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. 2023 Oct;38(Suppl 4):956-964.
doi: 10.1007/s11606-023-08276-3. Epub 2023 Oct 5.

Transitioning from One Electronic Health Record to Another: A Systematic Review

Isomi M Miake-Lye  1   2 , Alison M Cogan  3   4 , Selene Mak  3 , Julian Brunner  3 , Seppo Rinne  5   6 , Catherine E Brayton  3 , Ariella Krones  6   7 , Travis E Ross  8   9 , Jason T Burton  10 , Michael Weiner  11   12   13
Affiliations

Transitioning from One Electronic Health Record to Another: A Systematic Review

Isomi M Miake-Lye et al. J Gen Intern Med. 2023 Oct.

Abstract

Background: Transitioning to a new electronic health record (EHR) presents different challenges than transitions from paper to electronic records. We synthesized the body of peer-reviewed literature on EHR-to-EHR transitions to evaluate the generalizability of published work and identify knowledge gaps where more evidence is needed.

Methods: We conducted a broad search in PubMed through July 2022 and collected all publications from two prior reviews. Peer-reviewed publications reporting on data from an EHR-to-EHR transition were included. We extracted data on study design, setting, sample size, EHR systems involved, dates of transition and data collection, outcomes reported, and key findings.

Results: The 40 included publications were grouped into thematic categories for narrative synthesis: clinical care outcomes (n = 15), provider perspectives (n = 11), data migration (n = 8), patient experience (n = 4), and other topics (n = 5). Many studies described single sites that are early adopters of technology with robust research resources, switching from a homegrown system to a commercial system, and emphasized the dynamic effect of transitioning on important clinical care and other outcomes over time.

Discussion: The published literature represents a heterogeneous mix of study designs and outcome measures, and while some of the stronger studies in this review used longitudinal approaches to compare outcomes across more sites, the current literature is primarily descriptive and is not designed to offer recommendations that can guide future EHR transitions. Transitioning from one EHR to another constitutes a major organizational change that requires nearly every person in the organization to change how they do their work. Future research should include human factors as well as diverse methodological approaches such as mixed methods and implementation science.

Keywords: electronic health records; organizational change; systematic review.

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Conflict of interest statement

The authors have no conflicts of interest to report.

Figures

Figure 1
Figure 1
Literature flow.
Figure 2
Figure 2
Transition start date and capability change during transition (n = 40).
Figure 3
Figure 3
EHR systems described in included publications (n = 40). Number of EHR transition = 1 unless otherwise noted. *more than 1 EHR system represented. ^other EHR systems such as QuadRI and AllScripts; details in evidence table.
See this image and copyright information in PMC

References

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