Legacy Archiving How many lights do you leave on? September 14 th, 2015

Transcription

1 Legacy Archiving How many lights do you leave on? September 14 th,

2 Introductions Wendy Laposata, Himforma(cs Tom Chase, Cone Health 2

3 About Cone Health More than 100 loca=ons 6 hospitals, 3 ambulatory care centers, 3 outpa=ent surgery centers, 4 urgent care centers, over 95 physician prac=ces 1,300 physicians 11,000 employees 1,273 beds Primary Service Area Cone Health 3

4 Objectives 1) Outline the major business objec=ves for implemen=ng a data reten=on program 2) Describe the Legacy Archive Framework 3) Describe the specific ac=vi=es that have led to an improved applica=on porqolio. 4

5 Legacy Archiving I. Why? Outline the major business objectives for implementing a data retention program. 5

6 Legacy Archive Background Create a framework focused on legacy por9olio efforts to either decommission or archive legacy applica(ons that are no longer needed for opera(onal purposes. The house- wide EHR implementa(on typically drives this effort. Archive (retain to access) Legal data reten=on =me requirements exist for the data within the applica=on. Internal recommenda=ons require us to keep the data. Decommission (permanently destroy) Legal reten=on requirements have been met, the data is no longer needed. The data does not have legal requirements to retain. I. Why? 6

7 Objectives Reduce Costs Applica=on maintenance, hardware and resource costs over mul=ple applica=ons likely exist as opera=onal expenses that can be reduced. Efforts to con=nue keeping the lights on get expensive! Meet Legal Reten1on Requirements State and federal reten=on requirements are likely in place that could lead to fines if your organiza=on is non- compliant. Audits are also a key reason to ensure access to legacy data. Release of Informa=on (HIM) Minimize Security Risks Minimizing loca=ons of data as soon as it is no longer required for opera=onal purposes helps minimize the risk of security breaches. Hardwire Enterprise Process Implement data reten=on standards for enterprise processes to ensure steps to decommission are consistent throughout the organiza=on. I. Why? 7

8 Retention Requirements There are mul=ple sources that can be leveraged to generate standard policy and procedure. Per AHIMA, there is no single standardized record reten=on schedule that organiza=ons and providers must follow. Instead, a variety of reten=on requirements must be reviewed to create a compliant reten=on program. I. Why? 8

9 Retention Requirement Resources I. Why? 9

10 Retention Requirement Resources I. Why? Source: hcp:// 10

11 Legacy Archiving II. What? Describe the framework that leveraged. 11

12 Data Retention Governance Establish Project Governance and Ongoing Support Structure Descrip=on: Develop the management framework within which Data Reten=on and Legacy Applica=on related decisions are made and support is provided on an ongoing basis. This provides hospitals with a structured approach to conduct ini=al Legacy Applica=on remedia=on ac=vi=es as well as future data reten=on efforts. Benefits: Provides a logical and repeatable decision- making framework. Iden=fies who in the organiza=on is responsible for overall and day- to- day Data Reten=on decisions and ac=vi=es. Helps IT provide more consistent response and support related to Legacy Applica=ons. II. What? 12

13 Data Retention Governance Finance Opera=ons Informa=on Services HIM Risk Legal Purpose Group Decision Efforts Vendor Strategy Priori=za=on of applica=ons Ensure policy and standards are followed Legacy applica=on related decisions (Who owns the data?) Applica=on valida=on oversight Organiza=on & Regula=on Awareness II. What? 13

14 Governance & Support Establish Ongoing Governance and Support Structure Oversight Data Reten=on Steering CommiJee Project Management Communica=on Policy & Procedure Business Sponsor Data Reten=on Program Management Exis=ng Forums Legacy Applica=on Vendor Applica=on SME Valida=on Users Applica=on Users (Training) IT Security DBA Data Reten=on Vendor II. What? 14 App Support

15 Vendor Strategy & Approach Single Vendor Mul1ple Vendors Enterprise Portal for all legacy applica=ons ( one stop ) Limited training Loss of intellectual property over =me Ease of use/support Higher return on investment Lower Opera=onal Costs Disparate Solu=ons Technical Support Impacts Higher administra=ve costs II. What? 15

