Subscribe
You can subscribe to the HealthData Talks Podcast on Spotify, Amazon Music, Apple Podcasts and more.

Transcript

[00:00:02.548]

Welcome to HealthData Talks, where industry experts offer bite sized tips and trends for managing data. Thanks for joining us. I’m Amy Holmes from Harmony Healthcare IT, and I am joined today by my colleague, Jake Carson who is our Solutions Engineer. Thanks for being here, Jake. Yeah, thanks for having me. So at Harmony, we manage health data. Most often we are helping our customers by extracting migrating or archiving legacy records and Jake, you are integral in that process and work with them very closely.

[00:00:36.219]

Can you give a quick description of the role that you play at Harmony and what you do?  Sure. So, my title is Solution Engineer and Solution Engineer is a little vague, I think because every department and every company maybe uses solution engineering a little differently. And so at Harmony, I am a pre-sale analyst, I guess would be a way to describe my role. I work with the sales team and I’m kind of the liaison between sales and operations, and what I do is I help sales, and really the customer, understand the scope of what the archive is going to be. So I do what’s called discovery and I guide the customer through the discovery process and help understand what systems they have, what they’re trying to archive, how fast they’re trying to archive it, all the technical details. We group that all in a process we call discovery, and I will build out the scope of work for the customer.  We’ll build the contract out, have it all defined and package that up and move things through the sale process. And that’s how I fit into the picture.

[00:01:44.168]

So you mentioned the client discovery and scoping and how closely you are involved there. Can you give us a little overview of what that process looks like for us and the client working together? Yeah, absolutely. So, discovery at Harmony is a pretty well defined process. So it’s not vague. We have kind of, I guess the first point of engagement would be a discovery document. We shorthand it to DSD but what it is, is just a list of questions, kind of like an inventory sheet of what you are trying to archive. So let’s say you come to us and you say, hey, I need help archiving. Our question is going to be well, what are we archiving?  So there’s a place where you can fill out what the system is, what type of database it runs on. Do you have images in that system you need to archive? Tell us about how long you’ve been on the system. How many patients are in there? How many providers were using it? Is it an employee system? Do you have employee health records in there? Do you have behavioral health patients? I mean, literally anything you could think of, that’s a question about how a system was used. We’ll have that and the discovery form and that’s kind of our first point of contact. But what we really like to do during discovery is go a little bit deeper  than that. So not just the surface level technical questions, but the actual hard scope of what you need to archive within a system. So, I think a good example would be an ERP system like Lawson. You know, there’s a lot of different modules in Lawson. So what I’ll do with the customer that brings me a Lawson is, I’ll say, you know, what specifically in that Lawson product do you need archived? And we usually ferret that out on what we call a discovery call. So, it’s where I’ll sit down with the experts. Basically, we call them subject matter experts. They’re the ones that use the system every day.  They’re the ones going back into the system to retrieve and print out medical records or view employee information, if it’s a Lawson or employee system and they’re the ones who I interviewed to understand, what do they need archived out of the system? And what I’ll ask normally is, pretend you are going to lose access to the system today. What would you miss? What if you can’t go into the system anymore? What are going to be the key data points that you’re going need to hold on to in the long term future. From there, we’ll get a walk through the system and kind of understand all the different screens and data points that either make up the medical record if it’s a health system, you know, make up the reporting needs and  all the different nuances and things that make certain systems unique will dive into and understand and it sounds pretty daunting, but normally it’s a session that you can knock out in a half hour to an hour and just collaborative back and forth. As we talk through what the scope is and what needs to be archived. And that is kind of the gist of what we call  the discovery process.

[00:04:38.519]

I know when you’re working with prospective clients they’re always interested in kind of what that pricing is going to look like. So what are some of the key factors that go into pricing our solutions for potential projects? Yeah. So, I would say there’s three main areas that go into pricing and they’re all things we think about on every single project that we quote. The first one would be, I think it’s the most important one which is, what is the data or where is the data? And by what is the data? I would mean what type of database does your product run on? If it’s an on premise product, it’s going to be running on a database. I mean, every application runs on a data structure of some kind which feeds information to the front end. And that’s actually what Harmony does is part of our process is going in and  getting at that source data if we can get at the source data. And so that is actually a big call out I think is the fact that we’re not always going to be allowed to get at that source data.  There’s a lot of applications and we’re seeing it more and more nowadays with kind of the recent applications that these health systems have purchased are hosted applications, meaning the data, the actual management of that data, is all hosted by the vendor. So the vendor owns it, the vendor maintains that database. Sometimes the vendor is actually taking multiple clients data and merging them together into a multi-tenant platform. And in those instances Harmony is not going to be allowed to go pull the data ourselves. So that becomes one of our questions. How do we get that data? And if we’re going to have data delivered to us by a third party, what is that data going to look like? Are they going to give us a full copy of the database? Sometimes that’s our preference. Sometimes it’s not. Are they going to give us CSV flat files? PSV flat files? Is it going to be related data where you get a nice clean medication file or will it be a dump, where we have 30 tables worth of medication data and we’re going to have to merge together all 30 of those tables to build out what makes up a medication record for a patient. So what does that data looks like? Who’s pulling the data? What format it’s in? How the extract looks?  That’s a pretty big factor that, I mean, that’s just one factor, but it’s a pretty major factor  that plays in the pricing. The second one, which I kind of mentioned beforehand,  it’s the scope. So it’s far, it’s, you know, what are you trying to archive? Are we just doing problems, allergies, medications, immunizations, or do you have assessment forms we’re trying to rebuild? Do you have assessment forms that are coming as a document?   Are the documents in PDF format? Do you have a bunch of custom reports that you need us to archive for you, which we absolutely have the expertise to recreate pretty much any report   a customer may have in their system. We can rebuild that in the archive.  What product features do you need to keep the use of the archive fall in line with the use that you have, you know, current day in the system. So scope is a pretty big point as well, kind of maybe a more minor point but as in terms of pricing, but I think is worth mentioning is kind of the logistics side of the fence. So, are there any deadlines that we need to be aware of? Does the archive need to be done and deployed by a certain date because you lose access to  the system, you know, December 31st or something like that.  That’s something we like to   be aware of. It can affect the pricing if we have to, you know, pull resources to make sure we can get something done on time. But even if it’s a more minor piece of the piece of the puzzle, it’s definitely a good thing  to discuss and make sure there’s no surprises or gotchas down the road because  what we don’t want is anything that is assumed or expected to not  be communicated and then it ends up being a problem down the road. Part of why we go through the discovery process is to kind of make sure we talk about everything.

[00:08:31.519]

So Jake, obviously, we’ve been doing this, since 2006. So I know that we have continually refined our scoping and discovery process over the years to where we feel really confident about it. Could you talk a little bit about the benefits of how we’ve defined our scoping process? Yeah, absolutely. So, one of our core values of Harmony is do the right thing.  And that’s something I kind of internalize as part of my role in helping in the discovery process  and doing the right thing to me means getting it right up front, and getting it right up front means maybe sometimes taking a little bit longer to ask the hard questions. Because defining the scope is hard to do. Sometimes we’ll talk to customers who are still live on their current system and they’re not even retiring for the next year, but to save money and continue to be efficient health organization, they’ve decided they want to have the archive plan set in place. So here we are having our discovery scoping process one year before the product gets shut down. But having those conversations, getting to the point where we’re having a to find scope that’s been  mutually agreed upon. That’s going to do a couple things for us that I think really help both us and the customer. One of those is just reducing the risk of under quoting and over quoting what they need. We don’t want to under quote and undersell anything. And you know, our goal is not to just give the best and lowest price, we want to give the right price, right? So, making sure we don’t miss any key reports, miss any  gotchas like, oh yeah, here are all these documents we forgot to tell you about.  Then over quoting, if you just need a Civic, we don’t want to try to sell you a Lamborghini. So we definitely account for that as well in our discovery process and getting deeper and seeing. Oh OK. Well, we’ve been static on this application for 10 years, maybe we don’t need all of these extra products and features. We can just save this core data and we’ll be good. And  also in the discovery process, we are allowed to get a little more nuanced in understanding what the needs are. So our archive, you know, if no one listening to this knew this, our archive is custom built based on the customer’s needs. We don’t try to jam every archive and every clinical data source into a template. We have templates that are system specific. So if you come to us with an ECW, you’re going to get the ECW template, but   you’re not necessarily going to have all your clinical data jammed into a clinical template. If you come to us with a behavioral health system or a home care system, like a McKesson or CERN or Beyond. Now, Those are systems that we will look at and build a data source that very closely resembles, I mean, down every single data field that existed for the medication field, for example, we’ll make sure that gets properly mapped out and built out. So it’s in a readable, easy to understand format that in a way kind of resembles what the source system was. So that customizability, not being a one size fit all solution, I think is a big selling point of the discovery process because that allows us to understand what the needs are and clearly communicate a scope that aligns with the system, early on. One other thing I think might be important to mention is the benefit of defining requirements   before we start the project. It really just makes the project that much smoother. It’s one of those things that once you have a lot of our returning customers get fully on board with is just having those conversations. Sometimes they’re tough conversations, right? You know, you tell these customers, hey, you might, you have 100 reports you run every day right now. When the system’s static, you may not need 100 reports. Maybe there’s 10 must haves.  And having that conversation to think about what are these 10 must have reports? Make  the project go smoother, faster, easier. When we actually get into the archive build  and we’re validating what’s in the archive. So all of that, I think is one of the benefits to our discovery process.

