Now that the pandemic chaos dust has settled, healthcare organizations want to optimize technology and build advanced analytic capabilities to digitally reshape patient care delivery and accelerate process transformation.
While that race to digitize continues, we’re faced with the complex challenge of managing a vast array of clinical data that resides in multiple applications, device types, and operating systems. As I ponder the state of clinical data today, I am reminded of a childhood nursery tune that goes something like this, “Make new friends but keep the old. One is silver, the other is gold.”
Just like an old friend, our healthcare data is an asset.
CLINICAL DATA CONVERSIONS — RISK AND REWARD
A clinical data conversion is the process of transferring patient data from one format or location to another. These conversions (also known as migrations) are typically initiated by the need to do one or more of the following — switch from an existing electronic health record (EHR) system to a new one, build an enterprise clinical data repository, consolidate medical images across modalities, or respond to business activities such as mergers and acquisitions.
While a clinical data conversion may sound simple, it requires a great deal of planning and preparation to ensure data integrity. Accurately identifying and linking personal health information over multiple systems, databases, and technologies is no small feat. In addition to existing in multiple places, formats, and file structures, personal health information may be inconsistent even within a single platform.
Reimagining your clinical data’s future state — to drive innovation and improve patient outcomes — should be approached in a methodical and thoughtful way in order to ensure that technology investments will deliver value in an industry fraught with overspending, access and quality gaps, staffing shortages, capacity issues, inflation, and increasing regulatory pressures.
HOW TO GET CLINICAL DATA MIGRATIONS RIGHT — PAY NOW, OR PAY LATER
So, how does an organization get a data conversion right the first time when there is so much to do and no time to waste? The simple answer is “pay now or pay later.” Your organization will be well served by an up-front investment in thorough planning when converting clinical data, bringing all stakeholders to the table to understand scope and requirements in order to ensure success.
PROPER PLANNING IS KEY.
If you plan to implement a new EHR, or if you’re involved in a merger or acquisition, human nature will automatically place priority on those activities, and conversion activities may end up taking a backseat. We recommend conversion activities be part of your upfront plan if you want to avoid problems down the road.
How long does proper planning take? We recommend at least three months to have a solid approach, more depending on your organization’s size and circumstances. You need to involve the right people, come to consensus on multiple decision points, inventory your existing systems, examine your vendor contracts, and carefully plan your implementation timeline. You should create a project charter that identifies stakeholders, clearly defines expectations, and delineates exactly what’s in scope vs. out of scope. Proper planning upfront — and good documentation throughout the conversion — will ensure stakeholder buy-in, make for much smoother change management, and avoid problems down the road.
There are five W’s to consider when planning a clinical data conversion that will ready your organization for 2023 and beyond:
1. What. Determine what data needs to be migrated or converted. Patient data rarely exists in one place and is always subject to privacy, security, and retention regulations. Inventory all of your existing clinical systems – including stand-alone ones. State requirements and contractual requirements for data retention must also be considered.
2. Who. Identify who needs to be involved to ensure data quality and integrity. Companies providing services such as data validations, artificial intelligence for improved patient indexing, or paper record scanning are all options to be considered. And do not overlook the benefit of having your own clinical domain experts provide final sign off once the data has been converted.
DATA VALIDATION IS CRITICAL.
This may be a paradigm shift for your organization, but we recommend that the clinicians who use the data be the ones who validate it. Who better to validate converted fetal link strips, for example, than someone with OB expertise? And leadership needs to give clinicians good tools to validate data (for example, dual monitors to do side-by-side data comparisons). Regulations require blood bank data be validated when a conversion takes place, and some organizations use a 3rd party to perform the validation if they don’t have the resources to do it themselves.
Your clinicians will be much happier with the new system if they’re involved with how data was converted and have input into how it’s presented in the new system.
HIM’s involvement is also critical during data validation – sometimes there can be hundreds of pages in an image archive, for example, and HIM staff are usually exceptional at making sure that all the pages are there, ensuring medical record numbers and patient demographic data are correct, etc.
3. When. Be sure to communicate the timeline for when the data migration will begin and end. Timeline will drive budget for both internal and external resource needs as well as impact IT’s budget, as they may need to keep old and new systems running.
4. Why. Delve into the questions of “why we are doing this project?” to ensure benefits can be clearly articulated to all stakeholders. Data conversions are time consuming and demand resources that could be needed for other organizational demands. Keeping communication clear, concise, and consistent is the best way to keep everyone on the same page. Be certain to include the right people in the right meetings and provide regular updates on progress and issues.
5. Where. Perform due diligence to determine where clinical data should reside. Should all clinical data reside on premise? Should it reside in the cloud? Is a hybrid approach for clinical data archiving and/or managing future growth a better fit?
Set expectations, involve stakeholders (especially clinicians), explain the benefits of properly converted data, and explain the negative ramifications if converted data isn’t properly validated. Continuing to use legacy systems as a backup after a new system is in place is a very costly decision because you’ll pay to run two systems for a period of time.
The results of a well-planned and executed clinical data conversion are accurate patient data and happy clinicians — worth their weight in gold.
If you think you may need some data migration expertise, HealthNET can help. Contact us to learn how our clinical and/or financial conversion experts can help ensure a well-planned and executed conversion.
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