Emr Data Migration Project Plan v1.4

EMR and Data Migration Plan Template (V1.
0) Page 1 of 35
EMR and Data Migration Plan Template (V1.0) Page 2 of 35
On
VERSION HISTORY
[Use the table below to track the development and changes to the EMR and Data
Migrati on Plan. Begin by entering a version number, the name of the author
implementi ng the version, the date of the version, the name of the individual approving
the version, the date that parti cular version was approved as well as a brief descripti on
of the reason for creati ng the revised version.]
Version Implemented Revision Approved Approval Reason

# By Date By Date
1.0 <Author name> <mm/dd/yyyy> <name> <mm/dd/yyyy> <reason>
[Insert appropriate disclaimer(s)]

Introductory Notes
[This document is a template for the migration of data in a community care setting. It is meant to be a
template and is by no means an exhaustive project plan. This document is a complement to the EMR
and Data Migration guide, a copy of which can be found at TBD]. It is not mandatory to use this
specific template. You may already have one developed within your practice or, your EMR vendor may
provide you with the other templates to track and manage the project.
EMR migrations are not linear. The process will vary depending on your practice size, type, location
and even the vendors involved. It may take anywhere from a few weeks to over eight months
depending on the complexity of the migration. As such, this document may not cover all
considerations for your EMR Migration. However, following a structured process as shown in the EMR
and Data Migration guide and utilizing tools such as this EMR Migration Project Plan will help ease
this process.
How to use this document
This template includes instructions on how to use this document, standard boilerplate text, and fields
that should be replaced with the values specific to your migration project. Please refer to the table of
contents for additional detail.
 Blue italicized text enclosed in square brackets ([text]) provides instructions to the document
author, or describes the intent, assumptions and context for content included in this
document.
 Before submission of the first draft of this document and circulation around your practice,
delete this “Notes to the Author” page and all instructions to the author, which appear
throughout the document as blue italicized text enclosed in square brackets.(“[Text]”)]
 Delete the “sample” text embedded within the watermark of this document
TABLE OF CONTENTS
1.0 PURPOSE OF THE EMR AND DATA MIGRATION PROJECT PLAN.....................................5

2.0 PLANNING...................................................................................................................6
2.1 PRACTICE OBJECTIVES................................................................................................6
2.1 EMR AND DATA MIGRATION SCOPE..........................................................................7
3.0 EMR VENDOR SELECTION.............................................................................................9
4.0 MIGRATION SCHEDULE..............................................................................................13
5.0 IMPLEMENTATION AND DATA MIGRATION GO-LIVE..................................................14
6.0 APPENDIX A: EMR AND DATA MIGRATION PLAN APPROVAL....................................18
7.0 APPENDIX B: REFERENCES..........................................................................................19
8.0 APPENDIX C: KEY TERMS............................................................................................20
9.0 APPENDIX D: SAMPLE USER SCENARIO FOR VENDOR DEMONSTRATIONS..................21
11.0 APPENDIX E: SAMPLE ISSUE LOG................................................................................31
1.0 PURPOSE OF THE EMR AND DATA MIGRATION PROJECT PLAN
[Describe the purpose of the EMR and Data Migration Project Plan. Summarize the purpose of the
document, the scope of activities that resulted in its development, the intended audience for the
document, and expected evolution of the document. Some examples are provided below]
 [This EMR and Data Migration Plan is a description of the goals, vision, preparation, vendor
selection, implementation and post go-live considerations and specifications for the migration
from one EMR 1 to EMR 2.]
 [The intended audience of the ] EMR and Data Migration Plan is the practice, EMR vendors as
well as all associated project teams.]

2.0 PLANNING
In the first phase of the EMR and Data Migration, six (6) to eight (8) months before Go-Live, consider
outlining the following detail:
2.1PRACTICE OBJECTIVES
Describe objectives of your EMR Data Migration. For example, what do you want your practice to look
like once the EMR migration is complete?
 [Insert description of the first objective.]

 [Insert description of the second objective.]
 [Add additional bullets if necessary]
Engage your practice. What are some key messages for practice staff on the vision for the EMR
migration? Who will lead the EMR migration?
 [Insert approach for the engagement of practice staff]

 [Insert the vision and specific goals that practice staff can identify with]
Analyze your practice. Identify any gaps between your practices current state and the desired future
state with the EMR.
 [List patient flow gaps in your practice]

 [List and identify gaps in point of care, such as with forms and documents on patient visits]
 [List the gaps in the flow of information in and around your office]
 [List the gaps in the flow of documents in and around your office]
 [List any other opportunities for practice workflow improvement]
 [Insert additional detail as required]
Prepare your data.

 [Assess your Data. Refer to Section 1.4 of the EMR and Data Migration Guide]
 [Identify and list the type of data that is to be migrated and the data that is not.]
 [Outline your current EMR vendors EMR migration support clause]
 [Current version of your EMR software]
Review Privacy and Security Considerations
 [Outline your existing privacy policy and any improvements to be made]

 [Outline your obligations as a Health Information custodian under PHIPA]
 [Insert additional detail as required]
2.1EMR AND DATA MIGRATION SCOPE

[Provide a rationale for the Migration and a general description of the boundaries of the data
Migration effort. This may include, but not be limited to, specific practice functions affected and
functions/data not affected.]
 [Measurable targets: List the targets and what your practice like to achieve as a result of this
EMR and Data migration]
 [Insert description of the second item.]
ROLES AND RESPONSIBILITIES

[List all stakeholders and document their roles and responsibilities in the Migration process.]
 [List the first stakeholder.]