[00:12:38.808]

So Jacob, can you talk a little bit about this process that we’ve defined and how  our clients have reacted to it? Sure. Yeah, our process, I won’t say a lot of work but it is some work you’re putting in sometimes before there’s even a contract in place. So, you know, we’ll get customers that maybe sometimes will question. Well, why are you asking me all these questions are all these details really important? But I think  some of the benefits you see by going deeper into these conversations come, I’ll give an example of like we mentioned earlier, having these systems that are hosted by the source vendors. You know, one of the parts of our discovery process is understanding what the deliverable is going to be from these vendors and not just saying, oh, you know, we, we know they’re going to give you the data. So leaving it at that we’ll actually say, hey vendor, do you have example specifications for what data you’re exporting? Because I think what we found sometimes, take a system like Cerner for example, we’ve seen exports come back from Cerner that have been incomplete or have been missing data. Whereas when we have the chance to dig in beforehand, share those example specifications, look at those together with the customer, they can say, oh well, that won’t work for medication detail. We’ll need a lot more than that, and then we can have those conversations beforehand. So we don’t get to the point in the project when we’ve gotten a full delivery of data from the source vendor and then all of a sudden we have this archive built based off of an incomplete data set. And then at that point the project timelines have to be extended because we have to then receive another set of data delivered from the vendor. So, you know, that’s just one example of many ways that through doing this discovery we’ve brought clients on board because they understand that these are really important things to have worked out beforehand.

[00:14:37.690]

So Jake, can you give us some examples of where our scoping process turned out to be beneficial and really helped out a client? Yes. So we’ve had customers too, where they’ve been maybe working with one of our competitors or another archive product that hasn’t asked all these questions that we ask beforehand and hasn’t gone to that deeper level with the vendor to understand what’s in a system, and specifically, how they’re going to get that data out of the system. You know, a good example would be a system like NextGen which just has a bolt on dental application. We have a customer that was working with another vendor and the other vendor did not go to that deeper level to understand that. Oh yeah, they have dental images here.  Odontograms. That really the only way to get that odontogram data out of the system is to print it from the front end.  Maybe they assumed that the vendor would just pass them those odontograms as PDFs. Come to find out the vendor is not going to do that. So where does Harmony fit in? Harmony has an entire team devoted to printing out records from the front end of systems. So that’s an example of where we were able to save the day by going to that deeper level in PreSale Discovery where we saw, oh, we need to include some automation scoping out of the front end to get the odontogram records out which, for the archive, we save as PDFs. But our expertise there is in one, it’s identifying those gotchas. We identify the gotchas in discovery where your archiving vendor may miss those things. And then the second point is that we do have the tools and the resources to get at that data. When even the source vendor doesn’t have a path or a solution to export that data. Odontograms are one of, I don’t want to say 100 because that’s probably a little too many, but probably one of dozens of different examples of types of data that we have the ability to get out, via front end automation, via screen scraping, via our back end data capabilities. We’ve worked with dozens of different types of databases, so we have a lot of expertise and experience to offer there.

[00:16:50.109]

Well, that’s great. Thanks, Jake for giving us this overview of our scoping and discovery process and the benefits of it for us and the client just to make sure we’re all on the same  page and we have smooth project delivery. So thanks for joining us. Oh, Absolutely. Thanks for having me. And to our audience. Thanks for tuning in. Be sure to join us next time for another episode covering tips and trends for managing HealthData. That’s it for this session of HealthData Talks, check out helpful resources at HarmonyHIT.com and follow us in your favorite podcast app to catch future episodes. We’ll see you next time.

Speakers

Host:
Amy Holmes, Director of Marketing, has gained over 15 years of diverse marketing experience. At Harmony Healthcare IT, she is responsible for all aspects of marketing, helping connect the healthcare market with our legacy data management solutions.

Jake Carson,

Subscribe
You can subscribe to the HealthData Talks Podcast on Spotify, Amazon Music, Apple Podcasts and more.

Transcript

[00:00:02.548] – [00:00:40.000]

Welcome to HealthData Talks where industry experts offer bite sized tips and trends for managing legacy data. Hello, thank you for joining us. I’m Amy Holmes with Harmony Healthcare IT, at Harmony, our specialty is working with legacy data. We’ve been focusing on that in healthcare for the past 17 years. So, we’ve encountered a lot of extraction work over that time and we work on data migration and archive projects for our customers. So today we have Darryl Mais, our Solution Engineer Director at Harmony joining me to talk about this topic. Thanks for being here today, Darryl. Thanks Amy. Happy to join.

[00:00:42.810] – [00:01:01.889]

So, Darryl to start, can you give us just a brief background on yourself and your role here at Harmony? Yeah, sure thing. I’ve been at Harmony Healthcare IT for about 12 years now. I started off in the data extraction and integration services side of the fence. Built up the Solutions Analyst team and then moved over on the solutions engineering side of the fence.

[00:01:05.189] – [00:01:47.150]

So, what does solution engineering mean? Like what is your team responsible for? The Solutions Engineering team is really a precontract function and our job is to understand the client needs around an archive or migration so that we can craft the proper solution to solve a particular client ask. So, our work kind of meets at the crossroads of architectural engineering and data engineering and sales operations and product knowledge. There’s a lot of technical aspects to it, but at the end of the day, it really is about asking questions and understanding the core of the client need. Otherwise, it’s kind of like building a vehicle. As I like to say, you can build a really nice car. But if the client really wanted a Jeep, you haven’t done your job. That’s true.

[00:01:48.150] – [00:02:48.409]

So generally speaking, how important is understanding data lineage and dependencies before digging into an extraction project, especially when it comes to the database types platforms, data scope? I’ve been in the medical automation and data space for a little over 30 years now. And the idea of data lineage is just another name for knowing the data you’re working with. I think without having context to the data, it really is a quote, our CEO likes of mine, all ones and zeros. In that understanding of the data, you have to get down in the dirt of things. And what I mean by that is you have to know what platform products are running on and the data lives, on how it’s used, how it’s structured, who the consumers are, those kinds of things. And knowing those kinds of things, both in the extraction of the build work, you’re going to be much more effective in whatever you’re delivering. Whether that happens to be an archive or migration, you’re doing data analytics reporting, any of those types of activities. That’s certainly true.

[00:02:50.808] – [00:04:32.649]

Speaking of understanding the data, I know non-structured data like notes and images are the bane of many of the people working on extractions. So, let’s hear about the challenges of extracting that non-structured content from diverse data sets. What are Harmony’s kind of go to strategies for wrangling it that we’ve seen success with? Well, I think the most complex thing you run into in the non-structured content and is and what lends a little bit of complexity to it or makes it tricky is because it can be such a vast set of content. It can be scanned, documents, images, forms, worksheets or anything the rigid any product needs to capture. Our strategy around it though it is very similar to what we do with discrete data is to get an understanding of what it is and how it’s used in the context of the product and the data consumer. Once we have that knowledge, we can then go about determining the technical underpinnings whether it is in the database or stored outside of it, what format it’s in, whether it’s encrypted or it’s compressed in a format that’s not standard industry standard. Those kinds of things I’d say in that chain, the last step really is how you’re going to convert that to something that is industry standard if it’s required. I think a lot of data engineers tend to look at it through the other end of the tunnel and come at it from a oh, is this in a format that I know angle and when it isn’t then either considered a dead end altogether or try to back into its technology and purpose to gain context of that content. I think that kind of point of view is one of the reasons why we’ve had success serving many health systems and IDNs that often have that larger, more complex data sets.

[00:04:34.798 – [00:05:24.139]

Can you talk a little bit about how Harmony services, the unique needs of these large organizations? Well, there’s certainly some, you know, shifts and pivots that we do in working with large healthcare systems. and IDNs. We generally leverage our standard processes, we might eliminate some high-level steps in the introduction processes because many of these entities and organizations were working with time and again, they already understand those steps. We also might have personnel on the other end that are responsible for the content, you know, the care and feeding of it in the legacy application or the legacy infrastructure. So they’ll know where that content lives. They can provide us backups versus you know, us going and getting them those kinds of things. But I’d say that, you know, the real core of what we do within our proven standard processes serves us well, whether that be in a small organization or a large IDN.

[00:05:26.298] – [00:06:24.449

So, what are some of the unique data challenges faced by those larger IDNs given their multi-hospital structures and often the larger number of applications that they have under their management? Yeah, I’d say that the real challenge within a multi-hospital structure versus maybe a single clinic entity, those two big challenges within there are within the terms of legacy data that needs to be archived or migrated around the mix of the platforms and the legacy software solutions that make up their decommissioning portfolio and personnel who have experience with those legacy solutions. It can make the route to understand the what of the legacy solution difficult and the what is what drives the route to the solve at the end of the day? Fortunately, in a lot of those cases, we can assist clients with those legacy systems in terms of some of their infrastructure and by infrastructure. I mean, both what it runs on database platforms, those kinds of things due to our vast experience with over 550 software brands that we’ve worked with over the years.

