Over the course of this series, we’ve looked at the many definitions of “archive” and reviewed the various use cases for each. Let’s recap the use cases that we explored along the archive continuum.
High-functionality archives have nearly the same functionality of an EMR (thus the EMR-minus-one moniker). One of the most distinguishing features of an EMR-1 type archive is that the data may be modified as needed. Additionally, clinicians can review the archival data alongside the current patient record, in context, utilizing single-click access from within the new system. These archives boast very sophisticated release of information (ROI) capabilities as well. And, if data in the archive was edited, the high-functionality archive can automatically post the edited information to the appropriate records – even creating claims on demand. An interface with a claims scrubber application further reduces the likelihood of a rejected claim. Some use cases for the EMR-1 archive include:
Editing demographic and insurance information
Making changes to a patient’s account – posting, modifying, or reversing charges
Adding intake or post-transaction notes from an external source
Creating claims files to export for evaluation
Adding strike-throughs or amending a patient’s file via notes or scanned documents
Saving custom reports to maximize ROI
At the opposite end of the spectrum, we have the cold-storage archive. Cold storage is an offline database where the data within it exists in a read-only state. There is no functionality to add or append the existing records. In fact, some cold-storage archives can’t even support a user interface. The data must be queried by SQL or another tool in order to pull the data into a useful format. Although these archives align with regulatory compliance requirements, query-level access is very limited for users and should not be used for frequently accessed data. Cold-storage use cases include:
Infrequent, query level data access is appropriate
Storage for compliance review or occasional ad-hoc reports
Data does not require modification or appending over the lifetime of the storage
Clinicians and staff do not require real-time access
Now that we’ve been to both ends of the continuum, what about that unexplored space in the middle? These “in-between” archives combine features of both high-functionality and cold storage archives to try to achieve the ideal balance.
Borrowing from the cold-storage side of things, the data is in a read-only state, but just like with an EMR-1 system, a medium-functioning archive will have a user interface. This increases the access and utility of the data in the system. Medium-functioning archives may allow simple ROI functions and include some patient accounting tools, but, again, having the ability to modify data quickly moves us from the middle of the continuum toward the high-functionality end. Example use cases for these in-between systems include:
Variable, but limited reporting formats
Storage of enterprise resource tools such as W2s
Clinicians and staff need to view and access data – but not in real time
Patient accounting tools such as payments, adjustments and claims may be included
Finding your perfect fit
So, with all these types of archives to choose from, how do you know what is the best approach for your organization? First, start by asking a few basic questions to help assess your data needs:
Do we just need to store data for compliance reasons without it being easily accessible? If yes, cold-storage may be a perfect fit for your organization.
Do we need to access the data regularly without the ability to edit the data? If yes, cold-storage is not the solution for you. You may need something in the middle depending on what type of interface you’re looking for.
Do we need to access the data regularly and edit that data? If yes, you are leaning more towards a high-functioning archive.
Remember, there’s no “one size fits all” archive solution. And, as you discuss what you need to do with your archival data, you may find a combination of archiving approaches best meets your organization’s needs. Your approach will begin to take shape once you’ve taken the time to understand what you need – in terms of data access, but also what capabilities your users will need from an archive solution. With a little work up front, you can find the right solution – or solutions – for your needs. You may find you’ll be looking at options all across the continuum.
Need help starting the archiving conversation at your organization? We’ll be glad to partner with you to find the right path.
About the Author:
Dr. Shelly Disser began developing strategies, methodologies and processes to enable health enterprises to efficiently archive, manage and activate legacy data more than 20 years ago. She founded one of the first data archiving companies for the health sector, competing solely with MediQuant. Shelly led the company for 15 years, selling it in 2014 to develop her own consulting firm for healthcare services. In 2017, Shelly joined her old competitor MediQuant to help lead the company supporting client advocacy. Today, this industry leader is vice president of solution delivery – offering her expertise in management, data strategy and analysis.