Joshua Halpern cut
As soon as the new (and empty) computerised system is turned on no more maintenance is done to the legacy system. No maintenance means no cost.
All new data is recorded in the new system, along with the fact any legacy information exists.
Workflow would be:
1) Patient asks for an appointment. 2) Receptionist locates patient using computer system. 3) If patient not found, check legacy system and create new computer record. 4) Put a mark on the legacy file to avoid any possibility of duplication 5) Use the computer system to make the appointment.
At this point the computer has a minimal patient record with one appointment and a field indicating legacy records exist. (or don't if the patient is new)
At the appointment time, which could be days, weeks or months later:
1) Computer generates appointment list, flagging legacy record instances 2) Computer prompts receptionist to pull legacy records (if any) 3) Receptionist locates and delivers legacy record to doctor (if any) 4) Doctor reviews patient history on-screen and on paper if necessary 5) Doctor calls for and treats patient 6) Doctor updates patient's computer record only 7) Receptionist collects and refiles unchanged legacy record (if any)
The cost of maintaining the static legacy system is trivial and declines. As more and more data is accumulated in the computer system the value it adds to the workflow increases.
Transfer of data from legacy system to computer can be done by clerical and reception staff during idle time. Even if this takes years the system will deliver benefits from day one at zero cost beyond its purchase price and maintenance contract fee.
This procedure neatly sidesteps a common excuse for not moving to a computer system immediately. The excuse usually stems from resistance to change rather than genuine concerns over cost or work practice. As such the advice may well be greeted with a sullen look and silence. Just remember, you can only lead a horse to water, you can't make it drink.
DM personal opinion only