[00:06:26.750] – [00:07:33.189]

So, thinking about those challenges that they’re facing, do you have a kind of ideal engineering process when working with an IDN client, from that initial consultation to the implementation and then the support afterwards? Kind of a difficult question to answer because I don’t think it’s a one size fits all kind of framework. More generally, I’d say the biggest advantage, whether it’s in IDNs or clients with a small set of legacy solutions is to have someone that knows the product on staff. And by knows that, I mean, can know it from a usage standpoint, can know it from an infrastructure standpoint, those kinds of things because if you strip away all the technical wizardry involved in the process, at the end of the day, you’re trying to preserve patient care data and have it accessible to the staff, having that person that can ensure that the critical content that existed previously is somewhere that is accessed and secured and can provide context in both what is needed for retention as well as looking at through the right lens in the target endpoint. And by target endpoint there, I mean, the consumers that are going to use it once, once that legacy applications retire is really key to successful outcomes.

[00:07:39.809] – [00:08:40.710]

So you’re working with a lot of different organizations. How do you help foster the strong relationships with IT teams and stakeholders within the IDNs to ensure a successful data extraction project? Well, I think that comes back to one of our core values here at Harmony, which is to be easy to work with as we’re working with client resources and teams, not just on the extraction engineering side, but throughout we try to be supportive of what clients are ultimately attempting to accomplish. I’ve had an opportunity where we’ve been collaborating with the client on it for a number of months. So instead of coming at it, like some votes would by saying, Yep, looks like you have a real problem there. I’ve tried to be and I think we all do within Harmony Healthcare IT collaborative with them as an extension of their own team. I think the fact that we do that a lot here at Harmony is what has allowed us to have strong long-term relationships with any of our clients. That’s true. We have strong devotion to our core values, which I think helps serve us well for your sales engineers on your team that are working with these IDNs or other organizations.

[00:08:42.960] – [00:09:32.428]

What are some of the best tips for identifying needs? Showing ROI and navigating those kind of complex procurement processes when we’re trying to get a process going or project going. I say on the need in the ROI side of the fence, we, we pretty much covered that in some of the topics we talked about before but to summarize it, it really comes down to understanding what is historically significant and necessary for content consumers and ongoing patient care. On the procurement side of the fence, I’d say, you know, no one to raise your hand. We’re always willing to collaborate with outgoing legacy solution vendors go-forward target system vendors, etc, as a client advocate again, we handled a lot of knowledge around many legacy solutions and their respective vendors and that tends to reduce some of the complexity around those procurement and delivery processes.

[00:09:34.599] – [00:10:26.308]

So, looking ahead, what do you see as emerging trends and technologies that will shape kind of the future of data extraction in health care? I think we’re going to continue to see data platforms that become a lack better way to put it more agnostic. The players in this space were able to look at data transport, whether it be medical data or other kinds of data. For more of an efficiency angle and have agility versus a rigid set of well, we’ve always used X platform or X technology are going to emerge as leaders. I also think the whole notion of proprietary closed off data storage platforms are going to continue to die off. It’s not to say they’ll be less secure. Certainly. And the idea that you have to lock down the technology or product uses in such a way that one of ten people in the world can use it or more importantly in in the functions that we do in the services we provide the data related to it. It is in a viable future model.

[00:10:28.649] – [00:11:26.389]

That makes sense. And of course, we’d be remiss not to talk about perhaps the biggest trending topic in healthcare, which is AI. How do you see that affecting what we’ve talked about? Yeah, that certainly is the big buzzword right now. AI and I don’t think there’s any denying that has implications both on the data extraction and delivery side of the fence. If you just think about that as kind of a slice from the security angle and the ability for human touches to be removed from the process. It’s significant. I think AI will also play a major role in the management and cataloging. An incredible amount of data organizations have under management and stewardship. One thing we talked about internally is just making sure that AI is well vetted and secure and you’re thinking about it from all angles before adopting it in an organization, whether it’s ours or you know, a healthcare provider. So it’s a responsible adoption of it. Right. Absolutely.

[00:11:28.469] – [00:12:03.340]

Well, Darryl, thank you so much for taking time out to join us today. I think that was a good overview of data extraction challenges and addresses, you know, a lot of the questions that we field from healthcare organizations every day. Appreciate you jumping on. Thank you. It’s been a pleasure to speak with you today and enjoyed it. And to our listeners, thank you for joining us. Be sure to tune in next time for another discussion about legacy data and healthcare. That’s it for this session of HealthData Talks, check out helpful resources at www.harmonyhit.com and follow us in your favorite podcast app to catch future episodes.

Speakers

Host:
Amy Holmes, Director of Marketing, has gained over 15 years of diverse marketing experience. At Harmony Healthcare IT, she is responsible for all aspects of marketing, helping connect the healthcare market with our legacy data management solutions.

Darryl Mais, Darryl has worked in the healthcare automation and data space for over 30 years. Currently at Harmony Healthcare IT, Darryl is the Director of the Solutions Engineering team. His daily activities include infrastructure, data, and platform design to support both our Sales Team and our clients. He takes a lot of pride in making sure we have the right solution for the opportunities presented to us and that our clients feel like they’re well-informed about the details of our offerings.

Subscribe
You can subscribe to the HealthData Talks Podcast on Spotify, Amazon Music, Apple Podcasts and more.

Transcript

[00:02.70] – [00:15.01]

Welcome to HealthData Talks where industry experts offer bite sized tips and trends for managing legacy data. Thank you for joining us. I’m Shannon Larkin with Harmony Healthcare IT and at Harmony, our specialty is working with legacy data. We’ve been focusing on that in healthcare for the past 17 years. And the thing is legacy data isn’t always the easiest thing to get. There’s aging out of production software and servers that can sometimes pose real challenges for technicians. So, that’s why we’ve asked Ally Hysell, our System Analyst Manager at Harmony to join us today. So, Alli, thanks for being here. Thanks, Shannon. Happy to join today.

[00:48.52] – [01:29.21]

So I know you’re the right person to talk about legacy data acquisition, but to get us started, why don’t you give our audience some background? You know, on yourself, your role and your team. Yeah, absolutely. So, I’m a local here in South Bend. I live here with my husband and our son who will be two at the end of this month. I’ve been here at Harmony for a little over five years and I oversee the Systems Analyst Team who primarily is responsible for all incoming and outgoing data. Our team primarily coordinates with our clients and their vendors on expected deliverables, which includes the format of their data, their timing and the confirmation of their overall alignment of the scope.

[01:31.95] – [02:50.28]

So, this is a definitely a critical role. It’s like the starting point for bringing data into our environment. So, it can be but transformed, converted stored right to fulfill whatever scope of work we’ve contracted for. So, tell us how this works. Most often is your team extracting the data directly from a legacy system? Is the data provided to us from that legacy vendor? Just kind of talk about how we get started. Yeah, absolutely. So, sometimes we are contracted to do the the legacy extraction. Primarily, we do see that we are often working with the legacy vendor to provide us the data and data is typically delivered to us one of three ways, all of which are equally secure. That transfer method mostly depends on the total size of the data that needs to be moved. And any data that is less than one terabyte, we typically recommend utilizing SFTP which is secure file transfer protocol. That’s typically utilizing an application such as FileZilla when SP or go anywhere for any data totally totaling data size larger than a terabyte. We typically recommend sending an external encrypted USB hard drive.

[02:51.05] – [04:25.64]

Let me stop you right there because I know Harmony works with some of the largest health systems in the nation. So, I would imagine that we’re seeing data sizes in excess of a terabyte quite a bit. So, can you comment on typical data sizes maybe and then maybe expand on the hard drive process a little bit? Yeah, absolutely. So, our data size is vary astronomical sizes. So, typically practice management systems we can see in megabytes to gigabytes. Those systems are typically on the smaller side. Whereas our acute clinical systems for larger hospitals, those are where we start to see larger sizes where we see closer to the terabytes. So, those could be 10, 50, even at the 200 terabytes worth of data and external images. So, in terms of our hard drive, so we typically utilize those for our larger projects. So, our larger terabyte transfers for our data sets, our go to brand is APRicorn. So, for some of those key features or that hard drive include a 256- Bit AES hardware encryption, which basically just equates to two layers of added encryption. You are also provided a pin to unlock the device utilizing an external keypad on the drive. And one additional security feature includes an unattended auto lock set which sets the drive to a lock after a period of inactivity for extra added security.

[04:26.45] – [05:04.81]

So, just out of curiosity, how are those hard drives shipped? It sounds like the device itself is very secure. But I’m just wondering how the precious protected health information cargo makes its way from the client site to our physical site securely. Yeah, so, absolutely. So, we ship our hard drives in a secure case with a custom insert for each drive and it’s cabling. We’ve recently made the change in our shipping to ensure the security and the durability of our transporting of the physical hardware. But it also helps us reduce the our carbon footprint. That’s interesting.

[05:06.92] – [05:48.19]

So, you mentioned I know I got us off track here with the hard drive, but I find that kind of interesting. So, you originally mentioned three ways data gets delivered. So, what’s our last method then? So, our last method is our cloud storage transfer. So, this is where our clients utilize their existing cloud storage such as AWS Azure or GCP, which is Google Cloud Platform where they are able to provide us connection credentials to allow us to securely download their data utilizing that connection information. And that’s where we’re able to securely transfer their data or external images.

