{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,23]],"date-time":"2026-04-23T05:37:05Z","timestamp":1776922625282,"version":"3.51.2"},"reference-count":53,"publisher":"Georg Thieme Verlag KG","issue":"05","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Appl Clin Inform"],"published-print":{"date-parts":[[2020,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Objective\u2003We address the challenges of transitioning from one electronic health record (EHR) to another\u2014a near ubiquitous phenomenon in health care. We offer mitigating strategies to reduce unintended consequences, maximize patient safety, and enhance health care delivery.<\/jats:p><jats:p>\n          Methods\u2003We searched PubMed and other sources to identify articles describing EHR-to-EHR transitions. We combined these references with the authors' extensive experience to construct a conceptual schema and to offer recommendations to facilitate transitions.<\/jats:p><jats:p>\n          Results\u2003Our PubMed query retrieved 1,351 citations: 43 were relevant for full paper review and 18 met the inclusion criterion of focus on EHR-to-EHR transitions. An additional PubMed search yielded 1,014 citations, for which we reviewed 74 full papers and included 5. We supplemented with additional citations for a total of 70 cited. We distinguished 10 domains in the literature that overlap yet present unique and salient opportunities for successful transitions and for problem mitigation.<\/jats:p><jats:p>\n          Discussion\u2003There is scant literature concerning EHR-to-EHR transitions. Identified challenges include financial burdens, personnel resources, patient safety threats from limited access to legacy records, data integrity during migration, cybersecurity, and semantic interoperability. Transition teams must overcome inadequate human infrastructure, technical challenges, security gaps, unrealistic providers' expectations, workflow changes, and insufficient training and support\u2014all factors affecting potential clinician burnout.<\/jats:p><jats:p>\n          Conclusion\u2003EHR transitions are remarkably expensive, laborious, personnel devouring, and time consuming. The paucity of references in comparison to the topic's salience reinforces the necessity for this type of review and analysis. Prudent planning may streamline EHR transitions and reduce expenses. Mitigating strategies, such as preservation of legacy data, managing expectations, and hiring short-term specialty consultants can overcome some of the greatest hurdles. A new medical subject headings (MeSH) term for EHR transitions would facilitate further research on this topic.<\/jats:p>","DOI":"10.1055\/s-0040-1718535","type":"journal-article","created":{"date-parts":[[2020,11,12]],"date-time":"2020-11-12T00:02:19Z","timestamp":1605139339000},"page":"742-754","source":"Crossref","is-referenced-by-count":72,"title":["Transitions from One Electronic Health Record to Another: Challenges, Pitfalls, and Recommendations"],"prefix":"10.1055","volume":"11","author":[{"given":"Chunya","family":"Huang","sequence":"additional","affiliation":[{"name":"Geisinger Commonwealth School of Medicine, Scranton, Pennsylvania, United States"},{"name":"Department of Anesthesiology and Perioperative Medicine, University of Louisville School of Medicine\u2014Louisville, Kentucky, United States"}]},{"given":"Ross","family":"Koppel","sequence":"additional","affiliation":[{"name":"Deparments of Biomedical Informatics and of Sociology, University of Pennsylvania, Philadelphia, Pennsylvania, United States"},{"name":"Department of Biomedical Informatics, University at Buffalo (SUNY), Buffalo, New York, United States"}]},{"suffix":"III","given":"John D.","family":"McGreevey","sequence":"additional","affiliation":[{"name":"Division of General Internal Medicine, Section of Hospital Medicine, Perelman School of Medicine at the University of Pennsylvania, University of Pennsylvania Health System, Institute for Biomedical Informatics, University of Pennsylvania, Philadelphia, Pennsylvania, United States"}]},{"given":"Catherine