The provider community strives day and night to improve patient outcomes and contribute to the dream of value-based healthcare. However, the complexity of chronic diseases renders strategies ineffective and prevents them from reducing available utilization. In the US, chronic diseases account for 75 percent of all healthcare spending, to the tune of $3.5 trillion. In fact, every 6 out of 10 US adults is living with a chronic condition.
And, the costs are going to inflate in the future as well
By 2030, there will be more than 77 million+ people above 65 that necessitates Medicare coverage, which also calls for better chronic care management measures. If high-risk populations are identified now, the US healthcare can be better prepared to meet care expectations in the future and contain the costs for good. That said, a myopic approach to chronic care isn’t going to cut it. Let’s take a look at the loopholes in current chronic care management programs.
Pitfalls in Chronic Care Management
Fixation on short term goals
Effective chronic care management requires providers to focus on long-term well-being and stabilization needs of patients. However, the Affordable Care Act incentivizes providers for a reduction in 30-day re-admissions post-discharge. To witness a visible and landslide impact in chronic care management, providers must be looking for a mechanism that can track care management for high-risk patients beyond the 30-day readmission policy.
Less accommodation for comorbidities
Multiple chronic conditions have associated comorbidity that can increase the costs in the long run. Healthcare needs to inch to a robust system that takes into account the needs of comorbid patients. Mckinsey research suggests that 71% of patients with heart failure have hypertension, 37% have diabetes, and 53% have hyperlipidemia. These stats indicate that providers have the opportunity to go upstream and engage with these patients while they have a low-morbidity condition.
Inadequate risk stratification
Risk stratification is majorly centered on the needs of high-risk patients and often negates rising-risk patients. While preventive mechanisms for “high-risk” and “rising-risk” patients require a demarcation, specialty care and telehealth don’t promise a similar ROI for both patient pools. Aside from this, additional factors such as Social Determinants of Health are not an integral part of every risk stratification algorithm that results in skewed chronic care management plans.
Fragmented care delivery
A lack of coordination renders chronic care management ineffective and many a time, patients end up receiving clashing treatments that can lead to increased costs.
Primary care vs. specialty care
Primary care providers often face a hard time figuring out when a patient can be successfully managed in a primary care setting or qualifies to be under specialty care. Taking the right call between the two often becomes the reason for higher costs because of an increase in acute care utilization.
One of the many aspects that insurers focus on to create more value through their health plans is to improve communication with the members. In the era of growing digitization, most payers have started to offer online services. However, many beneficiaries still use traditional channels to interact with insurers.
Does it imply that members are averse to using digital channels for communication?
On the contrary, members are, in fact, more inclined to using digital channels than ever before. A survey revealed that 77 percent of consumers would like to pay their health insurance bills through an online portal. If members have the option to use digitized modes and they still continue to use the traditional modes, it clearly indicates there is a problem.
What prevents beneficiaries from using digital channels?
At this point in time, multinational giants such as Amazon and Google have made customers accustomed to unbeatable customized digital content. If members are still using old forms of communication, that is bad news for health plans. The probable reason behind this is unsynchronized information on offline and online channels.
Take an example of a member who has been communicating with their insurer through a call center and wants to shift to online communication. For that, they would have to share all their details on the new channel all over again, despite the fact that their information was already available to the insurer. This may lead to frustration because this interaction is neither convenient nor fast. As a result, they wouldn’t want to switch to a channel that makes the process more cumbersome than before.
The solution? Building omnichannel capabilities
For digital channels of communications to thrive and boost member experience, payers must work on developing omnichannel capabilities. Omnichannel communication can allow members to switch seamlessly between online and offline channels at their own convenience, without any additional steps. Even though most health plans offer digital communication, can only creating omnichannel communication maximize its value?
“Pop health is still a pretty manual process. Having a dedicated solution, let alone a dedicated analytics platform, to address pop health is not as widespread as one might think.” — Brendan FitzGerald, research director, HIMSS Analystics
When I first heard this line, a number of thoughts came rushing into my mind around the different population health management strategies deployed today. In my experience, I’ve noticed a lot of variance in these strategies, and somehow, all of them traced back to data integration.
