Data archiving represents an important way for healthcare systems and hospitals to move from costly and fragile legacy IT systems to create a central data repository that can be readily accessed. Some systems, however, are easier to archive than others. For example, it often requires an expert to know how to extract data from Cerner. Electronic health record (EHR) data extractions can be complex and difficult endeavors because of the depth and breadth of data that an EHR system contains.
Even if a hospital or health system is moving from one instance of the same EHR to another, very little data typically gets moved from the old system to the new one, as most vendors want the cleanest installation possible. That creates another instance of the legacy system that must be addressed. And, if a health system purchases another hospital that’s not on the same system, those older systems should be moved to an archive, so critical data remains accessible for clinical, financial, and regulatory purposes.
Although IT leaders are becoming more knowledgeable about EHR data extraction, many misconceptions remain. Extracting data is not a straightforward process. Cerner health data archiving is becoming more popular as many health systems and hospitals are transitioning to other EHRs from Cerner Millennium, a robust combined EHR and patient accounting system that has grown into a complex data store due to Cerner’s investments in their platform. While all the data resides in an Oracle database, the data is stored in different formats and across different tables, depending on the age of the system and how it changed over the years.
The following three steps outline how to extract data from Cerner and other legacy systems.
Step 1: Understand Your Archive Goals
This first step is important regardless of the legacy system being considered for archive. Legacy data remains useful to clinicians to understand patient histories and past visits, tests, and treatments. Financial data is often required for historical accounting and to plot trends. Data also must be retained for regulatory and legal reasons — often for 20 years or more, depending on state statutes.
During those 20-plus years, a hospital could have used dozens of IT systems for the same type of data, so any archive plan must account for those various systems as a unified whole. Software configurations and usage procedures may have changed over time, and those changes can impact the integrity of the database. As vendors improved their platforms over the years, database formats and data storage paradigms may have changed. This can result in a database with the same data types (i.e., orders and results) stored in different source tables in the same database.
When it comes to Cerner health data archiving, hospital technology, clinical, and financial leaders must think about how much data is actually required based on the age of the data and the system’s retention policies. They must also consider the options available for the data to be extracted, where it will be stored, in what format, and how it will continue to be accessed by authorized users. All of this is defined in a healthcare data archiving plan. Determining retention and purge policies up front as well as understanding the data use cases can help limit the amount of data that is archived in the first place.
Step 2: Check the Quality of the Database Prior to Archiving
EHR databases are massive, which can present unique challenges during the archive process. Hospitals should enlist the help of a trusted partner to collaborate on any archive project. Insist on a vendor with robust experience on how to extract data from Cerner systems.
Until recently, the only way to move data from a Millennium system was by using the company’s proprietary server Cerner Control Language (CCL) interface that was designed for reporting and customization, which has no direct database access. As a result, past archive projects moved slowly because of speed constraints. Since Cerner was purchased by Oracle, more direct transfer through SQL is now possible. Cerner has become more willing to allow customers to copy their own database when upgrading or leaving the platform.
Before starting a healthcare data archiving project, healthcare providers must estimate how much storage will be required and what underlying technology may be needed for each archived system. With EHRs like Cerner Millennium, the data sizes can easily outstrip storage modalities. Receiving a copy of the Oracle database also requires an Oracle database engine that is configured properly to restore the backup.
An experienced archive vendor can help determine the quality of the database in advance. Depending on system configurations and the reliability of network connections, all data could be correct and accounted for the first time. Our experience has shown that this is not often the case, and even data that is provided via an Oracle backup may need scrubbing and correcting for errors. Data that’s covered by retention statutes but not needed for hospital or health system reporting could have stopped flowing for several years. In those cases, extra steps are required to ensure all the data to be archived is present and usable.
Step 3: Expect to Collaborate with Your EHR Data Extraction Partner to Ensure Success
Healthcare data extraction is likely not a core competency of any healthcare IT department. That’s why healthcare systems and hospitals should work with an archive partner with vast experience in healthcare and the systems they want to archive — including Cerner Millennium.
Healthcare systems and hospitals must work directly with Cerner to receive data backups in the required format, but they need a trusted partner that knows what to ask for, has the proper infrastructure and technology investment to utilize the extract, and can check the data for accuracy and completeness. Collaboration between the provider organization and its archive partner helps ensure that backups are complete, holistic, and contain everything the hospital or health system needs from their legacy data.
Avoid any vendor that promises a simple “lift and shift” solution, because that’s not an achievable or ideal approach to EHR data extraction. Every hospital’s retention policies, data needs, and configurations are unique and require a custom solution that takes these and dozens of other factors into consideration.
Finding the Right Partner Is Key
Discover the MediQuant difference and the customized approach we take to EHR data archiving and migration. There is no one with more expertise in how to extract data from Cerner. Contact MediQuant at 844.286.8683 or request a free demo of our data extraction tool and process.