16 Cone Health Archiving Summary Cone s Experience MediQuant was selected as the archiving vendor One applica=on GE/IDX Centricity Business, Ac=ve A/R 7 month project dura=on Hosted remotely ~.25 FTE =me commitment for internal IT Analyst ~.5 FTE Program Management, strategy, applica=on porqolio, future archive planning II. What? 16

17 Cone GE/IDX Timeline Nov 2014 Dec 2014 Jan 2015 Feb 2015 March 2015 Sample Extract Provided Sample Extract Loaded Sample Extract Validated Staging Period (View Only) Final Extract Provided GE/IDX Centricity Business (Physician) BAR PA & GE Centricity (Hospital) HPA PA Final Extract Loaded Final Extract Validated Go- Live 17

18 IT Analyst Role IT Department Coordina1on Liaison between end users, vendor, PM, IT department, contractors Network & security teams, Ac=ve Directory Archiving Applica1on SME Assist with valida=on Determine end user roles and security Fulfill report requests for users User administra=on up front and on- going Interim end user support Transi=on to business unit resource aner stabiliza=on is complete II. What? 18

19 Legacy Archiving III. How? Describe the speci;ic activities that have led to an improved application portfolio. 19

20 Prioritization Drivers Business opera=onal needs and =ming impacts Return on Investment Vendor Maintenance & Contractual requirements Impacts (cancella=on/no=ce requirements) Vendor applica=on confidence level Sonware not supported factors, sonware stability Infrastructure Concerns III. How? 20

21 Examples of Data Sources Op=cal Drives Applica=ons that will require formal archiving Unsupported Applica=ons Paper Charts Data PorNolio Unsupported Servers e.g. Win Server 2003 III. How? 21

22 Legacy Portfolio Components A well documented legacy applica(on por9olio is vital to the success of the program. Data Element Examples Applica=on Site Current Maintenance Vendor Fees (Annual) Addi=onal Annual Costs (Hardware, Staffing) Vendor Contract Requirements (Cancela=on) Type of Data (PM, EMR, Images) Data Timeframe Data Popula=on Reten=on Requirements Accounts Receivable Status (if PM) Technical Considera=ons Opera=onal Considera=ons Contact(s) Applica=on Name Clinic A, geographic loca=on $XX,XXX $X,XXX Descrip=on/Example 90 day no=ce prior to annual renewal PM & EMR Feb 2007 through Fall 2011 e.g. Adult, Minor, Ob/Gyn 7 years (from 2011) $XX remaining balance ac=vely being collected Hardware is unstable, not connected to the network, storage space is limited, physically located in the clinic Clinic site will move into new building over the next 6 months, prefer not to move the system due to stability issues. Primary contact name for informa=on provided. III. How? 22

23 Vendor Storage Terminology Tier Examples Interac=ve/Dynamic: Ac=ve A/R and bad debt, pos=ng payments/adjustments/account and line items, claims update, field level edi=ng, Agency exports/imports Sta=c: Data records viewed on demand either on screen or through report genera=on Vault: Full implementa=on, Front End GUI developed Straight to Vault: No GUI, validate & vault III. How? 23

24 Some Lessons Learned Enterprise Governance is an absolute must- have. There are lots of decisions! Commence archiving projects ASAP, while SMEs are s=ll available. All stakeholders need to be at the table to define requirements. Gathering requirements from legacy applica=on end- users is cri=cal. There are a small number of healthcare specific archiving vendors in this space currently, more entering the market every month. No one vendor is going to have all of the skills necessary to convert all your disparate applica=ons, there will be some ramp- up on some applica=ons. Incumbent vendors may provide archiving services. Watch out for proprietary and encrypted databases. Keep watching your converted legacy applica=ons, you may be able to vault or turn them off at some point post- conversion. Strong Project Management is required. III. How? 24

25 Questions & Open Discussion Wendy Laposata Himforma=cs Tom Chase Cone Health 25