Chapter 8: What We Preserve vs What Starts Fresh
Chapter Overview
This chapter clears up a common fear: “Will we lose our old visit notes?”
No. We preserve clinical history. What we avoid is copying Axxess’s messy Schedule Activity table row-by-row into live Betasky workflow.
8.1 The important distinction
| What it means | |
|---|---|
| We preserve | Visit note PDFs, OASIS PDFs, POC PDFs, and other chart documents — stored on the episode and searchable |
| We register visits when we can | When a PDF is a visit or assessment type, Betasky reads the document and creates a completed archive visit linked to that PDF (date, visit type, clinician when detected) |
| We do not bulk-import | Thousands of Axxess Schedule Activity rows as editable live visits — duplicates, missed visits, and illogical dates would break Betasky episode and QA rules |
Your old charts are not thrown away. They are archived properly, and visit-level history appears on the episode timeline when the PDF supports it.
8.2 What we preserve (archive + visit registration)
| Legacy document (Axxess print) | What Betasky does |
|---|---|
| SN / HHA / LVN / therapy visit notes | PDF stored on episode; archive visit registered when date and type are extracted |
| OASIS SOC, Recert, ROC, Discharge, Transfer, Death | PDF stored; archive assessment visit registered when extractable |
| Plan of Care, Physician Order, HHA Care Plan | PDF stored on episode (document archive) |
| Medication Profile | Structured med list for active patients (Tier A) + PDF reference |
| Discharge / Transfer Summary | PDF stored on episode |
You print these from Patient Chart → Schedule Activity (printer icon on each row) and from Quick Links (Medication Profile, POC Summary).
8.3 What starts fresh or stays out of scope
| Legacy data | Treatment |
|---|---|
| Axxess Schedule Activity imported row-by-row | No — curated instead; PDFs preserved individually |
| Future “Not Yet Started” visits in Axxess | Reschedule in Betasky — not imported as live visits |
| Paid claims and remittance history | Billing starts fresh in Betasky |
| Legacy task lists and alerts | Not portable |
| Old OASIS reopened as editable new assessments | Archive PDF + archive visit only — staff start fresh OASIS on go-live episode |
| Every physician order ever written | Current orders (Tier A) + archive PDFs |
| Axxess passwords | New Betasky credentials |
| Custom Axxess forms | Rebuilt as Betasky forms going forward |
8.4 Why Axxess is different
Axxess allows clinical timelines that do not follow Betasky rules — for example Death and Start of Care on the same list while the patient header still says Active. Betasky enforces episode logic.
So for each patient we curate go-live truth (Chapter 12) and archive everything else as PDFs — including visit notes — rather than copying chaos into live workflow.
8.5 Typical agency scope (illustrative)
For a mid-size agency, a standard migration often includes:
- Full patient registry (active + discharged)
- Structured data for go-live census (one current episode per active patient)
- Medication lists for active patients
- Historical episodes with PDF archive
- Archive visits registered from uploaded visit and OASIS PDFs
- Forward scheduling built in Betasky after go-live — not bulk-imported from Axxess
Your kickoff call defines exact scope.