Flatirons Digital Innovations – Case study on EHR data


The DFW Hospital Council posts guest blogs by Associate Members. The following was provided by Flatirons Digital Innovations.

During the past several years, three hospitals in the northeast were acquired by a larger hospital network. The parent network has more than 90 hospitals and 100 continuing care facilities, home care agencies and outpatient centers in more than 20 states. In order to simplify its expanding IT infrastructure, the network standardized on the Epic suite of enterprise software applications for electronic health records (EHRs).

When each of the three hospitals was acquired, it switched from its existing EHR to Epic. However, they still had patient and other information on their original systems. In addition, as the hospitals adopted more modern applications, they kept a number of older systems for ongoing access to their data.

As a result, the three hospitals had more than 40 applications that required read-only capabilities. The data in these legacy applications had to be retained, but the applications’ core functionality was no longer required. Each hospital was paying licensing, maintenance and support costs solely to have occasional access to data on its legacy systems. This resulted in higher IT costs and greater data management risks, because applications that no longer supported presented security vulnerabilities and had a greater chance of operational failure.

“In the healthcare space, the ongoing trend of mergers and acquisitions has created complexity in application portfolios, as acquiring companies absorb the applications of their new organizations—which was the case for this series of hospitals,” said Regina Kershner, Vice President of Operations for Flatirons Digital Innovations (FDI).

For the first project, FDI worked with one of the hospital’s information systems teams to understand the objectives for its growing application portfolio. Primary among them were controlling increasing costs related to outdated or redundant EHRs as well as mitigating risks related to their information.

To meet the hospital’s needs, FDI proposed a data archiving and application decommissioning solution based on OpenText™ InfoArchive—a secure, compliant, XML-based system of record to store, retrieve and present both structured and unstructured historical data. The solution would migrate data from the old EHRs and other legacy systems to a single archiving repository.

By moving data from multiple legacy systems to one modern archive, the hospital could:
1. Make it easier for clinicians and H.I.M. users to access historical patient information, from directly within Epic or the InfoArchive search interface;
2. Strengthen security controls for legacy data and apply records retention policies;
3. Eliminate the legacy systems, along with their recurring licensing, maintenance, and support costs.

The first hospital proceeded with a project to archive Carelink, one of its primary legacy EHRs that was costing the hospital more than $1 million in annual licensing fees. For the Carelink project, FDI developed the technical architecture and built a solution that:
• Transferred 1.2 terabytes of data from the Carelink application to InfoArchive.
• Provided integration assistance between the archived Carelink application and Epic.
• Met the hospital’s requirements.
• Allowed legacy data to be used for business purposes, such as compliance requests and big data analytics.

Carelink data archiving and application decommissioning project allowed the hospital to save $1 million in hardware, licensing, maintenance and support costs in the first year alone, which covered the project payback costs within a few months.

Based on the success of the Carelink project, the hospital’s project sponsor identified a second legacy system to decommission. The application contained 1.5 TB of financial and patient accounting information related to the original Carelink system.

The scope of the second project included extraction, transformation and loading (ETL) of data from the second legacy system to the InfoArchive repository, along with continued post-project support for the Carelink archive.

This project included similar implementation to the Carelink archiving and decommissioning project and was completed within 24 weeks.

By archiving data from the legacy systems to InfoArchive and decommissioning the original applications, the project sponsor—whose responsibilities span multiple hospitals—progressively identified and executed additional data archiving and application decommissioning projects with FDI. During a three-year period, the three hospitals archived more than 30 terabytes of data from nearly a dozen systems.

The archiving and application decommissioning solution provided several benefits to the hospitals, particularly due to their relationship within the same network.

1. Shorter Project Timelines and Lower Project Costs
The three hospitals used one instance of InfoArchive and shared the supporting server infrastructure. After the first system was decommissioned, each subsequent project was completed faster.

2. Data Standardization
Archiving data from disparate EHRs to a single archive provided the opportunity to standardize dates and formatting across all legacy data.

3. Reduced IT Costs
Each hospital was able to eliminate the hardware, software and support costs associated with its systems.

4. Lowered Risk
Proactively archiving legacy data from unsupported systems improved each hospital’s data security.

5. Facilitated Clinician Access to Patient Records
Consolidating patient information from several EHRs onto a single archive made it easier for clinicians working in the network hospitals to retrieve historical patient information from within Epic, contributing to improved care.

6. Easier Requests for Information
Providing access to legacy information on a single archive also made it easier for H.I.M. staff to respond to requests for information and perform audits and other tasks.

The healthcare network recognized that acquisitions had an impact on its growing IT portfolio. In the effort to standardize on Epic as its EHR, something needed to be done to address other systems. By proactively archiving data from legacy systems to InfoArchive, the hospitals simplified their IT infrastructures, reduced costs and improved patient care. Because they are sharing a single archiving infrastructure, they can continue to decommission other systems to further reduce costs and strengthen their data management capabilities.