[05:48.75] – [06:41.85]

So, this method seems really logical to me. So, do you see this transfer method happening more often as hospitals transition to the cloud? And, if so, is there one platform of the ones you mentioned, the big three that emerges is more prevalent? Yeah, absolutely. So, a few years back, we ran into a few cloud transfer request maybe once every three times a year. Nowadays, I see it at least twice a month. You know, our larger hospital and enterprise clients are investing in cloud storage and utilize that storage to their advantage as they look to archive their data. In terms of, you know, one cloud storage platform to another, I would say kind of the big three are again, you know, AWS or GCP. Those are probably the top two I see most often.

[06:43.07] – [07:37.81]

So, we’ve covered the methods for data delivery. Let’s say we have a client that implements a new EHR and they’re ready to archive the legacy systems that EHR just displaced. Maybe talk to us about the process and when and how your team engages in that project. Well, that’s a good question. I think about it as a kind of a ticking clock. It starts pretty much as soon as the client engages their vendor for a date extraction. And the Systems and the Analyst Team is often engaged along the way to ensure that the expected distraction deliver often aligns with the appropriate format. So, we often help kind of navigate through any technical conversations with the vendor and the client and this can be anywhere between a few weeks to several months, really just varies between vendor to vendor.

[07:38.80] – [08:58.47]

So, what kinds of things might make that extend from weeks to months? That’s a good question. So, a few things, I think most commonly it’s going to depend on the size of the data. So, depending on your total size of the discrete data that you’re extracting and the total size of your external images. So, if it’s a few megabytes to gigabytes may take that, you know, 4 to 6 weeks. If you’re looking at a larger acute clinical system where we’re looking at terabytes worth of data, that might range for a couple more months where in some cases, it might take 3 to 6 more months. You might also need to look at the the database platform size that will also play a factor where it’s going to determine the overall format of the deliverable where that will play a role in in the length of time, it’s going to take your vendor to actually extract that. And I would say that the most challenging is when the clients data is held in a multi-tenant vendor hosted database. And that’s usually where we see extraction times usually take the longest because the vendor often has to perform their work after hours, so it does not impact their other tenants.

[09:00.30] – [ 10:39.91]

So, I’m kind of surprised at the time frames and there is an information blocking provision in the 21st Century Cures Act, right? So, even if some of these factors you’re mentioning might slow the data acquisition process down, you’re ultimately always gonna be able to get at the data, right? Because the legacy vendors just have to provide access to the data. Yeah. So, you know, in some cases, we’re not always able to have, you know, direct access to the data itself, but we’re always able to kind of navigate our way around it. So, in some cases, there are what we call proprietary files delivered. So, in this case, all vendors have different files or versions of an encrypted file, which is unique to them. Ultimately, those are files that we’re not able to work with unless it’s an in the lock or decrypted. For example, we often work with eClinicalWorks where they have encrypted progress notes. And if a vendor is unable to provide this um XML, which is a type of document in an unencrypted format, the alternative is to engage our cross functional team, which is our data automation specialists who utilize their role product, automated processing tools to capture that data on the front-end of the application to mimic the actions of the front-end user. So, ultimately, we won’t necessarily if they’re not able to provide us access to the data, either delivering that to us, and we’re not able to provide us access to the back end of the data, we definitely have the tools to kind of work our way around it.

[10:42.42] – [12:03.89]

So, Harmony archives, hundreds and hundreds of legacy systems each year, how would you characterize the percentage on how many data extractions go, let’s say, smoothly versus not smoothly? In general, my team works effectively on their day-to-day items. I think the big thing is being proactively engaged to plan and emphasize the importance of communication, you know, a typical day for a Systems Analyst could include chatting with a client about dating credentialing information to a vendor’s SFTP site to, you know, transfer the data or working on a troubleshooting call with a vendor to review an index file that maybe was delivered without header information. So, I think despite some of these challenges, we’re always working with our clients on a path forward. So, you know, I think at the, the start of all of our products, Harmony conducts the technical key decisions and planning call right after the kickoff and at that session, you’ll meet one on one with our Systems Analyst. And we’ll confirm, you know, the optimal data transfer method kind of map out when, where and who on the data of delivery. And you know, I always highly encourage all of our clients to invite their vendor to their meeting at that time. That makes sense.

[12:04.34] – [13:05.61]

What kind of background do the System Analysts on your team have technically like what would your ideal candidate look like if you were hiring your next Systems Analyst? Oh I like this question. So, for Systems Analyst, you know, I often have a mixed bag of experience. I think the ideal candidate has an experience, has experience with, you know, database management, overall data extraction but can also kind of put on their general IT admin hat and dive into some troubleshooting with an LDAP issue. You know, we’re often dealing with a wide variety of different database platforms such as Db2, Sybase, Oracle, Postgres, and FoxPro. And that’s just to name a few. So, this requires the SA to kind of, you know, sometimes act as a technical liaison with our Project Management Team, which is crucial, you know, when translating technical challenge to our clients for just general next steps. Crucial for sure.

[13:07.64] – [14:05.52]

I think Harmony is pretty lucky to have you at the home to manage that team and just the data acquisition process overall so that, you know, the ata specialists at Harmony can complete the data conversions and the archives that we’re contracting for and that, you know, just keeps patient and employee information safe the entire time. So, Ally, I’m so glad you were able to carve out some time and join us today. Thank you very much. Yeah. Thank you so much for having me today. Yep. I think we learned a lot about the data extraction process and how we’re handling it. So, to our audience, thank you for joining us and be sure to tune in next time for another discussion about legacy data in health care. That’s it for this session of HealthData Talks check out helpful resources at www.harmonyhit.com and follow us in your favorite podcast app to catch future episodes. We’ll see you next time.

Speakers

Host:
Shannon Larkin, VP of Marketing and Business Development at Harmony Healthcare IT, utilizes her 25+ years of health IT experience to connect healthcare organizations with a team of experts that consolidate and modernize data storage to reduce cost and risk.Guest
Allison Hysell, has worked with Harmony Healthcare for 5 years within the Systems Analyst Department. She graduated from Saint Mary’s College with a bachelor’s degree in management and information systems with a passion to pursue accessible technology. She currently reside in South Bend, IN with my family. In her free time, she enjoys traveling to various local state parks in Michiana.

Subscribe
You can subscribe to the HealthData Talks Podcast on Spotify, Amazon Music, Apple Podcasts and more.

Transcript

[00:00:02.568] – [00:00:57.452]

Welcome to HealthData Talks where industry experts offer bite sized tips and trends for managing legacy data. Thank you for joining us. I’m Shannon Larkin with Harmony Healthcare IT. And as most of you know, at Harmony, our primary focus is helping hospitals to decommission legacy systems. And those system types range from electronic health records to billing systems to enterprise resource planning software. So today, I’ve asked Amanda Alth an Implementation Specialist at Harmony to join us because I want to talk specifically about active archiving for financial systems. So, thanks for taking time to be here today. Amanda, thanks Shannon. I’m happy to join. Awesome because I think you’re the perfect person to talk to us about archiving when there are still accounts receivable to collect.

[00:00:58.689] – [00:01:39.454]

So, can you just share a little bit about your background and what you do at Harmony to get us started here? Absolutely. I’m an Implementation Specialist and my specialty is revenue cycle. Back end revenue cycle is my passion. And when I talk about back end, that means anything pulsed your billing, anything that has to do at the end of the revenue cycle, I like to cut those payments work denials and all of that I have an HFMA which is the Health Care Funding Management Association certification as a revenue cycle representative. I also have an MBA in healthcare administration. In the last 12 years. I’ve been working in both as a vendor and I have been the client as well. Oh, yeah, I love that, that you are both a vendor and a client. I think there’s always value when someone like you has been on both sides.

[00:01:42.959] – [00:03:30.955]

So, and with that, then talk to us about managing legacy A/R and like what is driving these account receivable teams to wind down A/R from an archive versus, you know, the actual billing system they’ve been using. It’s all about system transitions. A lot of health organizations are now ready to transition to a new accounting system and decommission their legacy systems. They’ve spent years and millions of dollars so they can meet federal electronic health record mandates and what’s critical during that transition to a new EHR is understanding the nuances and balancing and the need to manage historical accounts receivable with increased regulations related to patient privacy. And then billing, you need to have a strategic approach to managing legacy patient accounts post EHR and the conversation for that is key. I’m sure it is. You, you’ve always got to keep your eye on collecting the money, right? I mean, that definitely is key. That’s exactly right. And a lot of these organizations now are looking at that no one ever really looks at revenue cycle. You know, healthcare executives are so focused now on accelerating the cash migrating revenue cycle performance risk. And to do that, we help them identify strategies to access and manage legacy accounts and receivable data. There are federal and state regulations and guidelines that define time frames for retaining patient accounting data. And I think it’s 10 years, but certain states have different regulations. It’s very important that health care organizations understand the functional capabilities that an archiving system can offer them to meet those requirements. The great thing is at Harmony, we can make that very easy for you. So, now you’re doing my job as a marketer. That’s right. I mean, I think we can make it easy.

