Complexity & Backup Delivery Timing Rating System

Leveraging Aesto's experience with over 120 different EHR vendors, our team has categorized the difficulty of extracting discrete clinical data and documents into three levels: Low, Average, and High Difficulty.

Take a look at our ratings for eClinicalWorks (eCW) below, along with the typical turnaround timing for receiving database backups from eCW.

The Aesto team has facilitated migrations for over 100 clients migrating data from eCW. In our experience, we have found that extracting Discrete, Clinical data from eCW is straightforward. However, due to the wide range of document types supported by eCW, converting these documents presents significant challenges.

How to Request a Full SQL Backup from eClinicalWorks

If hosted by eCW, you can request a SQL database backup by submitting a ticket within your eCW portal. 

This option may come at a cost payable to eClinicalWorks. 

eCW will provide you with a formal outline of expectations when the request is submitted. Aesto needs the option entitled One-Time Unencrypted Database Backup, Including Scanned Documents. 

You will be prompted to e-sign your confirmation of the backup requested. After that, an eCW representative will schedule a call to collect the static public IP address for Aesto’s environment where the data will be loaded.

PLEASE NOTE: It is important that you provide eCW with Aesto’s IP Address, not your own. If you provide your own IP Address, the Aesto Team will not be able to access your data.

For assistance with obtaining our IP address, please contact your Aesto Health Project Manager.

eCW’s delivery method for the database backup is through Azure. Once available, the Aesto team will promptly extract your data from Azure.

Aesto Health cannot request a backup from eCW on your behalf, but we are happy to lend our expertise if you need further help. 

How to Extract a Database Backup Using an Onsite Server

If you have direct access to your server, you will need to provide the Aesto team a standard SQL database backup. 

The standard database name for an eCW .bak file is mobiledoc. This backup includes all of the necessary tables for both clinical and financial data. 

Deliverable Considerations

Progress Notes

It is important to be aware that all of eCW’s Progress Notes are encrypted. eCW must decrypt this data to allow the Aesto team access. While there is no additional charge for this service, it does contribute to the typical six to eight-week timeframe for database backup delivery.

PLEASE NOTE: Clients need to ensure that all Encounters are enclosed before the final backup is extracted from eCW. This involves e-signing and locking the Progress Notes within the EHR. If these notes are not locked or closed, they will not be included in the backup from eCW.

Style Sheets

When eCW performs an update, they append the style sheet with a new date. This can result in what appears to be hundreds of style sheets. Some clients have difficulty locating their style sheets folder, which can cause project delays.

The Aesto team has a standard set of scripts that can be run to load a base set of style sheets. This eliminates the need to obtain them from the client or map hundreds of style sheets, streamlining the documentation process.

Potential Risks

Failure to use these scripts can jeopardize a client’s implementation timeline and may lead to incomplete documents. If the client can locate their style sheet folder, providing it to the Aesto team will streamline the process. The Aesto team will still need to remove the appended dates.

Previously Migrated Documents

Questions to Ponder: 

• Have you previously migrated data to eCW?
• If so, do you prefer the data to be displayed, or is it sufficient to keep a database backup for compliance purposes?

Inconsistencies in style sheets can impact how previously migrated documents are displayed.

To address this, the Aesto team recommends the following:

• Save a Database Copy: To ensure you can reference previously migrated documents if needed, it’s advisable to save a copy of your database.
• RPA for Migrated Documents: RPA (Robotic Process Automation) may be required to rectify the issues. Please note that this can increase the overall project cost.

Lab Results

Newer versions of eCW and lab interfaces offer enhanced XML formats but may present challenges with discrete data. For example, lab results intended to be displayed as discrete data might not transfer correctly.

Please inform your Aesto team of the eCW version and lab interface version you’re using so we can effectively address any potential issues.

Flowsheets

For OBGYN practices or facilities using flowsheets, these must be migrated as documents to ensure proper display. This process requires the additional cost of Robotic Process Automation (RPA).

Clinical Deliverables NOT Eligible for Import into athenaOne

• Encounters 
• Orders 
• Secure Sticky Notes 
• Diagnostic Imaging 

Document Migration Factors

Converting healthcare documents from legacy EHR systems can be highly complex due to the dispersion of data across multiple systems in different formats and varying definitions.

Patient data can be stored in various locations, including your EHR software, radiology information systems (RIS), pharmacy management systems, and other third-party applications. Some data formats are unique to specific EHR software, leading to compatibility issues during the migration.

Aesto’s document conversion process is integral to the overall strategy for archiving data, ensuring all documents are easily accessible in Aesto’s DataCapture Platform.

Learn more about Aesto’s solutions for overcoming technical challenges with document conversions.

Document Migration Timeline | 8 to 10 Weeks

Take a look at our implementation process specifically for eCW documents.