Some regions focus on leveraging their existing EHRs solutions. Other areas attempt to find the best point solutions and try to integrate them together. Many other organizations are looking for partners to help build and deploy more targeted solutions. Ultimately, these organizations are trying to find the right solution to achieve sustainability in these changing times.
Healthcare data: The problem of plenty and inefficient solutions
One problem that I usually see is that there has been a lot of talk around providing a holistic solution — and the industry isn’t even close. Healthcare organizations have already drained millions of dollars in the hopes of improving outcomes through new technologies, and I think there is a dire need for a change in what we promise to deliver. What organizations need now are infallible strategies that focus on achieving a better outcome.
It is never about just integrating the healthcare data!
There is a buzz in healthcare around aggregating data. However, they are far from making sense of this data.
The question which we should be asking right now is how we can help save money and continue to deliver better care. The easiest way to analyze the progress of organizations is by examining the returns on investment in terms of outcomes and revenue. And this return is only possible if organizations are successful in activating this data to ensure that every member is utilizing it to their fullest potential.
Unless healthcare members have a holistic pool of information regarding every activity in their healthcare network, they cannot ensure that they remain at the top of every process.
Taking long leaps to establish transparency in healthcare
A few months back, a tweet from the CMS Administrator, Seema Verma, took everyone by surprise, and the concept of siloed healthcare took a significant hit. Value-based care is the future, and #WheresThePrice laid the foundation for transparency in terms of cost, expenditure, quality, and data.
It is time we took this concept of transparency to a broader level, moving beyond merely the pricing to ensure the transparency of healthcare data. After all, only the right access to the correct data can result in the right outcomes.
What is that one factor that separates one patient from another? Can one identify why two patients with the same illness but from different regions respond differently to a particular treatment? Do we need to cater to the needs of patients even after they leave the clinic?
These questions have always intrigued not only the physicians but every member who is involved in the care journey— care teams, communities, social workers, even patients themselves. And the answer lies in just one fact— even if these two patients appeared similar on paper, their lifestyles are very likely to differ: socioeconomic status, gender, race, ethnicity, family structure, and education.
All of this comes down to just one term: Social Determinants of Health.
This is one of the prime problems that has kept healthcare organizations in a situation of dilemma.
We are way past the statement that SDoH is just another hype
Have you ever tried to score a home run with one hand tied behind your back? This situation is similar to the condition of healthcare organizations in the value-based ecosystem. They are trying to get 100% of the task of healing a patient done with just 50% of the insights.
Social determinants matter because they can affect the health of the population residing in a particular region, for better or for worse. We have countless studies that show the importance of social determinants, yet we are not able to properly address them because we are not able to answer these questions:
How do we address the challenges that we don’t even know exist?
Who is responsible for addressing these challenges?
Is there any ideal strategy to address SDoH?
No matter how famous they are in healthcare, working with SDoH requires a drilled-down approach and something that we have in abundance- healthcare data. This data can be leveraged, and with the use of predictive analytics, organizations can accurately measure the at-risk population and advance preventive care methods in the ecosystem.
The best way, I think, is to look at this picture with a magnifying glass. Traditionally, the endpoint is the state-level analysis of SDoH. However, it is not the end but the beginning of the study that should go to the zip code level.
Here are some of the most interesting stories of how the leaders in the field of addressing the Social Determinants of Health addressed the populations’ needs and did the undoable.
What was the Humana way to deal with the non-clinical factors?
Humana has the Bold Goal Initiative, which is a population health strategy that is aimed at improving the health of the communities and making them 20% healthier by the year 2020. Their Healthy Days surveillance process is a robust and scalable metric. Based on this, they found that food insecurity and loneliness were among the top contributors to the total unhealthy days among the population they serve.
With their holistic and comprehensive approach, they built an analytic intervention pipeline to address these issues. One instance is their intervention with Papa Inc., where they connected college kids to seniors who needed companionship. As a result, 94% of members stated that the Papa Program helped them to feel more socially connected.
Humana was able to reduce the number of unhealthy days from 2015 to 2018 by simply addressing the non-clinical aspects of care delivery for their population.