[00:03:32.679] – [00:04:44.579]

So, talk to us about how we do that because I mean, why not just keep the legacy rev cycle system up and running to wind down accounts receivable? It almost seems like that could be easier than moving it to an archive. It really comes down to managing cost versus risk, old production revenue cycle systems can be expensive to keep up and running for the time it will take to collect on those receivables, especially when you’re not billing any new claims out of that system. At Harmony we help reduce the cost of legacy system support and maintenance. It’s much more cost efficient to collect out of an archive solution. So, we’re enabling account resolution during the system transition and we’re ensuring that record retention compliance once receivables wind down and the records are stored for you long term. When it comes to risk, our HealthData AR Manager^® solution is HITRUST certified. We’re also fortifying defenses against cybersecurity threats. Your protected health information is really locked down and safe for all the years ahead that needs to be retained. Yeah, those are good points. I mean, and great reasons I guess to consider winding down A/R in an archive versus keeping the legacy system up and running because the cost can really run high.

[00:04:46.858] – [00:05:29.209]

So, if a hospital wants to consider an active archive for A/R wind down, like what is the best timing for that to make a transition to a new system? Ideally, you are working with your partner vendor like Harmony, I would say 12 months prior to go live. That means execute a contract between us to lay out the foundation for a seamless revenue cycle management system transition. It is critical to kick off an A/R wind down project at least a year in advance. I would definitely recommend that all legacy error account placements should begin four months prior to the go live date to allow enough time to begin the cleanup efforts and cash acceleration for the aged accounts that you’re going to be working.

[00:05:30.619] – [00:06:16.100]

So, what do you mean by you, you mentioned A/R account placements. What is that? When I say A/R account placements, I mean, the placement process continues monthly until about three months. Post-go-live. By that time, the large majority of those aged receivables will be worked and processed to allow maximum cash acceleration during a concentrated time period. You want to collect that money as fast as possible. This time timeline will allow for clean and smooth entry into your new A/R system. It will also allow your SMEs and staff adequate time to focus on training and preparing efforts without having to work aged receivables from legacy system. They don’t need to be looking at that while they’re also transitioning to a new system. Got it. That makes sense.

[00:06:17.699] – [00:08:23.699]

Can you describe then the various archiving solutions that are available to wind down legacy A/R? Absolutely. Harmony has been working with healthcare organizations to wind down A/R for years. So, we have many tools offered to meet our clients’ needs. After doing some discovery, we propose solutions based on their facility type and how much they have of the outstanding accounts receivable. We do offer actually, it’s four solutions. We can just take it the data just static out of your revenue cycle system and it would just be a look back that way you could go back and see accounts and everything that would that happened at static date. For transaction posting module, it’s actually a way for you to post anything like self-pay balances or maybe you have to post against the GL it’s just for a very small A/R and accounts receivable, that means that your A/R has to be very low. I would say like probably anything like in the $25,000 range, just something very, very minimal. You don’t have a lot of SMEs working in that. I’m sorry to interrupt you. But so far you’re describing almost a stair step approach. It’s like you’re not going to collect anything. We take a snapshot, it’s in HealthData Archiver^®. And then the next step is, well, if you still do have a little bit to collect, at least you’re only posting transactions that are coming in like you say, like patient pay or something. That’s correct. So far, so good. Ok. So then what’s the next step? The next step? Yeah, absolutely. The next step is our collection agency management and that gets layered with your transaction posting module. So, you’re adding your patient balances and self-pay, but you’re also adding a collection agency interface with that. So, with a collection agency management piece, we’re actually interfacing and taking payments from an agency and they come over and post automatically into the account. So, you’re actually managing your outsourced collection agencies, right? Within HealthData Archiver^®. Nice. Ok. Very good.

[00:08:27.660] – [00:09:57.219]

And then is there another layer? Like what if, what if I do have just a lot of accounts receivables left? But maybe my contract renewal is coming up on my rev cycle system. I mean, that’s probably the heavier lift like at the hospital level when they need to do some major collections and rebuilding. Absolutely. And that’s our HealthData AR Manager^® It has a lot of great functionality. You’re able to manage more complex A/R wind down after the financial legacy system is decommissioned. So, your SMEs and billing staff can continue to collection efforts by reflecting 837s if they need it and receiving 835s. You also can manage your collection agency workflows while maintaining your predefined interfaces. We also do GL interfaces and another great quality about AR manager is that we do build work lists and we also have the EOBs and your voucher history and all your payment information right, within the application. So, your SMEs are not looking to other tools like other insurance companies. Everything you need to do is built right into the app. So, it doesn’t take your SMEs a lot of time to get their work done. It also provides the ability to send statements as well as post payments adjustments, memos and we also do refunds. And then it comes with a great list of standard reports. Right. So that’s, that’s a lot. I mean, that’s almost like learning a new system, but at least you’re only going to use it.

[00:09:59.239] – [00:10:26.940]

How long would you say a team on average? I’m sure it varies from team to team. But how long would they use this system before everything gets wound down to zero? And then it is truly archived to meet the retention, you know, guidelines you were mentioning earlier. You would really want to have everything done. I would say at least 6 to 9 and stretching out to 12 before you would want to be fully static, and that means that all of your accounts from your transition would be paid.

[00:10:28.788] – [00:11:32.009]

So, within a year and you mentioned some of the interfaces like GL and I would imagine when you’re using HealthData AR Manager^® to rebuild claims, you would need to maintain those interfaces that were in place with the legacy system. What are some other interfaces? We’ve worked with a bunch of I would say your clearing houses and your scrubbers and that would be for an 837 claim to go out to the payer. We also do 835s that come in from maybe Workman’s Comp or whatever your priority is that comes in manually posts. We also do the lockbox and then we also do any type of interfaces with Workman’s Comp or your collection agencies. Got it, got it. That’s really a great solution. And like you said earlier, you know, you get all that functionality, and you really are decreasing the cost and the risk by decommissioning that legacy software and all of its infrastructure. That’s right. Great.

[00:11:34.308] – [00:12:03.529]

Well, Amanda, thank you so much for sharing your expertise on how we help our clients to wind down A/R. I appreciate you being here. Thank you so much. I appreciate your time too and to our listeners. Thank you for joining us and be sure to tune in next time for another discussion about legacy and health data management. That’s it for this session of HealthData Talks Check out helpful resources at www.harmonyhit.com and follow us in your favorite podcast app.

Speakers

Host:
Shannon Larkin, VP of Marketing and Business Development at Harmony Healthcare IT, utilizes her 25+ years of health IT experience to connect healthcare organizations with a team of experts that consolidate and modernize data storage to reduce cost and risk.Guest
Amanda Alth, Implementation Specialist at Harmony Healthcare IT, is passionate revenue cycle leader with 13 years of experience as both vendor and client. Amanda has a master’s degree in business with a healthcare concentration and a CRCR (certified revenue cycle representative) from HFMA. She specializes in back-end revenue cycle processes. In her spare time, you can find her coaching her daughters cheerleading squad and cheering on her boys in football.

Related Resource Links

Explore our services

Learn more about HealthData AR Manager^®

Subscribe
You can subscribe to the HealthData Talks Podcast on Spotify, Amazon Music, Apple Podcasts and more.

Transcript

[00:00:02.490] – [00:00:50.060]

Welcome to HealthData Talks where industry experts offer bite sized tips and trends for managing legacy data. Thank you for joining us. I’m Shannon Larkin with Harmony Healthcare IT, and as most of you know, at Harmony, we are working with legacy data. So, primarily that is clinical data that’s just trapped in these out of production systems after a new electronic health record is implemented or maybe because of a merger and acquisition. So today, I’ve asked Susan Martinez, who is a Product Specialist at Harmony to join us because I really want to talk about the benefits that a legacy data management strategy brings to the Health Information Management team. So, thanks for being here today, Susan. Hi, thanks Shannon. I’m happy to join.

[00:00:54.898] – [00:01:45.709]

I just think when it comes to records management, the HIM team is really tasked with ensuring, you know, the integrity of the medical record that it’s accurately documented, you know that it’s Comprehensive Complete HIPAA compliant. You know, what else are they dealing with? Well, really they want to make sure that it’s protected. So, not only that it’s private but also that it’s secured from a potential data breach. It needs to be accessible for release when it’s requested, whether that request comes from a patient, another department in the system or an outside entity like a lawyer or payers organization. It definitely needs to remain compliant with state and federal retention requirements and really just keeping that patient safe.

[00:01:47.750] – [00:02:34.729]

For sure, safety is important. And I know that, you know a lot about this space, you know, mostly because you’ve been working at Harmony and with our clients, but you also have some experience working in a health system. Isn’t that right? Yeah. Correct. Yeah, I spent about 16 years working directly in the healthcare industry. So, I worked anywhere from inpatient to outpatient therapy and home care, transitional care planning to working, you know, directly with providers ensuring that that EMR experience was efficient and thorough yet succinct. Yeah, good. That’s, I mean, that’s a great background for doing what you do today in your product role at Harmony.

