Making the case for Clinical Archiving

Author: Robert Porter, Senior Consultant - Enterprise Solutions

Healthcare providers are already realizing the benefits of electronic medical records systems. At the same time, they are experiencing frustration with the massive amount of data trapped in legacy systems that prohibits a comprehensive view of patient records. The need for an integrated, comprehensive repository for a Clinical Information Archive System is upon us.

This Clinical Archive System MUST meet certain requirements:

Risk mitigation

Legacy applications are a major risk to a covered entity. Along with the risks of failure for aging hardware and potential data loss, many legacy systems are all but ignored unless something goes wrong. The problem is CMS has ruled that failing to update operating systems and applications is ‘willful neglect’ making it a category 3 offense, or 4 if no attempt to correct was made. 

ROI measured in weeks not years

Decommissioning an application should return near immediate results. We are seeing ROIs in under 6 months for shutting down legacy systems.

Immutable Data

Once the data is archived it must never be changed. If updated or revised results are later obtained, both need to be held. An accurate picture of what was available at a particular time is crucial.

Structured Data and Unstructured Content in one place

Structured data is typically housed in databases while active. For example, a date of birth or gender is easily defined and stored. Unstructured content is x-rays, PDFs of reports, scanned images, etc.  It’s all the data housed and stored somewhere else. Often a record is some combination of both – orders, results, and images of an x-ray for example.  Traditionally these are in separate systems with some type of link between them. In the archive, it is important to combine the two into a single record, and store it as a hybrid object.

Security with auditing

The archive will contain vast amounts of Protected Healthcare Information or PHI. The archive needs to understand the security concerns and have comprehensive audit trails including who looked up what and when.

Encryption

Much has been talked about HIPAA rules and encryption. The Department of Health & Human Services has said that encryption is required if it is “reasonable and appropriate” to do so, or the covered entity must implement an alternative means. They also need to document why it did so. It’s becoming harder to maintain that encryption is not “reasonable and appropriate” given the technology available today.

Multiple source and destination support is necessary

Modern healthcare systems are growing through mergers, acquisitions and strategic partnerships. This means many diverse source systems. Different clinical systems may also be used.  Even those few places with only one facility, departmental systems may come and go.

Only OAIS standards-based systems should be considered for future-proofing your archive 

 Archiving clinical data in healthcare.

New departmental EHR systems come and go. The archive should be able to handle any of them. Once implemented, your archive should be the one system that never need to be replaced. It should be the one thing that grows with your organization. Open and adaptable, it should accept data based on open standards. Likewise, it should be able to provide data to consumer applications based on those standards as well.

It needs to be able to support research and ‘big data’ analytics 

It’s here in healthcare, now. If you’re a research or academic institution, you should already be using it. If not, you should start preparing now. In the world of outcome based payments, it will be needed to survive.

Your patients’ healthcare information is being targeted

The value of a stolen credit card can be as low as 50 cents. However, a single EHR record can go for $50 or more. Why the huge difference? The credit card company is monitoring for unusual use.  So the criminal may only get a few uses out of it. But a lot of the EHR record is useful on an on-going basis.  Not only for financial identity theft either.  The data often has the Social Security Number with it as well. Not to mention the possibility of obtaining fraudulent prescriptions and making false insurance claims.

Stay tuned for more posts on clinical archiving. We'll delve into this topic in more depth. Revolution Data Systems would be happy to discuss your specific needs and help design a road map to implement your Clinical Archive system.