K.","family":"Craven","sequence":"additional","affiliation":[{"name":"Department of Population Health Science and Policy, Clinical Informatics Group, IT Department, Mount Sinai Health System, Institute for Healthcare Delivery Science, Icahn School of Medicine at Mount Sinai, New York, New York, United States"}]},{"given":"Richard","family":"Schreiber","sequence":"additional","affiliation":[{"name":"Physician Informatics and Department of Medicine, Geisinger Holy Spirit, Geisinger Commonwealth School of Medicine, Camp Hill, Pennsylvania, United States"}]}],"member":"194","published-online":{"date-parts":[[2020,11,11]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"S13","DOI":"10.1016\/j.pmrj.2017.01.009","article-title":"Electronic health record transition considerations","volume":"9","author":"L E Penrod","year":"2017","journal-title":"PM R"},{"issue":"01","key":"ref2","first-page":"40","article-title":"Making the CEHRT Switch: EHR upgrade required for incentive payment programs","volume":"115","author":"S Price","year":"2019","journal-title":"Tex Med"},{"key":"ref3","first-page":"742","article-title":"Characteristics associated with hospital health IT vendor switching and dropping","volume":"2011","author":"E J Lammers","year":"2011","journal-title":"AMIA Annu Symp Proc"},{"issue":"01","key":"ref4","first-page":"13","article-title":"EHR switch survey: responses from 305 family physicians","volume":"22","author":"K G Adler","year":"2015","journal-title":"Fam Pract Manag"},{"issue":"03","key":"ref5","doi-asserted-by":"crossref","first-page":"401","DOI":"10.1136\/amiajnl-2011-000333","article-title":"Transitioning between ambulatory EHRs: a study of practitioners' perspectives","volume":"19","author":"S O Zandieh","year":"2012","journal-title":"J Am Med Inform Assoc"},{"key":"ref6","first-page":"S48","article-title":"Electronic health records: then, now, and in the future","volume":"Suppl 1","author":"R S Evans","year":"2016","journal-title":"Yearb Med Inform"},{"key":"ref7","first-page":"1191","article-title":"Providers' expectations of ambulatory electronic health records (EHRs)","author":"S O Zandieh","year":"2008","journal-title":"AMIA Annu Symp Proc"},{"issue":"01","key":"ref10","first-page":"56","article-title":"EHR DO-OVER? Providers begin replacing electronic patient record systems","volume":"25","author":"L Wilson","year":"2017","journal-title":"Health Data Manag"},{"issue":"19","key":"ref11","first-page":"10","article-title":"Vanderbilt is a case study for the dreaded EHR conversion","volume":"47","author":"D Barkholz","year":"2017","journal-title":"Mod Healthc"},{"key":"ref13","first-page":"209","volume-title":"Exploring HIT Contract Cadavers to Avoid HIT Managerial Malpractice","author":"H W Jones","year":"2019","edition":"3rd ed"},{"key":"ref14","first-page":"101","volume-title":"Great promises of healthcare information technology deliver less","author":"R Koppel","year":"2016"},{"issue":"01","key":"ref17","doi-asserted-by":"crossref","first-page":"186","DOI":"10.1016\/j.socscimed.2012.03.006","article-title":"Assessment of the sunk-cost effect in clinical decision-making","volume":"75","author":"J A Braverman","year":"2012","journal-title":"Soc Sci Med"},{"key":"ref18","doi-asserted-by":"crossref","first-page":"e48","DOI":"10.1055\/s-0040-1710007","article-title":"Data migration: a thorny issue in electronic health record transitions\u2014case studies and review of the literature","volume":"04","author":"R Schreiber","year":"2020","journal-title":"ACI Open."