[00:02:37.129] – [00:03:54.038]

So, I know there are a lot of technical aspects to what you do, but a large part of it, especially when you were in in the role of implementing our software in that role, you were definitely listening to our clients, particularly HIM, Directors to help sort of purpose build a data platform to meet their needs, right? Oh, yeah, absolutely. So, you know, we start every archival project with thoughtful questions like you know what type of data is in this application? What are your workflows? How is the data placed? What does it look like? But most importantly, expectations, you know, this helps us in translating that legacy applications data into HealthData Archiver^®. So, you know, previous workflows can be continued or better yet improved. To most archiving is a means to view historical clinical data for safe patient care or maintaining records for that legal retention period, right? But to us, archiving is deeper than that. We want you to use the application to help better your practices, whether that’s in clinical care, researching trends in your community or making work easier for your teams.

[00:03:56.500] – [00:05:16.439]

Oh, you know, I just love that you said that, that is such a good point that archiving means more to us than most people think. I talked to so many prospects on the sales side, I guess maybe more so in IT where they might come into it thinking that archiving is just like cold storage, but this is really a piece of software with workflows built in that largely is aimed at helping HIM do their job. Oh, yeah, absolutely. It’s important that we ensure the data is presented in the archive in a relevant and really easy to consume format, but will also dissect their workflows, placing more meaning into that legacy application, for example, you know, pulling sensitive information into separate areas of an archive if needed and you know, that will allow this type of data to be easily excluded from a request if not authorized. So, ensuring we build an archive that can allow granular filtering is significant and mandatory. Going back to that word safe, like restricted data access. We want to ensure that our customers can provide a record that contains the minimum amount of data that has been requested.

[00:05:18.319] – [00:06:35.809]

Good point. And with that in mind, you know, maybe you could step us through some of the features that are going to benefit that HIM team directly. So, you know, like first could you describe the typical scenario when a hospital or health system approaches Harmony with a need for a health data platform? Sure. Sure. So, rather than providing monotonous products, EMR vendors are creating solutions for different types of care. So, an organization can move from using multiple vendors for their hospitals, post-acute ancillary ambulatory services, but they can move that into one vendor. So, this really translates into efficiency and better access to current health documentation. So, you know, if getting to a record is already complex and cumbersome, then creating a refined output is really risky. I can’t spend my time and energy going into five different systems to see if my patient has a record there and still have enough cognizance to review each record and delete information that shouldn’t be in that output.

[00:06:37.588] – [00:08:36.962]

I mean that is less than ideal. So, what does an active archive product like HealthData Platform^™, bring to that team then? I think, you know, just going off of what I had just said it’s a centralized records management. You know, in keeping in line with the that smart market of using one go-forward vendor. HealthData Archiver^® is a one vendor application that stores all historical data with viewing and function permission restrictions. And you know, when I refer to archiving data into one application, I’m referring to any type of historic static data that the organization needs to store. So yes, patient-centric but also human resources, financial materials management, you know, blood bank labs, DICOM imaging, anything. That’s a great point. I’m sorry to interrupt you, but I do think also that when we think of archiving, we think of it to be clinical only. So, I’m really glad that you mentioned some of those record types that are outside of what the HIM team manages because that’s also important. So sorry, I didn’t mean to interrupt. No, no, that’s great. No, we’re seeing more and more of financial archival materials management. We’re seeing a lot of that lately too. So, it really is they’re moving up on the clinical archiving. I think it’s safe to say that moving to a new system, it’s overwhelming. But imagine adding the necessity of accessing many legacy applications, not knowing if records exist to produce a complete record request. It can get messy. With HealthData Archiver^®, you can do a simple search, sort ,and filtered to see all historic records that exist for patients.

[00:08:36.964] – [00:10:14.178]

And I’m sure that’s exactly what any HIM team wants, right? I mean, just centralized organized data. Yeah, absolutely. You know, thoughtful intent with data placement, meaningful construction for that granular output data management. Those are all really what we’re thinking when we are building an archive for a customer. So, you know that thoughtful intent, we put a lot of thought into the data that’s archived. If data duplication is eliminated, the records are less cumbersome, making them much easier to navigate and gather information as well as providing, you know, a better output. Going back to our discussion of questions to create a better archive. We use this information to create print templates and date range printing configuration, you know, better filters of record structure and that results in granular record output with minimal effort. So, again, that thoughtful work upfront with asking all of those detailed questions, that really is to provide that ease and consistency in the future when you’re using HealthData Archiver^®­. But also data management, you know, once your data is archived, again, we use our experience and the information that we’ve already gathered to create and provide valuable features to then manage that information with intent and accuracy.

[00:10:16.399] – [00:11:04.570]

What are some of those features? Oh sure. Print templates, you know, they allow you to create consistent predefined record outputs. Another significant feature is our correction management. So, this allows you to keep those records completely HIPAA compliant with our correction management features, you know, such as marking data in error, adding an addendum to a record and so forth. But then also purging manage your liabilities rather than them managing you. You know, you can purge that information that you’re no longer required to have, but still at the same time, provide traceability.

[00:11:08.048] – [00:14:20.849]

So, Susan, do a lot of clients use that purging function or how does that work? Because I would imagine that you know, some of them have strict policies not to purge, so I’m just kind of curious if it, if it weighs more toward purging or not to purge or not to purge? Right. Yeah. So, we have, we have a few customers that have really jumped in and said, yes, we’re going to do exactly that we don’t want these liabilities to affect our, our organization. So we’re, definitely going to purge. And, you know, another area that, that this purging conversation really comes into play is at the beginning when we’re scoping out a project, you know, your team will come to us with an application that needs to be archived and it could be an application that was live in 1995. So, that’s a big question upfront. We only have to hold this data until such a period of time. Do we want to archive all of this data that goes back to 1995? Or are we just gonna go back a certain period of time? And honestly, our response is always, let’s take all of the data, we know that it will be consistent. We won’t have to filter anything out. But once we place all of that data into an archive, use our purging routines, we have automated routines that we can set up for you. You’ll set the criteria. But then what happens is that’s where that traceability comes into place. You have a certificate of destruction that says yes, there was a visit or an encounter at this period of time, but it fell within your criteria to purge and then you know that that application is going be really truly accurate, comprehensive and, and paint the the correct picture of that patient.

[00:13:08.570] – [00:14:20.849]

That’s important. And then you also mentioned correction management. Is there an example of when you might attend a record in an archive? Just a quick example of that. Absolutely. When we archive data, we will archive the data exactly as it was while the application was live. But we all know corrections errors happen. So, you know, if you’re going through a patient’s record, historic record in HealthData Archiver^® and you see a medication on the list that just doesn’t fly, it’s not really an accurate medication. It was really documented in error. Well, you can use our error correction. We have both visual meaning if I mark data in error, you’ll have a visual that tells you this data isn’t correct. But then you can also use that addendum feature to close the loop and document why that medication was marked in error, and you can use a specific reason to really manage that chart and record.

[00:14:23.019] – [00:15:08.564]

That’s great. And then the last question I have just around features and functions. I know that in an electronic health record, you’ve got to break the glass feature and that is something that is available in an archive. Oh, correct. Yes. So, we have a few different layers of break the glass. But yes, we can definitely you know, working with the identifiers in the in the database, we can set up a break the glass feature for patient management within the archive. That’s good. So, a lot of rich features here for the HIM team and I really appreciate you stopping by to talk about that a little bit today. I think it’s been very helpful.

[00:15:08.570] – [00:15:42.710]

So, thank you for all the information shared today and we’ll have to have you back so that we can tackle another user persona on HealthData Archiver^®. Well, thank you very much. I will be happy to join whenever you want me. All right, Susan and to our listeners, thank you for joining us. Be sure to tune in next time for another discussion about health data management. That’s it for this session of HealthData Talks. Check out helpful resources at HarmonyHIT.com and follow us in your favorite podcast app to catch.

Speakers

Host:
Shannon Larkin, VP of Marketing and Business Development, utilizes her 25+ years of health IT experience to connect healthcare organizations with a team of experts that consolidate and modernize data storage to reduce cost and risk.

Guest: 

Susan Martinez, Product Specialist at Harmony Healthcare IT, brings a unique work history from both design and almost 20 years of healthcare experience to the team.  Blending her design background with healthcare experience, she focuses on understanding workflows and data content to assist our Product team create relevant, intuitive, and comprehensive products and features.

Subscribe
You can subscribe to the HealthData Talks Podcast on Spotify, Amazon Music, Apple Podcasts and more.

Transcript

[00:00:02.528] – [00:00:22.839]

Welcome to HealthData Talks, where industry experts offer bite sized tips and trends for managing legacy data. Thanks for joining us. I’m Shannon Larkin from Harmony Healthcare IT, and I’m joined today by Nick Cardwell. Nick is our Director of Cybersecurity at Harmony. Thanks for being here, Nick. Thanks for having me, Shannon.

