Smarter Healthcare Data Archiving Onboarding

Speaker 1: Hi everyone, this is Erika Spicer Mason with Becker’s Healthcare. Thank you so much for tuning into the Becker’s Healthcare podcast series. So today we’re going to dig into how healthcare organizations can build scalable success with data-driven onboarding. And joining me for this conversation is Dave Lamar, the Chief Growth Officer at MediQuant. Dave, welcome to the podcast. Thank you so much for joining us today.  

Speaker 2: Thank you, Erika.  

Speaker 1: Well, we’re thrilled to have you with us. And before we get into talking some more about data-driven onboarding and how organizations can scale success, could you just share a little bit more about yourself, your organization — whatever would be helpful for our listeners to know?  

Speaker 2: Yeah, as you said, my name’s Dave Lamar. I am the Chief Growth Officer at MediQuant, a Cleveland–based legacy data management solution. We’ve been at this for about 25 years and I’m excited to talk through some of the questions we’ve got today. I’ve been in the health information technology space now for, wow, coming up on 35 years. So, a lot of experience within the health system and the physician space. A lot of background I can reference here. Happy to take any questions from anybody that may be hearing this.  

Speaker 1: Yeah, Dave, it’s great to learn more about you. So, thank you so much for sharing, and with all of your experience in the health IT space, I think you’re going to bring a lot of wisdom to this conversation. I’m sure you’ve seen a lot of changes in those 35 years. So, I wanted to start by just kind of acknowledging how health systems really are expanding their networks and they’re seeking to do this through better clinical and operational integration. And in that process, of course data is becoming more and more important. So from your point of view, what are some of the key decisions and challenges that organizations are facing when they’re bringing new partners or practices onto a shared platform? Something like Epic’s Community Connect?  

Speaker 2: Yeah, great question Erika. I think we’re seeing a wide–ranging set of challenges in all types of acquisitions and partnerships. Bringing data sets together and bringing application stacks together present a lot of challenges, a variety of types and shapes. I think what — from a business perspective — the first step that I see that is oftentimes surprisingly under invested in, and that is reviewing vendors’ contracts prior to onboarding an acquisition or a partnership. Understanding detail — the terms and condition of the contract, specifically the notification window for termination of contracts — this is a mistake that’s cost many of our customers to focus their limited resources on the wrong applications. For example, an application may not actually be able to be terminated for 24 months, three years, and focusing on that application upfront is not necessarily a good use of time. So understanding the contracts is critical and the suspicious part of me will also tell you to remember that no vendors want to make it easy for you to turn off their applications.  

Speaker 2: And that would lead me to kind of the next point. And that is understanding the data acquisition timelines and understanding how to get data out of those applications is critical. Many legacy vendors require that you pull the data through them and then they ask you to order a data extract, and then if you end up ordering the wrong data extract product or dataset — not having all the data to complete your transition off of their system can oftentimes lead to a renewing of their contract suspiciously. So understanding those acquisition timelines because that’s critical for folks like us to support those transitions and those acquisitions of providers and provider organizations because we really have no control over that particular part of the timeline can oftentimes set you back. One of the items that we’re seeing is folks investing in application inventory management tools, tools that maintain the critical contract detail I just mentioned. The results of any of your application rationalization efforts — so many of these organizations are going through application rationalization efforts and there’s a lot of information that comes out of those efforts. And an application inventory management tool would house that information for the long term to help you maintain the data that’s associated with those applications that are being turned off or being archived. Also, understanding the data utilization detail and other detail in a consolidated application to monitor all of the contracts, etc. — those tools are all but paid for themselves by just avoiding one renewal that maybe could have been avoided as well as on the backend after applications have been archived to understand what data needs to be retained and allowing you to purge or as we call it, prune the dataset so that you maintain compliance with your data retention policies. Which leads me to my next thought, is that clearly establishing and enforcing your data retention policies are important.  

Speaker 2: It is still surprising to me how thin these data retention policies are even at very large healthcare organizations. We need to invest in those policies. These policies can help to minimize the cost of maintaining legacy data by establishing the minimal data that’s required to be maintained or the documents that need to be retained. These policies will also simplify and minimize the decision process that you’ll go through on what applications require investment in archiving and what type of archiving.  

Oftentimes, some of the smaller applications can take a different strategy in archiving. You can take documents, you can take a much smaller dataset. If you establish your data retention policies properly and enforce them, that type of information can save you a lot of money on the backend with the type of strategy you use to archive the data or documents. Far too often our clients are canceling projects post-contract after they learn that the projects aren’t necessary, the data is held in a different system or they’re canceling patient accounting interfaces because the amount of AR that’s maintained doesn’t require the three interfaces that they chose. Oftentimes, for example, they’ll invest and select a clearing house archive and later only to know that they’ve moved all of that data into their go–forward claims clearing house application. So there’s a lot that goes into those data retention policies and establishing the proper framework there upfront can save a lot of time and a lot of dollars down the road.  

Speaker 2: And an area you want to pay particular attention to: the infrequently used applications. We do a lot of work as an organization is acquiring an ambulatory practice or a larger health system is merging, or even just a regional or two–hospital health system. Pay particular attention to those systems that aren’t used often. There can be a quick and inexpensive strategy to archiving these applications, if you are using the right enterprise archive partner. Very few vendors out there offer a truly complete, comprehensive set of modules that properly service a health system’s entire application stack. Many of the vendors out there focus only on clinical data or patient–specific data, leaving a whole host of applications unserviced by their solution. And what that ultimately ends up with is folks having to go to market and utilize multiple vendors, or worse, they have to tolerate whatever approach or partner that the solution they invested in is providing.  