Performance of Humana’s seven original Bold Goal communities (2015-2018) – Humana Medicare Advantage members
How MercyOne PHSO took the understanding of non-clinical factors from the zip code level to an individual patient level?
MercyOne PHSO, one of the largest ACOs in the Midwest, wanted to know the factors affecting their patients. They took the simple concept of asking the right questions and leveraged it to understand their patients.
While their patients entered the hospital or examination room, they asked them to complete a survey consisting of questions that depict the factors that affect their patients’ health, such as:
In the last 12 months, were you worried that your food would run out before you got money to buy more?
What is your living conditions today?
Do you face any difficulty in reaching out to your doctor?
Imagine your favorite football team is in a real neck-to-neck with another team, and the game could tip in anyone’s favor. It is the last minute, and in an insane turn of events, the quarterback throws the ball in the air, hoping the player in the end zone could make a touchdown. Instead, the reckless throw results in confusion, the guy in the end zone gets tackled, and the game ends in disappointment.
Now, let’s step out of football and look at these statistics that show a little picture of referrals in healthcare:
Only about 50% of referrals result in a completed appointment
Less than 25% of referrals are completed as intended by the referring provider
In case one, the player didn’t score a touchdown, and in the second case, the patient didn’t end up with the right provider and the treatment. The reason being the process— a reckless throw and an inefficient referral procedure.
Most healthcare organizations lose about 30% to 60% of patients on account of inefficient referrals. Value-based care is expected to become the leading payment model by the year 2020, and healthcare organizations cannot afford losing more than half of their revenues due to reduced referral leakages.
How do you know that your referral management needs healing?
Imagine a situation where a patient, in his early 60s, suddenly suffers from severe abdominal pain. He goes to his doctor, and the doctor directs him to a specialist she knew out of her professional knowledge.
Now the situation can unfold in many ways, where the patient might end up getting treated or the exact opposite of it. In all the scenarios, the part where things might go wrong is the process of referring the patient. The problems that these stakeholders might face include:
The inability to identify in-network providers
Lack of proper patient information
Limited access to information flow among providers
Reliance on age-old techniques of fax-based referrals
… and many more.
Now the question is: ‘What is the solution?’
It all boils down to just one thing— having the right data. Imagine you visit your doctor. The moment you tell him your problem, he looks into his screen to look for the right specialist. In just one click, he gets all the correct specialists in a listicle format. And all he has to do for the rest of the story is just click on the ‘Refer’ button.
Seems undoable? Actually, all we need is a data-driven strategy.
Don’t just plan your data but also your approach
It is never about just knowing the patients but understanding them, their health, their socio-economic condition, and their care journeys. All of this is not possible if we do not have access to the right data. Whether it be a lab test or spiking blood pressure— nothing should be left undetected.
Easier it is for providers to understand, efficient will be the referral
You cannot expect the rest of the process to be perfect if the beginning is imperfect. If the provider is stuck finding the information, not only will this delay the referral but also increase the chances of errors. What they need is a single screen view of specialists in a list that includes every detail such as geography, specialist ranking, availability, and fees, among others.
Connecting communities and care teams to deliver the best care
It is crucial that care teams and communities remain aware of the events happening in the patients’ care journeys. They need a streamlined tracking of patient referrals at the clinical or patient level. It will reduce the turnaround time for escalations.
The patient lost in the process is the revenue lost
The right referral strategy includes two significant aspects:
Increasing the visibility into the process to the patient
Using advanced analytics tools to develop a lens into the referral process
What they need is a simple reminder that enlists all the details regarding the visit and gives timely updates to them regarding the specialist and the appointment date. Organizations can increase patients’ access to telehealth services by allowing plans to propose the use of telehealth services instead of promoting in-person visits.
The healthcare circles in the United States are reeled up by debates around the need for price transparency.
The federal agencies are coming up with regulations.
Healthcare associations are weighing in their concerns.
Physicians, patients, and economists – everyone is articulating the pros and cons in a rather plausible manner.
Wait. What has triggered this rush towards transparency?
To begin with, the healthcare costs across the country have gone from “extreme” to “unreal” in the last two to three decades. A regular MRI scan, for instance, costs twice as much as it does in Switzerland, another country where healthcare is considered “notably expensive.”
