Smart archiving preserves the utility of data for hospitals and health systems | Viewpoint

Data may be a hospital’s most valuable asset.

Jim Jacobs

However, most data is locked in antiquated software systems that are difficult to access, pose security risks, and likely won’t be formatted the same way as data from subsequent software versions and systems.

For many hospital and health system executives, migrating data from legacy systems is transactional — get the data migrated in any format and let it sit until needed for compliance, regulatory, billing, clinical, or release of information requests. Migrating data this way seriously limits its future utility.

Executives with longer-term visions recognize the value of the information locked within their software systems. Done right, archiving represents a way to extract and normalize legacy data, creating workflows that remain accessible through modern and secure interoperability channels. The emergence of industry interoperability standards and artificial intelligence (AI) brings new promise that data from a decade or more ago can remain as useful today as it was when it was created.

Data’s value remains long after patient encounter

Data sometimes needs to be archived immediately, the result of repeated server failures or emerging security threats for unsupported software. In those cases, it makes perfect sense to take the straightest path to data archiving and software retirement.

But an ideal approach to archiving ensures that data retains its utility long after the patient has been discharged and the bill has been paid. Regulatory compliance mandates data retention, and federal payers have extensive timeframes during which they can audit claims and potentially claw back reimbursements. State laws can vary widely, but patient records routinely need to be preserved for 20 years or more, especially for young people whose records start at birth.

A modern archive strategy treats data as powerful information that continues to have value — regardless of the age of the data. Rather than transform information into PDFs that can’t easily be parsed later for data aggregation purposes, forward-thinking organizations are exploring active use cases where data is retained in a format that can be accessed by current software of that type.

This is especially critical when one ponders the potential of AI to transform patient care. Health systems that are integrated delivery systems (IDS) or self-insured hospitals can use long-term data to determine the effectiveness of treatments such as hip replacements, comparing different surgical options to patient outcomes.

Archived data fuels current workflows

Hospital operating margins continue to improve, averaging 4.5% over the first three months of 2023, according to healthcare consulting firm Kaufman Hall. However, the March figure does not include any revenue shortfalls caused by the Change Healthcare data breach, which are expected to be significant.

The goal for data rationalization is to get to one patient, one record, combining not just clinical information but also billing and claims data that can potentially boost revenue.

One archive client has extracted 10 years of archived patient accounting data into an AI data warehouse to look for denial management opportunities. Instead of reacting to potential audits to preserve revenue, this health system is actively seeking additional revenue by investigating past claims practices. Another health system has incorporated archived data into current workflows, running more than 25,000 daily transactions through an interoperability platform.

As interoperability among software systems becomes more secure and robust, hospitals can improve workflows by incorporating legacy data to get a fuller picture of finances or patient outcomes. They also can perform tasks such as release of information requests much easier using a centralized data repository.

But none of this can happen unless the C-suite adopts a comprehensive data retention policy, understands short- and medium-term merger and acquisition goals, and takes a critical look at legacy systems from a data retention perspective. IT will play a vital role, but leaders from across the enterprise must be involved to ensure that archived data retains its value.

Archiving starts with a solid plan

Many hospitals have more than 1,000 current and legacy software systems, so the first step in the archive process is understanding how those systems are used and by which employee groups. Executives must make sure that any potential archive vendor understands those relationships, devises a custom plan to retain data in a usable format, and has experience archiving the types of systems a hospital uses.

For hospitals dealing with mergers and acquisitions, a common practice is to standardize systems to one EHR, one patient accounting system, etc., which can bring its own challenges. While a healthcare provider may not need a dedicated archive staff, stakeholders from the affected departments need to be involved at a high level to ensure the data is accurate and to create use cases for that archived information.

The health information management team should be involved in projects related to release of information, for example, and the patient financial services team or the CFO should have a say in how patient accounting data is treated.

A trusted archive partner can help hospital and health systems executives prioritize projects so that critical or vulnerable systems receive priority and that data remains valuable long after a patient is discharged and any bill is settled.

Jim Jacobs is president and CEO of MediQuant.