Speaker 2: So non-patient applications are very rarely covered in the module stack of an enterprise legacy vendor. And that’s something you want to look close at because we’re running into a lot of scenarios where we come in behind a competitor and we have to fill the gaps that are associated with really focusing just on one area or one application type, if that makes sense. Speed and cost are the game. I mean, that’s what all of our customers tell us. So engaging the right partners is a huge part of getting this transition done quickly, efficiently and at a low cost.  

Speaker 1: Dave, thank you so much for the overview. I know legacy data is really in MediQuant‘s wheelhouse. It’s your area of expertise and you’ve really clearly outlined for our listeners what a compliance and cost risk it can be if it’s not handled properly. And a lot of key considerations you highlighted for listeners like really reviewing contracts, understanding details, understanding data acquisition timelines, investing in inventory management tools. So I really appreciate all the best practices that you highlighted. And I know you also kind of started to talk about data retention policies, the importance of those, and of course engaging the right partners. So are those kind of those two top best practices you’d recommend in terms of what you’re recommending to healthcare organizations when they’re trying to manage their data responsibly during system transitions? Or are there other components that you’d like to highlight as well?  

Speaker 2: No, I would elaborate a little bit on, I mean, there’s a lot of compliance requirements out there. Some of them are self-imposed at health systems, and some of them are imposed in regulations. So I would pay particular close attention to the CURES Act and the impact that may have on your organization and specifically on your data retention policies. Familiarize yourself with that regulation and make sure you’ve adjusted your retention policies to that. There are a variety of ways to address the regulation requirements. Don’t make any assumptions. Some of the approaches to archiving or providing access to patient information in that regulation are much less expensive than others. So when the CURES Act says all of the patient information — it’s important for you to understand and define in your data retention requirements, information in the way that you intend to enforce or comply with your own policies. And I think that’s the biggest part of it.  

Speaker 2: The other item is that we’re starting to see a considerable amount of attention being paid to the patient experience. Part of this, patients are expecting to get access to all their data, and some of our customers are leaning into keeping data beyond their data retention requirements, specifically for the purposes of ensuring patients get all their information. They‘re discovering that many patients, and I think I’ve been one of them, when they’re providing their history to physicians when receiving care, oftentimes they don’t even remember the timing and what specifically was done years and years ago. And oftentimes that’s outside of the data retention requirements of an organization. So patients do appreciate having access to that data, even if it goes outside of, or I should say, especially if it goes out of the data retention policies and requirements. Those of us that are a little long in the tooth here do need a little help sometimes remembering when that shoulder surgery was done and who did it and what the diagnosis was in its entirety when you have an issue with the other shoulder, for example. And sometimes that was 15, 20 years ago outside the retention period. So back to my point is the patient experience can be greatly improved by potentially maintaining your data outside of those retention periods. And I know it sounds like I’m jumping both sides of the argument here to keep data or purge data, but just sharing a trend that we’re seeing out there as we work with more of our customers with the older data.  

Speaker 1: I appreciate everything that you just said, all the dots that you’re connecting here and how data retention and data management strategies, it’s not just something that organizations should feel compelled to do from an operational and compliance standpoint, but how does that trickle down into the patient experience? And I think it’s really important to highlight that connection. So I appreciate that you did that for our listeners. And it also made me think of how organizations of all sizes reach patient based size. Many are going through these transitions and are trying to really optimize how they’re managing their data. So when we think about groups like say ambulatory groups or MSOs (Managed Services Organizations), I’m sure not a one size fits all approach for all providers. So from your point of view, what is the right balance between standardization here and also flexibility, and are there any other common issues that you think leaders should really look out for?  

Speaker 2: I think if you lean towards standardization, the more you lean towards standardization, the better off you are. Just from a maintenance perspective and ongoing care and feeding of your archive program, these are becoming core competencies of every IT organization in the country. And a lot of folks are learning a great deal. We’re seeing a lot of standardization, especially in the space where you’re dealing with Community Connect as well as when an Epic site, for example, acquires a physician group, engaging your managed services organization, building a pre-planned approach to the onboarding that captures the steps required to maintain that data and capture that data and bring it into the organization’s dataset, both with the conversion effort as well as potentially augmenting your archive. I think the key is to standardize that piece of it in your managed services organization or your onboarding team so that there’s not a lot of decisions being made through that process and it can move quickly. Some people can make this really complicated by not being prepared or educated on some of the variables associated with bringing data from outside the organization into the organization. So again, keeping the onboarding teams and your managed services organization in a standard approach to onboarding data is key.  

Speaker 1: Yeah, really, really helpful considerations. Thanks, Dave. It’s been so great chatting through this with you. I know there’s probably a lot that we didn’t get the opportunity to cover in our short time together, but as you look ahead and consider healthcare organizations efforts to standardize as you’re just speaking to, as they’re looking to optimize data management and retention, any final thoughts or pieces of advice that you wanted to leave our listeners with?  

Speaker 2: Not a lot of thoughts, and I think I shared a lot of opinion there, but there is a lot of opportunity to be efficient and to be cost conscious in these processes as you make acquisitions, as you bring in new technologies, and as you partner with providers in an Epic Community Connect kind of environment. Work with somebody who knows the ropes. There are a lot of folks that are out there claiming to be experts or in this business. Pick a partner that’s been there and done that. This is not something you want to be responsible for teaching somebody who’s interested in getting in this space. So hire an expert, I guess would be my parting thought.  

Speaker 1: Yeah, that’s a great thought, Dave. And again, appreciate the wisdom that you shared with us today based on your experience here and what you’re seeing work and not work across healthcare organizations and your own partners. So thank you again for making time, for being with Becker’s today. And of course, we’d also like to thank our podcast sponsor today, MediQuant. So listeners, please be sure to tune into more podcasts from Becker’s Healthcare by visiting our podcast page at beckershospitalreview.com.