},{"issue":"04","key":"ref19","doi-asserted-by":"crossref","first-page":"367","DOI":"10.4338\/ACI-2012-04-R-0014","article-title":"Transitioning from a legacy EHR to a commercial, vendor-supplied, EHR: one academic health system's experience","volume":"3","author":"A Gettinger","year":"2012","journal-title":"Appl Clin Inform"},{"issue":"05","key":"ref20","doi-asserted-by":"crossref","first-page":"572","DOI":"10.1093\/jamia\/ocy007","article-title":"Changes in hospital bond ratings after the transition to a new electronic health record","volume":"25","author":"D McEvoy","year":"2018","journal-title":"J Am Med Inform Assoc"},{"issue":"10","key":"ref22","doi-asserted-by":"crossref","first-page":"999","DOI":"10.1093\/jamia\/ocz092","article-title":"Electronic health records systems and hospital clinical performance: a study of nationwide hospital data","volume":"26","author":"N Yuan","year":"2019","journal-title":"J Am Med Inform Assoc"},{"issue":"06","key":"ref23","doi-asserted-by":"crossref","first-page":"1751","DOI":"10.1111\/1475-6773.12406","article-title":"EHR Adoption and Hospital Performance: Time-Related Effects","volume":"50","author":"J Adler-Milstein","year":"2015","journal-title":"Health Serv Res"},{"issue":"10","key":"ref24","doi-asserted-by":"crossref","first-page":"1109","DOI":"10.1093\/jamia\/ocz098","article-title":"Six habits of highly successful health information technology: powerful strategies for design and implementation","volume":"26","author":"J M Ray","year":"2019","journal-title":"J Am Med Inform Assoc"},{"issue":"11","key":"ref25","doi-asserted-by":"crossref","first-page":"870","DOI":"10.1136\/bmjqs-2015-004323","article-title":"Identifying patient safety problems associated with information technology in general practice: an analysis of incident reports","volume":"25","author":"F Magrabi","year":"2016","journal-title":"BMJ Qual Saf"},{"issue":"06","key":"ref27","doi-asserted-by":"crossref","first-page":"1133","DOI":"10.1111\/j.1365-2753.2011.01756.x","article-title":"Satisfaction after the transition between electronic health record systems at six ambulatory practices","volume":"18","author":"E R Pfoh","year":"2012","journal-title":"J Eval Clin Pract"},{"issue":"01","key":"ref28","doi-asserted-by":"crossref","first-page":"489","DOI":"10.1177\/1541931218621112","article-title":"Transitioning from one electronic health record (EHR) to another: a narrative literature review","volume":"62","author":"J J Saleem","year":"2018","journal-title":"Proc Hum Factors Ergon Soc Annu Meet"},{"issue":"S 01","key":"ref29","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1007\/BF03167653","article-title":"\u201cPermanent\u201d records: experience with data migration in radiology information system and picture archiving and communication system replacement","volume":"13","author":"F M Behlen","year":"2000","journal-title":"J Digit Imaging"},{"issue":"03","key":"ref30","doi-asserted-by":"crossref","first-page":"318","DOI":"10.4338\/ACI-2012-03-RA-0006","article-title":"An integrated EHR at Northern California Kaiser Permanente: pitfalls, challenges, and benefits experienced in transitioning","volume":"3","author":"S Bornstein","year":"2012","journal-title":"Appl Clin Inform"},{"key":"ref31","first-page":"288","article-title":"Data migration from operating EMRs to OpenEMR with Mirth Connect","volume":"257","author":"J Lin","year":"2019","journal-title":"Stud Health Technol Inform"},{"issue":"05","key":"ref32","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1007\/s10916-019-1232-6","article-title":"Provider access to legacy electronic anesthesia records following implementation of an electronic health record system","volume":"43","author":"R H Epstein","year":"2019","journal-title":"J Med Syst"},{"issue":"06","key":"ref35","doi-asserted-by":"crossref","first-page":"1060","DOI":"10.1136\/amiajnl-2014-002883","article-title":"Are Meaningful Use Stage 2 certified EHRs ready for interoperability? Findings from the SMART C-CDA Collaborative","volume":"21","author":"J D D'Amore","year":"2014","journal-title":"J Am Med Inform Assoc"},{"issue":"05","key":"ref36","doi-asserted-by":"crossref","first-page":"899","DOI":"10.1093\/jamia\/ocv189","article-title":"SMART on FHIR: a standards-based, interoperable apps platform for electronic health records","volume":"23","author":"J C Mandel","year":"2016","journal-title":"J Am Med Inform Assoc"},{"key":"ref38","first-page":"112","article-title":"Application of Mirth Connect interface integration engine in medical data transmission","volume":"29","author":"Y Yang","year":"2016","journal-title":"Industrial Control Computer."