 [List the second stakeholders]
 [Add additional bullets as necessary]
ASSUMPTIONS
[This section identifies the statements believed to be true for the EMR and Data Migration.]
 [Insert description of the first assumption.]

 [Insert description of the second assumption.
CONSTRAINTS
[This section identifies any limitation that must be taken into consideration prior to the Data
Migration from the old to the new product or IT system. Describe any limitations or constraints that
have a significant impact on the Migration effort such as:
 [Identify the types of data may not be migrated to the new EMR?]
 [Identify any constraints with respect to the availability of practice staff to participate in the
EMR migration]
 [Insert description of a constraint.]
RISKS
[Describe any risks associated with the data Migration and proposed mitigation strategies. Include
any risks that could affect Migration feasibility, technical performance of the converted system, the
Migration schedule, costs, backup and recovery procedures, etc.]
 [Insert description of the first risk.]

 [Insert description of the second risk.]
TRANSITION PLAN
 [List the provisions for access to data in the old EMR after the EMR migration is complete.]
 [Outline your old vendors’ approach to provide your practice with copies of the patient records
for future reference]
3.1
3.0 EMR VENDOR SELECTION
Note: A more detailed EMR Vendor Selection Guide is available at http://bit.ly/1TdELX0. Please review
for additional detail.
EMR SELECTION TEAM

[Provide a list of the team members within the EMR Selection team. Also, include contact information,
roles and information. Please see section 2.2 of the EMR and Data Migration guide for additional
details.]
PROSPECTIVE EMR VENDORDEMONSTRATIONS (FUNCTIONAL TESTING)

[Use the sample reference guide below as a boilerplate of questions to ask EMR vendor reference
sites. The table below includes sample questions you can ask the reference site, to understand their
experience with the EMR you are considering. Use the column on the left to score the response from
1-10 with 10 being the highest]
# Question 1 to 10 or NA
General
1 Business Continuity and Disaster Recovery – Have you ever had a
disaster or loss of data from which you had to recover? How effective
was the EMR vendor in this process?
2 Security – Are you satisfied with the security and privacy?
3 Interoperability – Overall technical effectiveness of OLIS, HRM,

community lab results interfaces?
4 Patient registration effectiveness?
5 Patient appointment and physician scheduling process effectiveness?
6 Billing submission and reconciliation plus Financial reporting

effectiveness?
7 Posting scanned documents to patient chart?

8 Training – Overall effectiveness prior to and post Go Live?
9 Implementation – Overall effectiveness, timeliness?
10 Data Migration – Overall effectiveness? What EMR did you migrate

from?
11 Performance – Overall effectiveness of system performance (speed)?
12 Quality of EMR product – Overall quality of the EMR application? Is it

bug free?
13 Vendor Support – How effective is the vendor in providing support for

your questions and problems post Go Live?
14 EMR availability – How available is the EMR? (downtime)

15 Ability to create custom Letters / Forms / Handouts / Favourites?
Overall Score:
# Workflow 1 to 10 or NA
1 Creation of and monitoring Referrals?
2 Preventative Care Management?
3 Medication Management? (Rx, drug interaction, integration with

pharmacies)
4 Encounter Notes?
5 Managing chronic diseases?
6 Teaching Unit Functionality? (support of residents and learners.)
7 Do you have a patient portal? If so, how effective is it?
8 Communication of patient activities through EMR
Overall Score:
Please review Appendix D for Sample User Scenarios to test prospective vendor products
TEST SAMPLE DATA EXTRACTS AND SCENARIOS

[In addition to the functional testing activities in the previous section, prepare sample practice
scenarios. Use these to gain a better understanding of the prospective EMR products you are
considering. A sample scenario is provided below for your reference.
VENDOR PROFILE
[As a part of your research, request vendors to provide you with some or all of the following detail
 A brief resume for project managers, trainer(s) and IT implementation resources.
 Corporate marketing information that summarizes solutions offered, financials, geographic
markets covered, and the overall size of the company (an annual report may offer this detail).
 Number of physicians in Ontario using the EMR in their practice setting (not just billing and
scheduling)
 Support locations and the number of employees dedicated to support (e.g. telephone support,
typical response times, etc.).
 Systems and modules to interfaces currently in use in Ontario, such as pharmacies, patient
portals, laboratories and even OntarioMD′s Hospital Report Manager (HRM).
 References for other practices with whom the vendor may have performed a migration or
done business with before]
VENDOR SUBMITS PROPOSAL TO YOUR PRACTICE

The vendor proposals should outline the following:
EMR
 [Hardware needed for servers, workstations, printers, keyboards and peripherals]