[00:00:25.039] – [00:01:48.609]

So, Nick, at Harmony where our job really is to store and protect PHI for our health care customers, security is definitely key. I mean, I would say it’s more than key. It’s like our top priority. So, I was hoping today we could just have a general conversation about security in healthcare. I mean, it’s no secret that health data is highly sought after by cyber criminals. There’s just so much rich data in a medical record for a criminal like date of birth, social security number, insurance information. So, can you just generally comment on the risk for health care providers today? Yeah, I mean, in the past, you know, three years, health care data breaches have doubled, right? According to the 2023 CrowdStrike Global Threat Report, one of my favorite reports to read on an annual basis. Healthcare is the most attacked sector behind financial and technology. So cyber risks threat, you know, an organization’s ability to operate and access their information. Really impacts their reputation and customer trust when they are, you know, impacted by a cyber event. It obviously impacts the organization’s survival, right, the ability to keep doing business as a result of that. And then of course, in healthcare, it could come down to actually impacting patient safety. So, yeah, there’s a lot at stake when you take a step back and realize potential impacts to cyberattacks.

[00:01:50.739] – [00:03:56.838]

Yeah. And when health care organizations archive their legacy data with a vendor like us, they’re essentially offloading risk and transferring that risk to us. So, what would you suggest a hospital or a medical practice looks for in an archiving vendor when it comes to data protection? Ah, I mean, a few things, right? You want to look for a, a vendor who, you know, maintains certification such as HITRUST or an equivalent that just shows that they go above and beyond, standard security practices. But beyond that and included in that, right, you want to make sure they’re able to respond to incidents, nobody’s immune to incidents, right? So, you want to understand their endpoint monitoring, their endpoint response or they’re working internally with the security team or they’re working externally with a security provider. You know what tools or solutions do they have in place for instant response and recovery, you know, CrowdStrike, endpoint detection, Artic Wolf, Sophos Trend Micro, you name it, there’s plenty out there, right? Other than that employee training, right, I can’t stress enough how important it is to train your organization’s employees against social engineering, such as phishing, but also proper data handling. That really helps build a security culture, which I believe is one of the most important aspects of growing businesses, right? Building that security culture because it’s, it’s there, it’s the threat is there, and it will always be there. So, making security a common topic of discussion and everyday procedures. We tell our employees personally that if it doesn’t feel right, say something even from their first day here and then, you know, as in, you know, you know, every now and then we’ll have a reminder about that. But I truly believe that’s really helped set the tone for our organization personally. It just shows how seriously we take security. I totally agree. I mean, I’ve been an employee at Harmony Healthcare IT kind of since the beginning and I take all of that very seriously with our annual training and our phishing, you know, tests and, and that sort of thing, you always must be on guard. So those are good suggestions for what to look for in an archiving vendor.

[00:03:59.189] -[00:06:04.051]

How else would you say Harmony Healthcare IT is really ensuring the security of our clients’ data? Are there other, other things we’re doing? Yeah, I mean, you know, part of that is we go above and beyond from, from a security stance by just investing in HITRUST that when you, you know, invest in Harmony Healthcare IT as you know, you, you’re a third-party vendor. Our platform is backed by HITRUST certified infrastructure practices, solutions policies and procedures. And its no easy task to do and maintain, right? So, we’re constantly on top of, you know, making sure we’re compliant with HITRUST controls, making sure that we’re on top of everything we need to be to prevent any malicious event or any breach to customer data. Customer systems for instance, are filtered against whatever they decide they want to access. So, what I mean by that is IP whitelisting is a pretty common term across the industry. But essentially, if a customer says these are the only, you know, locations we want to access our platform, those are going to be the only locations that are going to be able to access that platform. It just kind of minimizes that attack surface right off the the bat, right? But then we offer MFA and SSO capabilities. So, we’ve got to help facilitate secure authentication by doing that, which in turn, that’s backed by industry standard security group and role configurations that customers are in control of so that they allow their employees only what they’re allowed to do. You know, this is also known as lease privilege. So, but on top of all that, when customers choose to go with us, we take on a significant portion of the security responsibilities such as intrusion prevention and detection, both at the endpoint and at the network level, this goes a long way because we essentially monitor the environment 24 by seven by 365.And we utilize two separate top of the class managed security providers who are considered some of the best in their field, obviously. So, we kind of go to those measures just to protect our customers data.

[00:06:05.600] – [00:07:11.379]

That’s a lot. Yeah. And I know HITRUST is so important and we’ve been HITRUST certified for years, right? Like I want to say five years since 2017 actually. So we’re going on our sixth year, going on our sixth year and how often is HITRUST recertified? So, we’ve, we’ve always certified every two years to complete and then every year, every other year, there’s an interim. So, you’re essentially goin through a certification every year. But they take it easy on you on the interim side and then the next time around you go for a full certification and in each time in that we’re constantly gauging where they’re maturing as far as a framework and going up to the next step. Right. So, they’re releasing new versions of their framework. We’re assessing that framework to make sure it’s still applicable to us, make sure that it’s still right for our organization and improves the security of organizations. So, each time is different, but, you know, it’s one of those things with HITRUST that you’re constantly maturing your security of your program, which is huge.

[00:07:13.059] – [00:08:09.047]

I love that. And I’m not sure if, if your average hospital is also HITRUST certified, I guess you can comment on that but, but I’m, I’m curious to know what organizations can do themselves in house to reduce cyber risk? Yeah, I mean, you don’t know what you don’t know. So you have to start with identifying the risk now how you do that’s up to you. There are many affordable offerings out there where you can get a qualified third-party consultant or organization to come in and provide you with your organization’s risk, right? But if you’re not willing to pay for something like that right up front, there are many resources out there, CISA, The Department of HHS also has some awesome free solutions that can really help you self-assess your organization’s security risk and also your security posture, so I urge organizations to at least start there. Right.

[00:08:10.509] – [00:11:18.349]

Yeah, that’s helpful. I, I saw an article recently around how security can really be a struggle for a lot of the smaller hospitals and clinics, you know, where they just, they may have limited resources. Is there advice that you would give to those smaller organizations? Yeah. So, some may not have proper security processes in place. And they may be wanting to improve on their existing security program. There’s a lot you can do. But, you know, in my opinion, I would definitely, you know, boil it down to this, you know, small list which starts with just knowing your systems, taking an inventory of what you have. There’s an old security adage that you can’t secure what you don’t know you have. So, it’s very important to know what you have. So you can assess what security controls you can put around those items. Antivirus is a big one, pretty common out there, but frankly, this is an evolving requirement. You know, antivirus is not the same as it was 10 to 15 years ago. There are vendors out there that are building on antivirus going towards more the endpoint detection and response.  Next-Gen Antivirus really just trying to prevent the next big cyberattack. So, depending on what you want to do, you don’t have to go that far, but really having pretty much standard antivirus in place can, can prevent quite a bit of significant attacks. So, I would look there and then finding the right security framework. This is very important for an organization because you know, it has to be right for you both paid and free security frameworks have their nuances, right. Finding the right one for you. That makes sense from both the financial and legal aspect can really help your organization build a valuable path to maturing a security program. HITRUST and not to plug them here. But HITRUST definitely helps us improve on that because it helps us dial in on what we’re scoped for, right? We’re not a hospital. but we do work with hospitals. So, they, they build control programs that are essentially built for us, which is pretty awesome. And then creating a security policies and training staff policies absolutely help govern your organization’s procedures on a day-to-day basis. I know policies can sometimes be tedious to maintain, but they are of the utmost importance and really they help build that security culture that I was referring to earlier. Security culture definitely helps organizations continue to improve their posture because everyone’s talking about it at the forefront of conversations. And so, and then the finally set approved access privileges, at least privilege, in my opinion, is probably one of the most important controls an organization can put in place. I mentioned antivirus before. You absolutely want to have antivirus. But if all your employees have, or employees have administrative privileges on your endpoints, that would make no difference to an attacker, they’ll just disable the antivirus and then move it out their way. So, I mean, who can do what essentially only admins should have admin accounts and building on that, those accounts should be separate from their day-to-day accounts. So that would be what I would break it down to be.

[00:11:20.099] – [00:12:44.798]

Yeah, and so helpful. I mean, I think that’s good advice, not only for small hospitals, but healthcare organizations of any size. So, there’s just so much to keep on daily, keep, you know, keep up on. Are there any, you know, blogs or reports that you find yourself checking every day or anything you would recommend? What’s your feed? Oh, there’s quite a bit. I do frequent social media and I like to follow a lot of the, you know, security experts in the industry. I think a lot of the material that CISA puts out there has come a long way. I think they’ve provided a lot of, you know, benchmarks and checklists and items of that nature to really help me kind of feel good about what we’re doing. And they’re also very good about, you know, alerting us of, you know, growing threats, commonly exploited vulnerabilities across, you know, industries and rights. So, I definitely recommend CISA and there’s, there’s quite a bit of others but really just going out there and to, and using your resources, Google, there’s, there’s quite a bit of information out there but you know, just focusing in on healthcare, The Department of HHS has quite a bit of resources around security controls. So, there’s, there’s no shortness of information, that’s for sure.

[00:12:46.058]- [00:13:20.629]

Excellent. Ok, great, Nick. Thank you so much for joining us. I think you provided a lot of good information that our listeners will appreciate. So, thanks for being here. Yeah, thanks for having me and to our audience. Thanks for tuning in and be sure to join us next time for another episode covering tips and trends for managing your health data. That’s it for this session of health data talks. Check out helpful resources at HarmonyHIT.com and follow us in your favorite podcast app to catch future episodes. We’ll see you next time.