},{"key":"ref39","first-page":"317","article-title":"Automated import of clinical data from HL7 messages into OpenClinica and tranSMART using Mirth Connect","volume":"228","author":"J C Camacho Rodriguez","year":"2016","journal-title":"Stud Health Technol Inform"},{"issue":"02","key":"ref41","doi-asserted-by":"crossref","first-page":"188","DOI":"10.1177\/0009922819892269","article-title":"Effect of an electronic health record transition on the provision of recommended well child services in pediatric primary care practices","volume":"59","author":"G Binney","year":"2020","journal-title":"Clin Pediatr (Phila)"},{"issue":"08","key":"ref42","doi-asserted-by":"crossref","first-page":"539","DOI":"10.1016\/j.ijmedinf.2012.02.010","article-title":"Physician experiences transitioning between an older versus newer electronic health record for electronic prescribing","volume":"81","author":"E L Abramson","year":"2012","journal-title":"Int J Med Inform"},{"issue":"04","key":"ref43","doi-asserted-by":"crossref","first-page":"504","DOI":"10.1016\/j.aorn.2015.01.015","article-title":"DRESSed for failure","volume":"101","author":"N J Girard","year":"2015","journal-title":"AORN J"},{"issue":"07","key":"ref44","doi-asserted-by":"crossref","first-page":"848","DOI":"10.1093\/jamia\/ocy034","article-title":"Transition to a new electronic health record and pediatric medication safety: lessons learned in pediatrics within a large academic health system","volume":"25","author":"K Whalen","year":"2018","journal-title":"J Am Med Inform Assoc"},{"issue":"04","key":"ref45","doi-asserted-by":"crossref","first-page":"581","DOI":"10.1377\/hlthaff.2011.0190","article-title":"\u2018Global trigger tool\u2019 shows that adverse events in hospitals may be ten times greater than previously measured","volume":"30","author":"D C Classen","year":"2011","journal-title":"Health Aff (Millwood)"},{"issue":"01","key":"ref46","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1055\/s-0039-3402715","article-title":"Reducing alert burden in electronic health records: state of the art recommendations from four health systems","volume":"11","author":"J D McGreevey III","year":"2020","journal-title":"Appl Clin Inform"},{"issue":"11","key":"ref47","doi-asserted-by":"crossref","first-page":"1868","DOI":"10.1007\/s11606-018-4415-9","article-title":"Reduced effectiveness of interruptive drug-drug interaction alerts after conversion to a commercial electronic health record","volume":"33","author":"A Wright","year":"2018","journal-title":"J Gen Intern Med"},{"issue":"06","key":"ref48","doi-asserted-by":"crossref","first-page":"755","DOI":"10.1007\/s11606-008-0573-5","article-title":"Challenges to EHR implementation in electronic- versus paper-based office practices","volume":"23","author":"S O Zandieh","year":"2008","journal-title":"J Gen Intern Med"},{"key":"ref49","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1016\/j.jbi.2018.05.018","article-title":"Comprehensive methodology to monitor longitudinal change patterns during EHR implementations: a case study at a large health care delivery network","volume":"83","author":"T K Colicchio","year":"2018","journal-title":"J Biomed Inform"},{"issue":"04","key":"ref50","doi-asserted-by":"crossref","first-page":"9955","DOI":"10.1007\/s10916-013-9955-2","article-title":"EHR implementation in a new clinic: a case study of clinician perceptions","volume":"37","author":"A Noblin","year":"2013","journal-title":"J Med Syst"},{"key":"ref52","first-page":"765","article-title":"Migrating from one comprehensive commercial EHR to another: perceptions of front-line clinicians and staff","volume":"2019","author":"T L Reynolds","year":"2020","journal-title":"AMIA Annu Symp Proc"},{"key":"ref53","doi-asserted-by":"crossref","first-page":"e157","DOI":"10.1093\/jamia\/ocw077","article-title":"Two-year longitudinal assessment of physicians' perceptions after replacement of a longstanding homegrown electronic health record: does a J-curve of satisfaction really exist?","volume":"24","author":"D A Hanauer","year":"2017","journal-title":"J Am Med Inform