 [Bandwidth requirements (i.e. data transfer rate), including upload/download specifications]
 [Pricing and details of software ownership and licensing for both physicians and support staff.]
 [Detailed pricing of any third party software or services required to make the EMR functional]
 [Costs for read-only access to the EMR if you decide to maintain the old EMR after the
migration]
 [The anticipated Go-Live Date - the date when the new EMR becomes fully operational]
 [The vendor′s standard approach to EMR migration (Are both EMRs available during the
migration or is it a “big bang” where the new EMR is turned on and the old one switched
off?)].
 [The vendors approach to making a read-only copy of your EMR available for review, after the
EMR migration, including any associated costs].
Data
 [A written assessment of your practice data and its suitability for migrating to their EMR
database].
 [A description of the type of data and EMR features that may or may not be migrated ]
 [Obtain estimates of EMR migration costs (What is included and what are the costs for what is
not included?) For example, some vendors may charge an hourly/daily rate for services
provided]
 [Prospective dates for a test EMR migration].
Service and Support
 [The location of the functional and data testing (this may be virtual or in person at the
practice].
 [Service support availability from the vendor, detailed training schedules and costs].
 [Outline any clauses in the new EMR vendor contract around data extracts and data
migration].
 [Outline privacy and security considerations. What provision(s) is the prospective EMR vendor
willing to make to ensure that patient data is not compromised during and after the EMR
migration. Please review section 2.3 for additional detail.]
 [Outline the Business Continuity and Disaster recovery plans for your EMR migration if
defined].
 [A description of the triage process for handling EMR and data issues encountered during the
migration.]
Third Party Contracts
 [Service support availability and schedules for third party vendors. Review Section 2.6 of the
EMR and Data Migration guide for additional information on third party contracts].
Migration Approach and Transition Plan
[Describe the approach to extract, transform/cleanse and load data from the source to target
destinations during the Migration/migration process. Consider and address the items in this section
and/or appropriate subsections, if applicable:
 [Identify if the Migration process is to be implemented in phases or stages, and if so, identify
which components will undergo Migration in each phase.]

 [Identify and describe parts of the Migration process that will be performed manually.]
 [Identify criteria for a Go/No-Go decision if challenges are encountered with the EMR
migration.]
 [Identify whether data availability and use should be limited during the Migration process.]
 [Describe security and privacy controls required for the Migration process.]
 [Describe the disposition of obsolete or unused data that is not converted]
 [Are both the new and old EMRs available after the EMR Migration? (This allows staff can
gradually get accustomed to the new EMR. If some data is missing or if the staff is unfamiliar
with a workflow, they can easily revert to the old EMR to verify.)]
 [Outline the plan for the transition of the practice during the migration including practice staff
schedules, practice capacity, patient appointments and other logistics].
 [Consider setting aside time before the practice opens for staff to get comfortable with logging
in, looking at charts and handling incoming calls.]
SIGN CONTRACT WITH VENDOR

[Review the approval section at the bottom of this document as well as Section 2.7 of the EMR and
Data Migration Plan]
4.0 SAMPLE MIGRATION SCHEDULE
[Outline a schedule of Migration activities, which have to be completed by your practice, the EMR vendor and any other contributors. Show
the required tasks in chronological order, with beginning and ending dates of each task, the key person(s) responsible for the task,
dependencies, and milestones. If appropriate, tables and/or graphics may be used to present the schedule. Ensure that this information is
appropriately integrated into the overall project schedule. The schedule should be as comprehensive as possible; however, the schedule may
be revised as needed. Rather than providing this schedule in the table below, the schedule may be added as an Appendix and may be
developed in a project management too such as Microsoft Project.]
Table 1 Migration Schedule

Task # Task Description Begin Date End Date Key Person(s) Responsible Dependencies Milestone
<task #> <task description> <mm/dd/yy> <mm/dd/yy> <name(s)> <task #(s)> <Yes/No>
Data Migration Plan Template (V1.0) Page 14 of 35

5.0 IMPLEMENTATION AND DATA MIGRATION GO-LIVE
TRAINING SUPPORT
 [Identify the training requirements and allocations for your practice]
 [Schedule first training session]
 [Schedule second training session]
 [Schedule third training session]
 [Will additional training time be required?]
PREPARE FOR IMPLEMENTATION

[Identify and document tasks to prepare your practice for the final migration]
 [Documents the login information, passwords and other data for all practice staff using the
EMR
 [Begin to populate the issue log checklist in Appendix D]
Prerequisites
 [Describe all preparatory and/or initiation processes that must be completed prior to data
Migration. Describe specific data preparation requirements].
Backup Strategy
 [Describe how the source EMR and target data will be created and managed prior to any
manipulation or migration].
 [Also, describe a schedule for backups that may occur incrementally while preparing, moving,
and manipulating the data.]
DATA QUALITY ASSURANCE AND MAPPING

Provide a high-level mapping of the data and data types to be converted or migrated to the new
system (e.g., the amount, type, and quality of the data; the original and target sources and formats;
and any cross-reference complexities.)]
Data Migration Plan Template (V1.0)
Page 15 of 35
DATA MIGRATION INSPECTION CATEGORIES
Category OMD Spec Notes

1 Patient Demographics Y
2 Family History Y
3 Past Health Y
4 Problem List Y
5 Risk Factors Y
6 Allergies and Adverse Reactions Y
7 Medications and Treatments Y
8 Immunizations Y
9 Labs Results Y
 CML
 Gamma-Dynacare
 Lifelabs
 Alpha
10 Appointments Y
 Past to chart
 Future to chart
 Future to Provider Schedule
11 Physician Notes (Pt encounters) Y
12 Reports Received (attachments) Y
13 Care Elements (height, weight, Y
smoker status, bp, etc.)
14 Alerts
15 Requests: labs, referrals, forms, etc. N
16 Drawings / sketches N
17 Forms: Antenatal, Rourke, etc. N
18 Address Book: N
 Physicians
 Pharmacies
 3rd party
 Insurance
19 Billing N
TEST FIRST DATA EXTRACT

 [Place request for first data extract from old EMR vendor].
Page 16 of 35
 [Identify the types of data quality problems that may occur, including but not limited to the
following considerations:
 [Data that will be migrated over].

