT industry, she is constantly on the lookout for technologies that will help providers optimize their processes, enhance patient experiences and build up more resilience in the face of the rapidly-changing world.