System Conversions

HIS system conversions can put a hospital at risk of significant cash flow slow-downs and begs the question of what to do with the legacy data (due to 10-year data retention requirements).

Traditional options for managing healthcare legacy data all have inherent and significant risks affecting cash flow, effective operation of the new system and the legally required retention of healthcare legacy data. These problems can all be solved with a new but well tested strategy: run the A/R out on the legacy system then migrate active and inactive (historical) data to the DataArk. Read more about DataArk...

Managing Legacy Healthcare Data

Converting Systems Can Create a Legacy Data Conundrum
By Tony Paparella

You've chosen a new HIS, now what do you do with the old data? You want to retire the legacy system, but need to retain the vital account level detail that it holds. Traditional options of full detail conversion, balance forward and A/R run out on the old system all have some advantages but also have significant shortcomings. If not managed right, bills aren't effectively produced from the new system, old A/R is ignored, data is lost and IT costs skyrocket. Managing the legacy data effectively will help maintain cash flow during (and after) the transition to the new system, reduce costs and headaches for the IT department and keep the healthcare provider compliant with Medicare, Medicaid, commercial carrier and Federal data retention requirements. The DataArk Solution is designed to manage all of these issues.

System Conversion and Data Retention Options Summary Matrix

For a more detailed breakdown of System Conversion and Data Retention Options, view this detailed matrix. (The matrix will open in a separate window.)

The Three C's of Legacy Data Management: Compliance, Cashflow and Cost

When evaluating conversion and legacy data options, it's important to weigh the impact on the Three C's: compliance, cash flow and cost.

Compliance: Legacy data must be retained for at least seven years, with some requirements exceeding 10 years. Medicare, Medicaid and commercial carriers require access to HIS data, including payments, adjustments, charges, notes, Medicare Questionnaire, CPT's, DRG's, ICD's, guarantor information -- any data that stands behind an account or will support an audit.

Cash flow can be easily interrupted for any number of reasons: aged accounts aren't properly managed in the new system; aged accounts aren't properly transferred to the new system (Detail Conversion option). Avoiding cash flow restrictions during a conversion should be strongly considered when selecting a conversion option.

Costs associated with Conversions should include the cost of effectively managing the legacy data. The cost of a poor conversion and the invoice cost of carrying out the conversion should both be considered. Poor conversions will result in higher write-offs, unbilled charges and cash flow interruptions.

Costs & Advantages of Conversion & Legacy Data Management Options

There are more options than ever for managing conversions to new systems. Options range from a Full Detail Conversion to use of an "Active" or "Live" Data Archive (DataArk). Each is listed below with an assessment of impact on Compliance, Cash flow and Cost.

Full or Partial Detail Conversion

In a Full Detail Conversion, all of the legacy system detail account data is converted into the new system. A "Partial" Detail Conversion usually moves only the active accounts. If everything goes right, a Full Detail Conversion will be compliant and maintain cash flow. However, a detail conversion assumes compatibility between the legacy system and the new HIS -- which is rarely the case. Newer systems often operate differently than legacy systems. Furthermore, a detail conversion will cost the most and have the highest risk of cash flow interruption -- if something goes wrong, the bills won't move. Making a Detail Conversion work requires a great deal of planning, analysis and the willingness to compromise receivables data or functionality in the new system.

Balance Forward

A "Balance Forward" moves basic account information (name, account number, MRN) along with the account balance on an account to the new system. The only real use is to complete the financials. Otherwise, no detail is moved, so accounts can't be re-billed or effectively managed. Many accounts will end up being written off because of insufficient information to support the bill. Keeping the old system running helps, but at some point the legacy system will be turned off. In the long run, a Balance Forward is least compliant and least helpful in maintaining cash flow. The upfront cost of moving balances is relatively low, but the cost of maintaining the legacy system longer than necessary will push up costs.

Run out the A/R on the Legacy HIS

The safest way to manage the aged receivables after the go-live of the new HIS is to run out the A/R on the old system. The bulk of the A/R would be exhausted after 4 to 6 months, leaving only a small receivable to manage. The problem here is two-fold: compliantly storing all the legacy data after the A/R run out and managing the small receivable amount remaining. However, used in conjunction with a "Live" archive (the DataArk), this solution satisfies the requirements of compliance, maintaining cash flow and low cost.

"Active" or "Live" Archiving -- The DataArk Solution

For this approach, data from the legacy system is migrated to a "Live" archive system -- the DataArk. "Active" or "Live" because the archive has updatable data elements that can serve to manage an A/R while archiving other zero balance accounts. It's important to note that the actual data elements from the legacy system are migrated into the DataArk. Users look up accounts, view notes, produce itemized statements, UB's, reports and even post payments to the system. No data is moved to the new system. The A/R is run out on the old system for 3 to 6 months then loaded into the DataArk. The DataArk is compliant with data retention requirements, helps maintain cash flow and costs less than traditional legacy options.

The importance of managing legacy data during a system conversion can't be overemphasized. While the legacy system may be a burden, the legacy data is money in the bank -- the best solution will retire the old system while retaining the data in the DataArk. Effectively managing this important transition to new a HIS will keep the cash flowing, maintain compliance, minimize the cost of transition and get you closer to the streamlined operations that come with the new HIS.

For more information on the Data Ark solution, visit the DataArk page, call 1-800-917-6379 and/or send an e-mail to info@Mediquant.com.