 [Data that may not be migrated over].
 data redefinitions (e.g., changes in patient data such as dates and measurement values);
 garbled content (e.g., multiple uses for a single field, freeform text values, corrupted data,
un-initialized data);
 missing data;
 Describe the strategy to be used to ensure data quality before and after all data Migrations.
 Describe the manual and/or automated controls and methods to be used to validate the
Migration and to ensure that all data intended for Migration have been converted.
 Describe the process for data error detection and correction, and the process for resolving
anomalies and any associated costs.]
Page 17 of 35
VALIDATE SECOND DATA EXTRACT

This step requires the use of an issue log, a sample of which can be found in Appendix E.
 [Provide a cross reference of the input (source) data that is to be converted to the resultant
output (target) data. Provide transformation/cleansing rules for each data element and any
other additional considerations.
 Use the Issue Log can be used to record data quality challenges as you come across them.
 Use the Issue Log to outline issues that can be cleared up
 Use the Issue Log to outline issues that cannot be cleared up and the course of action for such.
 Translation of literal value(s) to literal value(s)
 Default null to literal value
 Empty field processing (i.e., null to space or space to null)
 Formulas (i.e., simple equations and mathematical expressions)]
MIGRATE THE FINAL DATA EXTRACT

 [Address and outline any outstanding issues in the issue log].
 [Outline the plan for the transition over to the new EMR. Please refer to Section 3.5 of the
EMR and data migration guide for additional information].
 [Summarize what went well and what did not go as well with the migration].
 [Schedule a date for the close-out meeting].
 [Maintain a record of the total number of records extracted from the old EMR and the number
brought over to the new EMR].
 [Organize and schedule the sign off and a conference call or meeting to discuss the outcomes
of the migration with stakeholders].
Page 18 of 35
6.0 APPENDIX A: EMR AND DATA MIGRATION PLAN

APPROVAL/SIGN OFF
The undersigned acknowledge they have reviewed the EMR and Data Migration Plan and
authorize the project. Changes to this Data Migration Plan will be coordinated with and
approved by the undersigned or their designated representatives.
[List the individuals whose signatures are required. Examples of such individuals are Lead
Physician and Project Manager(s). Add additional lines for signature as necessary. Although
signatures are desired, they are not always required to move forward with the EMR migration.]
Signature: Date:
Print Name:
Title:
Role:
Signature: Date:
Print Name:
Title:
Role:
Signature: Date:
Print Name:
Title:
Role:

7.0 APPENDIX B: REFERENCES
[Insert the name, version number, description, and physical location of any documents
referenced in this document. Add rows to the table as necessary.]
The following table summarizes the documents referenced in this document.
Document Name and Description Location

Version
<Document Name and [Provide description of the <URL or Network path where
Version Number> document] document is located>

8.0 APPENDIX C: KEY TERMS
[Insert terms and definitions used in this document. Add rows to the table as necessary].
The following table provides definitions for terms relevant to this document.
Term Definition
[Insert Term] [Provide definition of the term used in this document.]

9.0 APPENDIX D: SAMPLE USER SCENARIO FOR VENDOR

DEMONSTRATIONS
[The text below is a sample (optional) template provided courtesy of the Summerville Family Health
Team. You may choose to maintain this section as a separate document, while you coordinate EMR
functional demonstrations with prospective EMR vendors. Please refer to Section 2.2 of the EMR and
Data Migration guide for additional information. The intent is that this document will be prepared
and sent to the prospective vendors in advance of the demonstrations].
Instructions for Vendors
Thank you for responding to our RFP and committing to your presentation and demonstration on
<date>. The location of the event will be: <practice address>.
This document will assist you in your preparations for the presentation/product overview and
scenario based demonstration. As we have mentioned previously, this evaluation process is seen as
extremely important to the Summerville Family Health Team. The entire selection team will attend the
demonstrations. Participants will include physicians, nurse practitioners, nursing, allied health
professionals, and administrative staff.
Vendor Demonstrations Format
Part 1 - Formal Presentation and Product Demonstration

Vendors are asked to prepare a 45 minute formal presentation and product overview. The formal
presentation/product overview will:
 Describe company profile

 Highlight Ontario experience
 Describe at a high level the solution proposed for Summerville
 Review partners providing additional services (if applicable)
 Future product roadmap
 Provide a brief general overview and demonstration of the EMR product (bearing in mind that
the scenario below is extensive)
Part 2 – Scenario based demonstration
A 120 minute scenario based demonstration along with question and answer will follow the
presentation. You will find the detailed user scenario below (page 4). To ensure the demonstration is
as effective as possible, vendors are asked to:

 Review demonstration data below (page 4) and ensure that data has been input into your product
to accurately reflect the scenario so that we can complete the scenario properly.
 Provide any supporting materials you may feel are beneficial to help participants through this
evaluation process
Next Steps
Continue to send any questions regarding this process to:
<Enter practice contact person name and email>
Thank you for your interest and time in responding to our RFP.
User Scenario
Data entered prior to scenario
Providers – 1 reception, 1 nursing, Dr. Schwarz, Dr. Smith

Results - 1 lab result with a Hb of 110 for Dr. Jones
1 scanned in consult note from Gastroenterology for Dr. Jones
Patient’s mother: Sarah Lambert

Address: suite 211 – 190 Main St.
Mississauga, ON
L5L 1T4
Home 905-456-7890
Fatigue order set – CBC, Lytes, Glucose, Cr, B12, TSH, Ferritin, Monospot
Data entered during scenario

Patient: Hannah Lambert
DOB 7/7/1950 (age 64)
Cell 416-223-4560
Work 416-597-9045
NOK Jane Green 416-789-0234
Hannah’s Previous Medical History

Crohn’s Disease dx’d age 30
Renal Colic – dx’d 10 years ago

Appendectomy as a child
Hannah’s Family History

Father - Early onset CAD (MI age 45)
Meds: Tramadol 1-2 tabs q4-6h prn started by Dr. Jones 2 years ago
Allergies: Amoxil
Hannah’s screening tests:

Most recent Mammo was Feb. 2, 2011
Most recent PAP was November 23, 2013
User Scenario: New Patient to the Practice
Hannah Lambert has moved to Mississauga to live with her mother, Sarah Lambert. Hannah has been
‘feeling down’ lately and is wondering if an antidepressant medication might help. Sarah’s doctor, Dr.
Schwarz, has agreed to take on Hannah as a new patient.
Hannah calls Summerville to set up an appointment. The receptionist gathers the minimum
information required to open a new record. While creating the new record, the receptionist is notified
by the system there is already another Hannah Lambert that is a patient at this practice.
The receptionist recognizes that a longer, 30 minute, appointment is needed (the default is a 10
minute appointment slot). Hannah tells the receptionist that she is only available Tuesday morning
and Wednesday afternoons. The receptionist finds the next available appointment meeting those
criteria and books the patient.
When she arrives at the practice, Hannah stops first at the registration desk where the receptionist
asks Hannah for her demographic information. Hannah states she is living with her mother and the
receptionist uses the address and home phone from the mother’s chart to populate Hannah’s record.
Hannah also provides her work phone and cell phone number as well as a next of kin, her sister Jane.
On saving the information, the receptionist receives a reminder that this patient needs to sign a roster
form and a consent related to storage and release of information. The patient states that she would
like to make sure her ex-boyfriend, Jeff, who is a social worker at another site, CANNOT view her
record. The record is locked down so that Jeff cannot access it.
The clinic nurse now sees on her schedule that the patient is ready to be brought into the exam room.
As this is a new patient, the nurse enters information regarding past medical history, family history,
current meds, risk factors and recent screening tests. (See above for detail). She also enters the
patient’s vitals into the EMR and puts Hannah into Dr Schwarz’s exam room.

Dr. Schwarz opens the patient’s record is notified that the patient is overdue for her mammogram.
Dr. Schwartz talks with Hannah about her symptoms and documents the history in the EMR. She
completes a PHQ-9 score to objectively assess disease severity. Dr Schwartz also uses the “SIGECAPS”
mnemonic to help document the aspects of the mood issue. She asks the patient if she has had any
blood work recently and the patient indicates she shad some done at a walk in clinic last month. Dr
Schwarz queries OLIS to retrieve the lab results. (NB: We recognize that this query cannot actually be
executed but we would like to see the process for querying OLIS)
Dr. Schwartz makes a diagnosis of depression and enters it into the EMR. She considers treatment and
decides to access the CANMAT guidelines for treatment of Depressive Disorders. Dr. Schwarz counsels
Hannah about her depression and prescribes a 1 month supply of Paxil 10mg daily for 1 week then
increase to 20 mg daily thereafter. Dr. Schwarz reads the drug interaction info between Paxil and
Tramadol and overrides it. Dr. Schwarz makes a referral to the Summerville FHT ‘Manage your Mood’
program and to a community Psychiatrist Dr. Jones. . He includes the chart note, the CPP and any
investigations with the referral to Dr. Jones. Dr. Schwartz sends a task to Reception to book the
appointments.
Dr. Schwarz determines that the patient needs to be off work for the next 2 weeks. The patient
advises Dr. Schwarz that she needs a note for work regarding the absence. The clinic policy is to
charge $20 for this. Dr. Schwarz creates the work note and reception is notified to invoice the patient.
Hannah asks Dr. Schwarz for a refill of her Tramadol. She mentions that she has had some fatigue
since starting it and Dr. Schwarz checks the product monograph to see if this is a common side effect.
Dr. Schwarz shows the patient a pain scale and records the patient’s pain level. She also orders her
standard ‘fatigue’ order set (see below). A patient handout authored by Dr. Schwarz on depression is
printed out for the patient.
Dr. Schwarz advises the patient she is overdue for her Mammogram and orders the Mammogram.
Dr. Schwarz bills an A007. The EMR reminds Dr. Schwarz that a roster code Q200 and a new pt fee
Q013 have not been billed. Dr. Schwarz orders these.
Dr. Schwarz recommends appointments be made to follow up with the NP and with the social worker.
The patient requests that these be made on the same day if possible to minimize time off work. The
patient returns to Reception who books the appointments with NP and SW.
Over lunch, Dr. Schwarz reviews some new lab results in her INBOX. One result shows hemoglobin of
110. Dr Schwarz wants to determine if the anemia is new or chronic. She also reviews a consult note
from the Gastroenterologist which was received by mail and scanned into the EMR. Today, Dr,