Assoc"},{"issue":"06","key":"ref54","doi-asserted-by":"crossref","first-page":"867","DOI":"10.1093\/jamia\/ocaa026","article-title":"Is a switch to a different electronic health record associated with a change in patient satisfaction?","volume":"27","author":"F North","year":"2020","journal-title":"J Am Med Inform Assoc"},{"issue":"04","key":"ref55","doi-asserted-by":"crossref","first-page":"753","DOI":"10.1016\/j.ophtha.2012.10.002","article-title":"The impact of an electronic health record transition on a glaucoma subspecialty practice","volume":"120","author":"R R Pandit","year":"2013","journal-title":"Ophthalmology"},{"key":"ref56","first-page":"1318","article-title":"Physician perspectives on training for an EHR implementation","volume":"264","author":"C J Pirtle","year":"2019","journal-title":"Stud Health Technol Inform"},{"issue":"05","key":"ref58","doi-asserted-by":"crossref","first-page":"793","DOI":"10.1016\/j.mayocp.2018.08.036","article-title":"Optimization sprints: improving clinician satisfaction and teamwork by rapidly reducing electronic health record burden","volume":"94","author":"A Sieja","year":"2019","journal-title":"Mayo Clin Proc"},{"issue":"07","key":"ref59","doi-asserted-by":"crossref","first-page":"586","DOI":"10.1093\/jamia\/ocz051","article-title":"Domains, tasks, and knowledge for clinical informatics subspecialty practice: results of a practice analysis","volume":"26","author":"H D Silverman","year":"2019","journal-title":"J Am Med Inform Assoc"},{"issue":"09","key":"ref60","doi-asserted-by":"crossref","first-page":"174","DOI":"10.1007\/s10916-018-1023-5","article-title":"An EPIC switch: observations and opportunities after go-live","volume":"42","author":"K B Johnson","year":"2018","journal-title":"J Med Syst"},{"issue":"01","key":"ref61","doi-asserted-by":"crossref","first-page":"143","DOI":"10.4338\/ACI-2015-12-R-0174","article-title":"The chief clinical informatics officer (CCIO): AMIA task force report on CCIO knowledge, education, and skillset requirements","volume":"7","author":"J Kannry","year":"2016","journal-title":"Appl Clin Inform"},{"issue":"05","key":"ref62","doi-asserted-by":"crossref","first-page":"991","DOI":"10.1093\/jamia\/ocv173","article-title":"A rational approach to legacy data validation when transitioning between electronic health record systems","volume":"23","author":"N M Pageler","year":"2016","journal-title":"J Am Med Inform Assoc"},{"key":"ref64","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1016\/j.ijhcs.2016.09.006","article-title":"Making privacy personal: Profiling social network users to inform privacy education and nudging","volume":"98","author":"P J Wisniewski","year":"2017","journal-title":"Int J Hum Comput Stud"},{"issue":"01","key":"ref68","doi-asserted-by":"crossref","first-page":"92","DOI":"10.4338\/ACI-2013-08-RA-0066","article-title":"CAH to CAH: EHR implementation advice to critical access hospitals from peer experts and other key informants","volume":"5","author":"C K Craven","year":"2014","journal-title":"Appl Clin Inform"},{"key":"ref69","first-page":"123","volume-title":"Committing leadership resources: A CMIO and CPOE governance","author":"G Keenan","year":"2019"},{"issue":"01","key":"ref70","first-page":"7","article-title":"New unintended adverse consequences of electronic health records","author":"D F Sittig","year":"2016","journal-title":"Yearb Med Inform"}],"container-title":["Applied Clinical Informatics"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/s-0040-1718535.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,11,12]],"date-time":"2020-11-12T00:03:09Z","timestamp":1605139389000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/s-0040-1718535"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,10]]},"references-count":53,"journal-issue":{"issue":"05","published-online":{"date-parts":[[2020,10,21]]},"published-print":{"date-parts":[[2020,10]]}},"URL":"https:\/\/doi.org\/10.1055\/s-0040-1718535","relation":{},"ISSN":["1869-0327"],"issn-type":[{"value":"1869-0327","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,10]]}}}