Worse still, one simply cannot tell how much money they might end up paying at a healthcare facility at any given point. A broken bone can take thousands of dollars to get fixed or at no cost at all – depending on a dozen factors that can vary drastically with each patient.
Frankly, there is no single moment that burst the bubble around the soaring healthcare costs. In many cases, what hurt patients more than the total cost of a procedure is the out-of-pocket expense that they are made to pay. The focus today has shifted to one fundamental question – how much money is justified for a given care procedure; and are we entitled to know it or not?
Cut to 2019, a movement to make care prices transparent is shaking the establishments across the US.
What is the government saying?
The government has taken the onus of ensuring transparency in healthcare prices. Last month, the White House issued an executive order aimed at making payers and providers publish the cost of each procedure available at their facility. The government believes that this step can get a long way in making patients take more informed decisions regarding their health and eliminate the opacity regarding the cost associated with such processes beforehand.
The intent here is to provide patients “access to useful price and quality information and the incentives to find low-cost, high-quality care,” something that can be a giant leap forward in the direction of enabling cost-effective care.
One of the greatest challenges in healthcare is keeping up with the changing landscape. Considering only since the beginning of 2019, the Centers for Medicare and Medicaid Services (CMS) and other federal agencies, such as the Office of National Coordinator of Health IT (ONC) and the Department of Health and Human Services (HHS), have introduced a number of rules as a measure of upholding their goal of empowering patients and enhancing healthcare efficiency. We’re at a very critical juncture in healthcare and from a regulatory perspective, there are a few key rules that merit a special focus which will have a great impact from both a clinical and financial standpoint.
The MyHealthEData Initiative in 2019
The MyHealthEData initiative, launched in March 2018, aims to “empower patients by ensuring that they control their healthcare data and can decide how their data is going to be used, all while keeping that information safe and secure.” Only a few days back, CMS upped the ante for better data access by expanding this initiative and announcing the pilot of “Data at the Point of Care.”
The Data at the Point of Care (DPC) pilot will be connecting providers with Blue Button data, where providers can access claims data to learn more about their patients and their previous diagnoses, procedures, and prescriptions. While providers had to comb through several hundred data sets previously, the DPC program would aim to make access to data easier and right within their workflows.
This announcement follows the relaunch of the Blue Button initiative, or Blue Button 2.0, that grants access to health data and enables patients to send that information using FHIR-based healthcare apps.
In a nutshell, these moves come as an overall push from CMS to promote better access to data and 100% healthcare interoperability. In addition to enabling data access, CMS has also been targeting information blocking, as reflected by 2019 MyHealthEData updates. With these measures, both patients and providers will have the required insights to make more informed healthcare decisions.
The Trusted Exchange Framework and Common Agreement
In April 2019, ONC published its second draft of the Trusted Exchange Framework and Common Agreement (TEFCA), focusing on three high-level goals:
Providing a single ‘on-ramp’ to nationwide connectivity
Enabling Electronic Health Information (EHI) to securely follow the patient wherever needed
Supporting nationwide scalability
TEFCA is basically a common set of principles which serve as “rules of the road” for nationwide electronic health information exchange across disparate health information networks (HINs). The framework, which was mandated by the 21st Century Cures Act, provides a set of policies and procedures along with technical standards required to enable healthcare data exchange among providers, state and regional HINs, and federal agencies.
By Abhinav Shashank, CEO and co-founder, Innovaccer.
The Johnsons were blessed with twins the day before; two healthy baby boys, haphazardly named Jill and John in the health records. Definitely, this marks the start of pediatric services in the family. Hospital records set for the twins hardly mark any difference, gender, weight, parents, address; all records read the same. The only visible difference is a skin allergy with the second baby.
Their names were changed to Jack and Ross in a
month, and records got multiplied by two. Vaccinations done within the first
month were registered in the records of Jill and John, while Jack and Daniel
got registered under fresh EHRs.
pediatric space ripe enough for Machine Learning?
How should the healthcare industry deal with
data redundancy or data hop, and maintain data integrity to ensure reliable
records? This is a real serious concern for pediatric organizations.
