Hayes' Healthcare Blog

Balancing Act: How to Effectively Maintain your Legacy System During the Chaos of an Install

Posted by Paul Allen on January 13, 2016 at 9:00 AM

Revenue-Cycle-Blog.pngResources are limited, funds are limited, and time is invaluable. What should an organization do to maintain their legacy system during the installation of a new system?   It’s impossible to ignore the compliance, patient service needs, and required enhancements to your current system.   What should you consider to remain compliant? What can be done to make the go-live more productive and seamless? What are the tasks that can be completed to make the post go-live more productive? How does one provide the dedicated resources during this transitional time? With so many questions to consider, we have broken it down into four central topics so you can confidently maintain your legacy system during your install.

Compliance

Keeping your system compliant does not stop once a new system has been purchased.    Your current system is still the system of record for those dates of service for both the revenue cycle and medical record applications. They must be accurate and accessible.

  1. Upgrades and enhancements - The legacy system will have upgrades and enhancements available during the transition time and it is pertinent that you do a careful review of both.   Some upgrades will be required by the vendor for continued support while other upgrades can provide the needed fields and services your organization needs.
  2. Regulatory compliance - Your legacy system will have to meet all requirements for documentation and claim submission.   For example you will need to ensure you convert to the most current ICD-10 coding requirements.   Even if a new system went live in November 2015, your legacy system would have to be able to utilize the ICD-10 requirements for the period of October 1, 2015 to October 31, 2015.

Go-live Support

You can use your legacy system to ensure a smoother transition to your new system.

  1. Preparation work for conversions - Appointment, demographic, prescription lists, and referral information are often converted from the existing system to the new system prior to the go-live. Matching data fields from the current system to the new system is critical before any conversion. Changes and updates may need to take place in the current system to make this conversion more effective. For example, you will need to populate the primary care physician field in the new system. Currently, it is not a required field, but by making it a required field in the current system, over the months leading up to the conversion, many of your current accounts will now have that field populated. This will save frustration time during the go-live weeks if these accounts are already meeting the required elements.
  2. New process flow introduction - During the build of a new system, process flows are often identified that will be altered due to the improvements or limitations of a new system.   These new workflows will be both a training issue and a hurdle for end-users to meet.   Can you introduce this new workflow utilizing the current system? By making the field required, the answer is often yes and by doing that in the current system, the training can focus on functionality, and the end-users can utilize these steps as part of their daily processes.

Post Go-live Activities

Even after go-live, there will be parts of your organization that will still need access to the legacy system. For example, historical references and the workings of accounts receivable. What can be done prior to the go-live to ensure proper and easy access?

  1. Accounts receivable run down - Most organizations have issues with various aspects of their accounts receivable during the transition. It may be credit resolutions, aging accounts, or other unresolved issues. Not only can concentrated attention on these aspects months before the go-live can make the accounts receivable clean up after the go-live much smoother, but it can also help identify needs or issues that need to be addressed during the new system build.
  2. Charge lag - A concentrated effort 30 days before go-live for providers to have all encounters entered must be done. Because it is not time efficient for providers to have to log in to the legacy system to enter past charges, it’s important to have all of those submitted by date of service before go-live.
  3. Security profiles - Decisions regarding the security levels and the timing of the updating of these profiles need to be documented and planned. Make sure that your organization has a clear idea of the select staff who require legacy system full security profiles, and the remaining staff who will only need inquiry.

Dedication of Resources

Resources are often stretched to their limits during the lead up to a go-live.   But, resources will still be needed for the current legacy systems during the installation process.  

  1. Backfill positions – Consider outsourcing to provide backfill for employees. This way, employees can dedicate themselves to the installation of the new system and the outside resources can utilize their knowledge of the legacy system and maintain it as go-live approaches.
  2. Recognize time restraints - Be mindful of the hours and resources needed by the various departments.   Augmenting staffing positions for the short term can provide the needed assistance.

The move to a new system can be an exciting time for an organization, but also can be one of great stress.   By carefully maintaining the current legacy system and working to make the transition to the new system smoother, any negative impact can be greatly reduced.

Topics: EHR go live, EHR implementation, revenue cycle management

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