If patients are the center of healthcare, nurses are its heart. So, when it’s time to archive legacy clinical data, it’s important to have a nurse’s perspective. I know because I was a hospital nurse when I entered the healthcare IT world. And since then, I’ve made nurses the backbone of my clinical data archiving team.


The global COVID-19 pandemic has revealed the heroic efforts of our healthcare workers. Nurses in particular are capturing the public’s attention and gratitude – and deservedly so. A prominent pillar of our healthcare industry – not to mention a hospital’s largest clinical group – nurses are subject matter experts on patient care and administration.


They’re where the action is, spending the most face time with patients and bridging the doctor-patient gap. They’re also medical record documenters and early informatics adopters, maintaining order in a complex, fast-paced, digital healthcare environment. Increasingly, doctors and management seek their insight and input.


Want something done? Give it to a busy nurse. Fifteen years ago, as a young nurse working for a Colorado hospital, I volunteered for everything – including work others didn’t want to do. This made me the perfect candidate to champion implementation of an IT product that had been sitting on the shelf for three years. It was this project that ignited a passion for health informatics and led to my present career.


Once a nurse, always a nurse


I may have left a hospital setting, but I am still a nurse. The difference now is that I work with my team to impact patient care on a different scale.


Managing data has taken center stage. Between the rise in the global population, and more specifically, the “silver tsunami” of the aging population, the demand for healthcare services is growing almost as quickly as the amount of data produced. System transitions compound the challenges of managing this data well, as many hospitals and health systems must move to new health information systems.


Whether the result of mergers and acquisitions, the need to integrate multiple facilities’ systems or the need to replace an old HIS, conscientiously managing the data during this time is no small task. While HIS vendors migrate about three years’ worth of patient data to the new system, these hospitals and health systems need all their patient data. Beyond being able to provide their clinicians with a view of historical information at the point-of-care, having this data is essential to support various other use cases. HIM needs it in order to provide a complete legal medical record upon request. It’s integral to successful legal and compliance audits. It’s used for research, for analytics and much more.


But knowing what, when and where to store clinical information has always been a tough challenge for healthcare service providers. There are so many things to consider: process, strategy, the volume of data, the number of systems, ensuring compliance, maintaining (or instituting) information governance policies, security, insights, tools, technology and cost. How do hospitals meet the challenge?


Want something done? Ask a busy nurse.


This is where pairing clinical and HIT knowledge with data archiving experience pays off and it’s why nurses play such an important role on my clinical archiving team. They speak our customers’ language and know not only what questions to ask, but also what to look for in order to avoid rookie errors that waste time and resources and create a disruption to care. There are three key areas in the clinical archiving process where we make the most impact:


  • The application and data gathering stage. My team meets with the customer’s HIS transition team, which typically includes doctors, nurses, pharmacists and lab technicians as well as staff from the IT, HIM and legal departments. We conduct an inventory to help the customer discover every system for potential archive. We advise on governance, provide data stewardship guidance and work closely with the full team to develop and confirm the scope of work, which is used to build a roadmap and plan of execution. We also help evaluate which of the data sets targeted for archival should also be converted to the new HIS.<l/i>
  • The data extract and analyzing stage. We work with our customers to extract and examine the data itself. Before moving the data to an archive platform, we perform this “checkup” to assess the data integrity, clarifying its context and significance. Having a trained clinical eye is essential to vetting the data, because that eye will recognize any missing, incomplete or inconsistent data.<l/i>
  • The discovery stage. At this point, we’ll look at the defined scope of work and help decipher what data needs to migrate to the archive. We know from experience that clinicians like to keep as much data as possible, so we take historical demand into account along with the needs of legal, audit, and compliance when deciding what data needs to be stored as well as how and how often it will be accessed. Record corrections, release of information (ROI), HIPAA tracking, role-based security and point-of-care access are a few of the many factors discussed when looking at data for the enterprise active archive. We’ll also make sure you’re complying with federal and varying state regulations for data retention.


Confidently decommission legacy systems


During the validation phase of a clinical archiving project, our clinicians sit side-by-side with our customer’s clinicians to parallel test the data so that your organization has all it needs going forward – which means the IT department can confidently shut down those old legacy systems. Not only does this reduce your healthcare organization’s technology footprint, but, more importantly, it also maximizes the return on the (rather significant) investment it made in a new HIS application.


In a pre-COVID-19 world, it may have been possible for some organizations to buy a little time before deploying an archive solution for legacy patient records. But, paying thousands, if not millions, of dollars in license fees for legacy systems that essentially serve no other purpose other than providing access to legacy data is a luxury no healthcare organization can afford anymore.


As healthcare data multiplies, so do the reasons to keep it. Engaging with a legacy data archiving partner who offers both clinical experience and HIT knowledge pays dividends in its effectiveness, efficiency and economy. And, it ensures complete medical records are available and accessible when and how clinicians need them for more informed care decisions that support better patient experiences.


And, that, my friends, is what nursing is all about.

Kel Pults, DHA, MSN, RN

Chief Clinical Officer

About the Author:
Kel Pults is Chief Clinical Officer for MediQuant. The first nurse to be hired by the company in 2014, she began helping to build the company’s clinical archive offering. Today she is one of 12 nurses and multiple others at the company with advanced degrees and both clinical and informatics experience.