However, to our rescue is machine learning technology aiding the critical issue of record matching and streamlining medical procedures in child healthcare. ML has the potential to revolutionize the pediatric care ecosystem and assist the major challenges in healthcare operations of the young population.
With the global healthcare market estimated to reach a sweeping $11,908 billion by 2022 and fast-growing problems in the younger population, there is certainly a vast frame of exploration for pediatric focus and care delivery for the young. Being a continuously evolving age group with tailored and sensitive healthcare needs at different stages of growth, the pediatric population is most challenged when it comes to successful reforms and insights.
EHRs doing injustice to the future of healthcare?
Kids from their birthdate are expected to face the EHR duplicity that scatters their record and essential medical data. The key facts of a newborn like weight, height, allergies, among others, are stored in an EHR that is occasionally hopped a month later, with a permanent name signing in.
Once a new EHR is registered with the new name, all medical information of the previous few months gets disconnected. This has a challenging impact on the entire care protocol. The critical notch here is incoherent vaccination and immunization information of the growing baby. Not only does it lead to seemingly real care gaps, but also ripples out to erroneous procedures and increased health costs.
Machine Learning is transforming the way
services are delivered globally. Detecting the minutest of factors in an
outcome, and cascading the learning over huge data, it can provide us with
crucial considerations which are evidently present but still go unnoticed by
us. ML is helping to deliver accurate algorithms for all domains. Applying ML
to pediatric care is sure to transform the current scenario of care delivery
for the younger population.
are the major challenges pediatric organizations are facing?
We need strict adherence and care, not only to
ensure healthy children but also to ensure optimized care procedures for them
in the future. However, there are a lot of shortcomings in understanding and
implementation of the medical requirements of the population aged 0 to 18.
The major challenges in this regard are:
Most pediatric organizations today do not have precise and distinct health measures to evaluate the younger population. We need measures that can efficiently assess the patients on their growth-specific checkers, respectively.
Patient records at different stages are difficult to merge, with inadequate data-merging proficiency.
Data hop in EHRs during record matching or establishment. This is of critical concern for babies and toddlers who need consistent care episodes.
Lack of customized reach to parents for time-sensitive immunization and vaccinations. This leads to missed appointments, which leads to complications and increased costs over time.
Care plans including uncertainties to manage intelligent adherence. This will enable strong network functionality and improved care.
Flexible and optimized timeline for care delivery.
Currently, about 50 percent of children under five years of age attend out of home care. Throughout childhood, children receive care at daycares, check-ups at community places, have physician visits at different pediatric facilities, among others.
It becomes essential to compile entire patient data at a single place to avoid redundant and erroneous procedures. According to the American Health Information Management Association, an average hospital has about a 10 percent duplication rate of patient records. A study by Smart Card Alliance in 2014 projected that about 195,000 deaths occur yearly in the US because of medical error, with 58 percent of them being associated with “incorrect patient” errors.
Machine Learning truly have the answer?
An article in the AAP News and Journals Gateway mentions that only 71.6 percent of young children in the United States have completed their primary immunization series. Moreover, evidence suggests that 10 percent to 20 percent of young children receive more than one unnecessary and extra immunization. Evidently, scattered records lead to a lack of timely, accurate and complete immunization. This can have serious repercussions on the health and care protocol of the patient, in addition to increased medical costs.
Machine Learning can nourish the split needs
and resolve the errors of pediatric healthcare in different domains:
Automatic Triggering for Episodes and Immunization: ML algorithms can be developed to track and prompt parents for necessary episodes and immunization. This will ensure timely care episodes.
EMPI Matching: Enterprise Master Patient Index is a database of medical data across departments and healthcare organizations. Machines trained in pediatric EHRs can develop a robust algorithm to match patient records across hospitals and unify them.
Streamlining Vaccinations: ML algorithms can regularize time-sensitive vaccination arrays for different pediatric categories as decided by the World Health Organization.
Scanning Data Hops: ML algorithms can detect data gaps in procedures, and point out critical consequences enforcing timely merging of EHRs.
Predicting Episodes and Costs: ML algorithms trained with localized pediatric data can detect underlying factors for an episode and predict the average costs for unforeseen episodes.
The pediatric population is foundational to a
healthy nation and demands our attention to reform its split functionalities.
