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NextGen migration data-loss checklist
Migrating to or from NextGen? The data-integrity failure modes are largely EHR-agnostic — but here's what to weight. Verify code-system mapping and C-CDA coded-entry survival.
The seven things that silently break
Structured → unstructured loss High-risk silent loss
Discrete, coded fields (labs, meds, problems) get migrated as scanned PDFs or free text — the values look present but become unqueryable and uncomputable. This can also implicate information-blocking …
Code-system mapping gaps High-risk silent loss
Crosswalking SNOMED CT, ICD-10-CM, RxNorm, LOINC, and CVX between EHRs is where meaning silently shifts: version drift, one-to-many ambiguity, RXCUI≠NDC, retired concepts, and codes landing in the wro…
Allergy & problem-list granularity loss High-risk silent loss
Status and granularity fields default-flatten during migration. A refuted or entered-in-error allergy arriving as 'active', or a resolved problem reappearing as active, is a patient-safety event — not…
Dropped HL7 v2 / FHIR interface feeds High-risk silent loss
Lab (ORU), registration (ADT), radiology, and pharmacy interfaces silently aren't reconnected after cutover — the classic migration failure where the data stops flowing and nobody notices for days.…
Attachment / scanned-document loss Medium-risk silent loss
Document metadata migrates but the binary doesn't: broken or relative `attachment.url` pointers are the classic silent loss. For C-CDA, teams keep the human-readable narrative but lose the coded entri…
Audit-trail / access-log loss Medium-risk silent loss
Legacy access histories and audit logs are dropped at cutover — but the HIPAA 6-year retention obligation follows the DATA, not the system. You must still be able to produce historical access logs for…
USCDI / C-CDA portability completeness High-risk silent loss
Use the cert-named US Core / USCDI version as the minimum completeness checklist. Anything in USCDI that doesn't round-trip is, by definition, silent loss of portable data.…
Read the full NextGen checklist →Validation toolkit