Schwarz is covering for Dr. Smith and she checks his INBOX to review his results. She signs off a lab
result of Dr. Smith’s.
Finally, Dr. Schwarz wants to know how she is doing in terms of her mammogram screening rates for
her practice. She runs a report to identify all eligible patients who are overdue for their mammograms
as she wants to contact these patients to have the test completed.
NB: Please see the table below to indicate objectives of each portion and vendor notes.

Scenario section Narrative Objectives Notes to Vendors

Background Hannah Lambert has moved to  See data to support
Mississauga to live with her scenario section above
mother, Sarah Lambert. Hannah
has been ‘feeling down’ lately and
is wondering if an antidepressant
medication might help. Sarah’s
doctor, Dr. Schwarz, has agreed
to take on Hannah as a new
patient.
Opening a new chart Hannah calls Summerville to set  Demonstrate minimum data
up an appointment. The to open a new record
receptionist gathers the minimum  Demonstrate duplicate
information required to open a record checking and
new record. While creating the notification
new record, the receptionist is
notified by the system there is
already another Hannah Lambert
that is a patient at this practice.
Booking an appointment The receptionist recognizes that a  Demonstrate booking a non- Vendor may want to
longer, 30 minute, appointment is default appointment type indicate if criteria sets
needed (the default is a 10 minute  Demonstrate searching for can be stored and quickly
appointment slot). Hannah tells an appointment that meets re-run (find next available
the receptionist that she is only specific criteria evening appointment for a
available Tuesday morning and specific provider?)
Wednesday afternoons. The
receptionist finds the next
available appointment meeting
those criteria and books the
patient.
Arriving a new patient When she arrives at the practice,  Demonstrate use of family If health card swipe and
Hannah stops first at the member’s info to rapidly validation cannot be
registration desk. The health card populate new patient’s chart performed in demo
is swiped and validated. The  Demonstrate entry of environment then
receptionist asks Hannah for her additional demographic info describe the process
demographic information. If the EMR has a special
Hannah states she is living with section for advanced
her mother and the receptionist directives please highlight
uses the address and home phone this
from the mother’s chart to
populate Hannah’s record.
Hannah also provides her work
phone and cell phone number as
well as a next of kin, her sister
Jane. She also advises the
receptionist that she is POA for
her mother and requests that this
be added to her mother’s record.

Notification and privacy On saving the information, the  Demonstrate Vendor may wish to
receptionist receives a reminder reminders/alerts for mention other ways chart
that this patient needs to sign a reception on saving may be locked down (by
roster form and a consent related registration data role, by data type, other)
to storage and release of  Demonstrate process to
information. The patient states apply patient privacy
that she would like to make sure requests by individual user
her ex-boyfriend, Jeff, who is a
social worker at another site,
CANNOT view her record. The
record is locked down so that Jeff
cannot access it.
Viewing the schedule The clinic nurse now sees on her  Demonstrate how patient Vendor may want to
schedule that the patient is ready state is reflected on schedule indicate all the state
to be brought into the exam room changes (booked, arrived,
in room, etc….)
Populating the CPP As this is a new patient, the nurse  Demonstrate how previous See above for detail
enters information regarding past medical, surgical and family regarding values to be
medical history, family history, hx as well as meds, risk loaded
current meds, risk factors and factors and previous
recent screening tests. (See above preventative care screening
for detail). She also enters the maneuvers are entered into
patient’s vitals into the EMR and the CPP
puts Hannah into Dr Schwarz’s
exam room.
Decision support Dr. Schwarz opens the patient’s  Demonstrate alerts and/or
record is notified that the patient visual indicators on opening
is overdue for her mammogram. a chart
Encounter capture Dr. Schwartz talks with Hannah  Utilize a standardized

about her symptoms and scoring sheet for symptom
documents the history in the EMR. scoring
She completes a PHQ-9 score to  Utilize a acronym to support
objectively assess disease severity. documentation
Dr Schwartz also uses the
“SIGECAPS” mnemonic to help  Demonstrate multiple modes
document the aspects of the mood of capturing encounter
issue. information (templates,
canned text, free text, other)
 Demonstrate how an inter-
disciplinary note is captured