Machine Learning can bring about unimaginable amendments in our current
pediatric care management and delivery. Data, which is foundational to all
ventures in the healthcare industry, can be merged with ML to close all care
gaps and invest in a healthy tomorrow.
By Abhinav Shashank, CEO and co-founder, Innovaccer.
Children have entirely distinctive needs as compared to adults. Care is delivered to them in a manner entirely different than adults by care teams that hardly ever double-up as providers for the elderly.
fact, we hear numerous stories of organizations that transformed their care
delivery by fabricating children-specific strategies and have been really
successful in doing so. However, very few experts ever discuss how little
thought we put when it comes to developing healthcare technologies tailored to the
specific needs of pediatric organizations.
Do pediatric organizations have the
technology to succeed?
2017, more than 95 percent of hospitals had certified EHR technology. However,
these EHRs are heavily adult care centric and may not include measures that are
specific to pediatric populations. In fact, in a recent research piece
conducted on 9,000 pediatric patient safety reports, it was found that about 36 percent of reports were related to EHR
usability has been one of the underrated issues that we need to address if we
are to build an efficient pediatric landscape. This can be attributed to the
fact that even a slight misjudgment in comprehending the information stored in
EHRs can substantially increase the chances of errors and adverse events. The
issue is all lot serious for pediatric organizations where patients are
extremely sensitive to the care provided to them at any given point of time.
Complicated EHRs can do no good to neither children nor pediatricians.
Why is the EHR usability valid ask for
born prematurely have different needs as compared to completely healthy
infants. A 5-year old kid faces problems that a 13-year old teenager does not.
Vaccination once missed can prove costly in the future. A child with Type 1
diabetes may require care plans entirely dissimilar to other children.
Theoretically and practically, each child is unique: from a prematurely-born
child weighing less than a kilogram to an obese 105 kg 14-year-old. The EHR
should be able to ingest all such details with perfection and should provide as
many measures that pediatricians may require.
twin siblings born on the same day, having an identical vaccination cycle, and
same last name. However, they may react differently to various treatments and
have different weight or gender. If they need some medication, they might be
given different mg/dose prescription. Amidst all this, the care teams have the
onus of ensuring that each exercise is taken care of with utmost precision. For
that, they need powerful EHR systems and alert systems, among other things. In
other words, organizations need advanced decision support systems, an ask that
is only valid to deliver value-focused care.
Doctors need reliable EHRs to understand
the complete picture
often than not, there are only two sources of information during any given care
episode — data stored in the EHR and patient’s own words. However,
pediatricians cannot expect much support from their young and very young
patients. For infants, it gets all lot difficult since it gets even harder to
comprehend their symptoms.
such patients, EHRs need to tell the complete picture each time lest errors are
bound to happen. Goes without saying, children are more vulnerable to such
errors as compared to any other patient population. Ideally, pediatric
organizations need to have extremely robust, agile, and accurate EHR systems.
However, the situation is far from ideal even at this age and time.
Pediatric organizations need custom-made
EHRs and IT infrastructure
begin with, EHRs should have an extremely user-friendly interface, support for
adding or converting charts locally for specific syndromes, extremely precise
dosage range, and capabilities to identify missed or pending vaccination. They
should strictly have a pediatric-specific threshold for each symptom,
treatment, or trait, while also having a feature for identifying copied and
newly-added records. Alerts, as discussed earlier, for potentially wrong data
entry should also be a default feature.
with a layer of advanced analytics system on top of their EHRs, pediatricians
can successfully navigate the challenges as they come their way. If pediatric
organizations have a system in place to send regular immunization and wellness
visit reminders, they can both increase adherence rates and reduce potential
access to sensitive patient information and automatic triggers for varying
health trends can further play a substantial role in making care more efficient
for the young. All such steps combined can help us in realizing the dream of
creating the “Internet of Healthcare,” where every stakeholder is connected
with each other and there is a seamless exchange of information at all places
The road ahead
we embark upon the journey of creating an “Internet of Healthcare” where
everyone would be connected with everyone, we first need to have quality IT
infrastructure that can make this possible. EHRs are the building block for
such a system. It’s time we add the human touch to such technological
solutions, and take the first step in the direction of reinventing EHRS.
Healthcare is one of the fastest-growing segments of the digital universe, with data volumes expected to grow by 48 percent annually. Healthcare applications will be the principal driver of this data growth, with EHR penetration in the US already reaching more than 80 percent and expected to reach 95 percent by 2020.
In addition, the healthcare space has matured to the point where EHR replacement has become commonplace, and up to 50 percent of health systems are projected to be on second-generation technology by the year 2020.
So why are these data points an important consideration?
Healthcare organizations have been facing
the major challenge of storing and securing patient information. This is not
just the problem with the providers, but for payers and patients too. While
transitioning to complete digitization of practices, healthcare leaders,
specifically CIOs, often find it a daunting task to identify the areas where
they need to scale up their technological approach.
EHRs are likely the necessary evil for
healthcare. No doubt they solved so many problems; however, they opened gates
to other problems. The complications with the legacy systems compel hospitals
to shift to modern technological solutions.
Right now, the story of mergers and acquisitions in the space is also like an adventure movie. According to KLAS Research, the number of EHR vendors dropped from more than 1,000 to around 400 now — the reason being the rise in mergers and acquisitions.
Where does the actual problem lie?
The journey of shifting from legacy systems
to advanced technology is also ripe with its own set of complications. As the
landscape is molded by M&As, consistent EHR replacements are not rare
In this scenario, organizations face two
Legacy systems have
to be maintained so that organizations are able to access the read-only PHI.
The cost of
migrating data from one EHR to another is unreasonably high.
Moreover, since these EHR replacements are directly linked to the retention of the data from the legacy systems for about a decade. Most states require Protected Health Information (PHI) to be retained for about seven to 10 years.
How is data archival the solution we need now?
Transitioning between EHRs require a
holistic approach to keep their data secure, and the best way here is data
archival. Data archival is a simple process of archiving the entire data from
legacy systems into a unified platform so that it can be kept secured for a
long duration. It is the perfect solution to the above-stated two problems: it
is easier and can be done at one-tenth of the price.
For instance, in the case of legacy systems, the EHR vendor can charge up to $10,000 a month for keeping the system running even after the transition. However, in the case of data archival, this entire process is fast, cheap and much more efficient. Also, it eliminates the necessity of keeping the legacy systems running.
The archiving process serves multiple
functions and has the following major advantages over other data-retention
It allows legal
decommissioning of the legacy systems
It ensures the
integrity of the vital healthcare data
It creates the
opportunity to realize opportunities for immediate Return on Investment (ROI)
It minimizes the
risk of maintaining the historical data
It develops a
centralized repository for all your legacy systems’ data
And many more …
What is the perfect data archival strategy?
The procedure of data archival mainly
consists of two major steps: identifying the need for data archival and
adopting the best archival solution. It is important to analyze the need first
and then take action. It is a complex process and involves complex compliance
requirements to be fulfilled.
So what is needed to be done now? Here is the list of essential prerequisites to be considered and followed religiously before archiving your crucial healthcare data:
Understand your healthcare data
The first step is to understand your EHR and legacy system data. One organization might be focusing on archiving the data from a single EHR while the other might be looking for a solution that can archive the data from multiple data sources. Everyone’s data needs are different and, thus, requires a different data archival approach.
Familiarize yourself with your state regulations
Every state has its own regulations to archive the data. The state of California might need you to archive your data for six years, while the state of Minnesota might have a span of more than 30 years. These regulations need to be considered and understood efficiently before investing in a data archival solution.
Chalk out your technological requirements
The next and
most important step is to identify the extent and the varieties of
technological features your organization might need. Every organization has
different needs which should be analyzed and understood well in advance. Based
on these insights, the final decision can be made about any data archival
solution and its abilities.
The road ahead
The space of healthcare is among the most diverse and ever-changing fields. New mergers, efforts towards making the practice data-driven, empowering providers with access to every single bit of data about their patients, and whatnot; these factors have compelled organizations to keep shifting towards a better option — a better EHR. And in this story, the ultimate goal is to make this transition as smooth as possible. It is important to ensure that organizations get rid of all their legacy system headaches instantly. With data archival, it is finally possible.