OLIS Integration She asks the patient if she has had  Demonstrate how OLIS is We do NOT expect a
any blood work recently and the queried query to be actually
patient indicates she shad some submitted but describe
done at a walk in clinic last how results return ( how
month. Dr Schwarz queries OLIS quickly, into chart or into
to retrieve the lab results. (NB: INBOX or both, are
We recognize that this query results trendable with
cannot actually be executed but private lab results etc…)
we would like to see the process
for querying OLIS)
Entering a new Dr. Schwartz makes a diagnosis of  Demonstrate how new dx Highlight coding options
Diagnosis depression and enters it into the are entered and naming options if any
EMR. (I.e. can different names
map to same code, can
different coding systems
be used)
Evidence based care She considers treatment and  Demonstrate how guidelines If guidelines can be
decides to access the CANMAT can be accessed from EMR embedded (not just linked
guidelines for treatment of to) please describe how
Depressive Disorders. this works
Write a prescription Dr. Schwarz counsels Hannah  Demonstrate entry of a May want to demonstrate
about her depression and medication writing rx from favorite
prescribes a 1 month supply of  Describe use of ‘favorite list and writing rx from
Paxil 10mg daily for 1 week then medication lists’ that may be full reference list of meds
increase to 20 mg daily thereafter. used for this and how they
are edited
Drug-drug interactions Dr. Schwarz reads the drug  Demonstrate how a drug- Optional : Describe if
and override interaction info between Paxil and drug interaction is indicated user can turn off a
Tramadol and overrides it. to the user particular drug-drug
She creates a narcotic contract  Demonstrate how the interaction so that it no
and pt signs it. interaction is overridden if longer fires an alert
required Describe how narcotic
contract can be completed
 Demonstrate how to
create/refill a controlled Advise users if drug-
substance prescription disease interactions are
which meets legislative and fired as well?
college requirements
 Describe how narcotic
contract can be completed
Create referrals Dr. Schwarz makes a referral to  Demonstrate both internal
the Summerville FHT ‘Manage (within the FHT) and
your Mood’ program and to a external (outside the FHT)
community Psychiatrist Dr. Jones. referrals
He includes the chart note, the  Demonstrate how to edit the
CPP and any investigations with referral note and add other
the referral to Dr. Jones. chart information to the
external referral

Creating a task Dr. Schwartz sends a task to  Demonstrate how task is If this is automatically
Reception to book the created and sent to another done as part of creating
appointments. user the referral please advise
Creating a work note Dr. Schwarz determines that the  Demonstrate how work Highlight any automation
and invoicing the patient patient needs to be off work for the notes are created in the process (i.e. can
next 2 weeks. The patient advises  Demonstrate how reception creating the note
Dr. Schwarz that she needs a note is notified of the charge automatically also create
for work regarding the absence. the invoice?:)
The clinic policy is to charge $20  Demonstrate how reception
for this. Dr. Schwarz creates the creates the invoice
work note and reception is notified
to invoice the patient.
Refill request – pt Hannah asks Dr. Schwarz for a  Demonstrate how to refill a Comment on how the
initiated refill of her Tramadol medication from the med list process differs when
request is pharmacy
initiated
Review drug monograph She mentions that she has had  Demonstrate access to a
some fatigue since starting it and medication monograph
Dr. Schwarz checks the product
monograph to see if this is a
common side effect.
Graphics for Dr. Schwarz shows the patient a  Demonstrate use of visual
documentation pain scale and records the analogue pain scale to
patient’s pain level. document intensity of pain
Order sets She also orders her standard  Demonstrate how several Vendor may choose to
‘fatigue’ order set (see below) test can be ordered in a describe at a high level
group whether order sets can be
made at a user, site or
enterprise level
Patient handouts A patient handout authored by Dr.  Demonstrate finding and Mention what formats are
Schwarz on depression is printed printing patient information supported
out for the patient.
Order a diagnostic Dr. Schwarz advises the patient  Demonstrate use of an order
imaging test she is overdue for her form to order a diagnostic
Mammogram and orders the imaging test
Mammogram.
Billing entry Dr. Schwarz bills an A007. The  Demonstrate how to order
EMR reminds Dr. Schwarz that a common OHIP codes
roster code Q200 and a new pt fee  Demonstrate billing
Q013 have not been billed. Dr. reminders
Schwarz orders these.

Follow up appointments Dr. Schwarz recommends  Demonstrate how

appointments be made to follow appointments with 2
up with the NP and with the social providers can be
worker. The patient requests that coordinated on same day
these be made on the same day if
possible to minimize time off work.
Dr. Schwarz puts the note on hold
to complete it later. The patient
returns to Reception who books
the appointments with NP and SW.
Results review Over lunch, Dr. Schwarz reviews  Demonstrate how to rapidly Describe how results and
some new lab results that have compare new results to other chart documents
arrived in her INBOX. One result previous could be faxed directly
shows hemoglobin of 110. Dr  Demonstrate how to create from the EMR
Schwarz wants to determine if the a task based on an
anemia is new or chronic. As the abnormal result
anemia is new she sends a note to
the receptionist to recall the
patient.
Scanned document She also reviews a consult note  Demonstrate reviewing a Describe what formats
review from the Gastroenterologist Dr. scanned document are supported
Smith which was received by mail  Demonstrate setting a
and scanned into the EMR. The reminder for a future task
note indicates that a repeat
colonoscopy is due in 3 years. Dr.
Schwarz sets a reminder to book
this in November 2017.
Covering for another Today, Dr, Schwarz is covering  Demonstrate how one Describe what happens to
provider for Dr. Smith and she checks his provider reviews results for the result after Dr.
INBOX to review his results. She another provider who is Schwarz signs off on it.
signs off a lab result of Dr. away Does it remain in Dr.
Smith’s. Smith’s INBOX when he
returns?
Reporting and patient Finally, Dr. Schwarz wants to  Demonstrate how to query a
contact know how she is doing in terms of practice for compliance with
her mammogram screening rates a screening test
for her practice. She runs a report  Demonstrate both canned
to identify all eligible patients who and ad hoc querying if
are overdue for their possible
mammograms as she wants to
contact these patients to have the  Demonstrate or describe
test completed. what options the system has
to contact pts
 Describe and/or
demonstrate if patient
portals or secure email can
be used for the recall task
Other questions you may be asked by users at the demonstration:

1. Demonstrate the level of integration between the clinical management system and office productivity tools (e.g., word
processing, spreadsheet accounting, email). For example:
 Mail merge patient and physician information into a word processing document. (This may have already been
demonstrated by the reference or recall letters.)
 Attach a word processing document within a patient’s electronic medical record.
 Move accounting information into spreadsheet applications.
2. Demonstrate how the CMS application supports both internal reporting and exporting of data
3. Demonstrate what offerings the vendor has in the way of patient access (e.g. can a patient book their own
appointments online? Can they see their lab results?)

10.0 APPENDIX E: SAMPLE ISSUE LOG
[These are two sample issue-logs to gather, document and respond to challenges encountered during the EMR migration. This template can be
replicated in a “Microsoft Excel” document for better portability and ease of use. Populate this table as required to record new EMR and data issues
as they occur].
SAMPLE 1
Issue ID
Numbe Area of Business Business Expected Resolution Suggested
r Issue Name EMR Originator Submit Date
Description Priority Status Impact Severity Date Assigned To Solution Progress Comments
001 <text> <text> <text> <text> <text> <text> <text> <text> <text> <text> <text> <text> <text> <text>

SAMPLE 2
Source Data Target Data Transformation/

Source Element Destination Element Cleansing Rules Notes
<Source Location (e.g., <Source Data <Target Location (e.g.,<Target Data Element <Describe data <Describe any timing constraints or anything
System/File/ Database Element Identifier Database Table)> Identifier (e.g., transformation that is to unique about the Migration.>
Table, etc.> (e.g., SSN)> Member ID)> occur, including any data
cleansing.>
Note: Screenshots can also be captured within the issue log to illustrate what the errors or challenges are.



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EMR and Data Migration Plan Template (V1.

Version Implemented Revision Approved Approval Reason

1.0 <Author name> <mm/dd/yyyy> <name> <mm/dd/yyyy> <reason>

[Insert appropriate disclaimer(s)]

How to use this document

1.0 PURPOSE OF THE EMR AND DATA MIGRATION PROJECT PLAN.....................................5

1.0 PURPOSE OF THE EMR AND DATA MIGRATION PROJECT PLAN

 [Insert description of the first objective.]

 [Insert approach for the engagement of practice staff]

 [List patient flow gaps in your practice]

Prepare your data.

Review Privacy and Security Considerations

 [Outline your existing privacy policy and any improvements to be made]

2.1EMR AND DATA MIGRATION SCOPE

ROLES AND RESPONSIBILITIES

 [List the first stakeholder.]

 [Insert description of the first assumption.]

 [Insert description of the first risk.]

3.0 EMR VENDOR SELECTION

EMR SELECTION TEAM

PROSPECTIVE EMR VENDORDEMONSTRATIONS (FUNCTIONAL TESTING)

2 Security – Are you satisfied with the security and privacy?

3 Interoperability – Overall technical effectiveness of OLIS, HRM,

5 Patient appointment and physician scheduling process effectiveness?

6 Billing submission and reconciliation plus Financial reporting

7 Posting scanned documents to patient chart?

8 Training – Overall effectiveness prior to and post Go Live?

9 Implementation – Overall effectiveness, timeliness?

10 Data Migration – Overall effectiveness? What EMR did you migrate

12 Quality of EMR product – Overall quality of the EMR application? Is it

13 Vendor Support – How effective is the vendor in providing support for

14 EMR availability – How available is the EMR? (downtime)

1 Creation of and monitoring Referrals?

2 Preventative Care Management?

3 Medication Management? (Rx, drug interaction, integration with

5 Managing chronic diseases?

6 Teaching Unit Functionality? (support of residents and learners.)

7 Do you have a patient portal? If so, how effective is it?

8 Communication of patient activities through EMR

TEST SAMPLE DATA EXTRACTS AND SCENARIOS

VENDOR SUBMITS PROPOSAL TO YOUR PRACTICE

 [Hardware needed for servers, workstations, printers, keyboards and peripherals]

Service and Support

Third Party Contracts

Migration Approach and Transition Plan

which components will undergo Migration in each phase.]

SIGN CONTRACT WITH VENDOR

4.0 SAMPLE MIGRATION SCHEDULE

Table 1 Migration Schedule

Data Migration Plan Template (V1.0) Page 14 of 35

5.0 IMPLEMENTATION AND DATA MIGRATION GO-LIVE

PREPARE FOR IMPLEMENTATION

DATA QUALITY ASSURANCE AND MAPPING

Data Migration Plan Template (V1.0)

DATA MIGRATION INSPECTION CATEGORIES

Category OMD Spec Notes

TEST FIRST DATA EXTRACT

 [Data that will be migrated over].

Data Migration Plan Template (V1.0)