Speakers

Host:
Shannon Larkin, VP of Marketing and Business Development, utilizes her 25+ years of health IT experience to connect healthcare organizations with a team of experts that consolidate and modernize data storage to reduce cost and risk.

Guest:
Nick Cardwell, CISSP, CCSP, Director of Cybersecurity, has 5+ years of experience in Cybersecurity since graduating from Indiana University with a B.S. in Informatics with a focus in Security and a minor in Criminal Justice. In Nick’s professional career, he’s had experience in Governance, Risk and Compliance (GRC), HITRUST Compliance, HIPAA Compliance, Security Architecture and Engineering, Security Operations, Identity and Access Management, Incident Response, System Administration, Networking, Data Analysis, and Management.

Subscribe
You can subscribe to the HealthData Talks Podcast on Spotify, Amazon Music, Apple Podcasts and more.

Key Moments

(0:54) The episode kicks off with Larkin introducing Liddell and his areas of focus within the organization – process improvement and quality. He hits on the structured program Harmony has formed around measuring quality regarding client feedback from projects.

(2:11) Next, Larkin and Liddell discuss the operational commitment it takes to get client feedback. Liddell explains how three sets of client interviews are set up and spread out amongst the different project stages and the selection process of who is interviewed.

(4:58) Project timeframe and Harmony’s structural approach to feedback is covered. Liddell hits on how the archives Harmony produces differ from client to client, meaning timeframes can range. Project Managers oversee scheduling quality checks at the appropriate times so the quality checks align with the correct project phases. The goal is to have client check-ins timed so the archive work Harmony has done is relevant and fresh for accurate feedback.

(8:45) Larkin asks Liddell how client satisfaction is measured. Liddell explains that Harmony has their own way of measuring satisfaction, and they use Net Promoter Scores (NPS). Harmony scores an average from the planning, work, and utilization scores to look for patterns and trends of where improvements can be made and identify areas they are doing exceptionally well in.

(10:08) The way Harmony tracks quality in comparison to other industry analysts such as KLAS, is the next topic of discussion. Liddell comments that Harmony has a unique program put in place that clients realize and appreciate Harmony’s efforts in improvements based on feedback and scores.

(11:47) The subject changes to the different stakeholders Liddell speaks to most often when conducting project interviews. He explains how he often speaks to Project Managers, subject manager experts, technical folks, and CIOs.

(12:40) Harmony has not only archived archives but has taken over and finished archives for clients when a competitor vendor was unable to complete the project. Larkin and Liddell discuss reasons competitors have been unable to deliver projects and the most difficult part of archives as it relates to the legacy system. Liddell hits on planning and expectation setting with clients. Archives are utilized by users in different departments within a healthcare organization. Harmony has been able to modify their products based on feedback provided by clients to better serve them.

Speakers

Host:
Shannon Larkin, VP of Marketing and Business Development, utilizes her 25+ years of health IT experience to connect healthcare organizations with a team of experts that consolidate and modernize data storage to reduce cost and risk.

Guest:
Tim Liddell, Strategic Advisor at Harmony Healthcare IT, brings nearly 40 years of experience creating and deploying IT offerings in the healthcare space, Tim brings a strong knowledge base to help facilitate operational efficiency and growth. Tim has worked successfully in a variety of verticals including EHR, ePrescribing, provider network development, medication adherence, population health and behavioral health.

Related Resource Links

Learn more about our quality process

Subscribe
You can subscribe to the HealthData Talks Podcast on Spotify, Amazon Music, Apple Podcasts and more.

Key Moments

(1:20) The podcast kicks off with Navarro diving into the Information Blocking Rule of the Cures Act, discussing how the  rule focuses on enabling patients access to their own health records. Better informed patients lead to better outcomes.

(3:26) Larkin and Navarro discuss who is impacted by the Information Blocking Rule in the health ecosystem further than providers. Navarro explains how the ONC has categorized three sets “actors” the rule applies to.

(3:12) Next, consequences for providers who are not complying with the Information Blocking Rule at a high-level. Navarro covers how and where people can submit an information blocking claim on the ONC’s website. Penalties are clearly defined on the website for health IT vendors and providers.

(4:15) Navarro shares statistics around valid information blocking claims that have been filed on the ONC’s website. Around 600 claims have been filed reporting information blocking and 499 of those claims were against providers.

(4:50) The information that is required to be shared with a patient when they make a request is covered by Navarro. He then explains how the USCDI has clearly defined the content that needs shared and recent changes to the Information Blocking Provision.

(6:20) When hospitals have an archiving strategy in place, Larkin asks how historical records and active records marry up to fulfill a patient request. Navarro covers how Harmony Healthcare IT is helping HealthData Archiver^® clients navigate the Information Blocking Provision of the Cures Act with a new offering – Secure Record Delivery, powered by HealthData Integrator^®.

(8:37) Lastly, Navarro encourages providers to come up with a strategy that includes a defined HIPAA designated record set, including data from the archive to provide patients a copy of their full clinical narrative.

Speakers

Host:
Shannon Larkin, VP of Marketing and Business Development, utilizes her 25+ years of health IT experience to connect healthcare organizations with a team of experts that consolidate and modernize data storage to reduce cost and risk.

Guest:
David Navarro, Senior Director of Data Science at Harmony Healthcare IT. David has over 22 years of health information technology experience in Integration and Health Information Exchange. In his professional career, David has focused on data quality, data insights, and interoperability. He has implemented hundreds of interfaces between clinical and financial systems utilizing a variety of integration platforms, custom ETL processes, and nationally accepted standards.  He continues to drive interoperability initiatives and focuses on the curation and accessibility of data in the healthcare ecosystem.

Related Resource Links

Discover HealthData Integrator^®  
Learn more about the 2022 ONC Annual Meeting Recap

Follow us

LinkedIn: @Harmony Healthcare IT, the Makers of HealthData Archiver^®

Twitter: @HarmonyHit

Subscribe
Don’t forget to subscribe to the HealthData Talks Podcast on Spotify, Amazon Music, Apple Podcasts, and more.

(0: 14) The episode kicks off with Shannon Larkin introducing Amanda Mais, Senior Director of Data Integration at Harmony. Mais gives a brief overview of the three teams she manages in Harmony’s Data Integration Department and their responsibilities.

(2:20) AI is broadly covered by Larkin.  The conversation then transitions over to Mais who explains how her team is utilizing AI along with ML in their data management work. Mais covers clinical examples of how AI and machine learning are being used to drive automation and efficiencies in health data.

(4:38) Larkin ties AI into initiatives Mais is driving so AI can help her team. Mais explains how her team has developed algorithms that assist in locating relevant data elements in unknown data structures, as well as suggesting potential relationships between tables inside the databases.

(5:34) Next, Mais covers the steps involved when her team is tasked with implementing and training a machine learning algorithm. Data must be properly set up to identify data from complex data sets that are consistent from one application to the other. Then comes a significant amount of time spent on training the algorithm by feeding it examples so it can become as humanlike as possible.

(7:03) The conversation turns to how the algorithm deals with legacy data that is extremely dated and inconsistent. Mais explains that in older systems with human entered data sets, the data can be questionable. Newer clinical applications have data entry validation on the front end, allowing for more consistency in data structures. On the practice side, quality check processes are used to minimize threats and improve data accuracy.

(9:35) Lastly, Larkin and Mais cover how AI is helping ensure data integrity and quality when archiving. Mais covers how all the different systems they deal with have unique features with tens of thousands of unique data tables, and a machine can use the algorithm to increase data accuracy and speed.

Speakers

Host:
Shannon Larkin, VP of Marketing and Business Development at Harmony Healthcare IT, utilizes her 25+ years of health IT experience to connect healthcare organizations with a team of experts that consolidate and modernize data storage to reduce cost and risk.

Guest:
Amanda Mais, Director of Data Integration at Harmony Healthcare IT, started her journey with the company as a data analyst in 2015 and with motivation, creativity and strong leadership skills, quickly grew into management roles, continuing to move up in the company. Amanda has enjoyed solving new and challenging databases and working closely with clients to migrate their data from legacy systems into their go-forward solution.

Related Resource Links

Learn more about data archiving options
Learn more about data integrations
Explore HealthData Archiver^®

(0:13) Larkin introduces guest, Bridget Group, Corporate Counsel and Privacy Officer at Harmony Healthcare IT. They start off with discussion around the 20^th anniversary of the HIPAA privacy rule and the significance behind it.

(1:10) Group dives into privacy laws in the healthcare space, HIPAA is a very mature law, but recently in the consumer space, more importance is starting to be placed on how data is collected and used with laws at the state level.

(3:00) The conversation turns to how privacy and state laws are applicable to health IT vendors. Group explains that when new types of regulations come out, organizations look at the data they collect and make sure it is compliant with HIPAA and appliable state laws. After a customer can look at their whole data set, they pass requirements and obligations down to the vendor through agreements which the vendor must follow.

(4:30) Larkin asks how archiving data supports compliance with privacy policies. Group explains that archiving data centralizes legacy data into one location, allowing ease of burden for implementing and monitoring privacy controls and auditing.

(5:35) Group gives an example of a tenant in the privacy space around data access and whether an individual can make a request about information captured on them and how the request is filled. As a steward of patient data, Harmony has an agreement with it’s clients on how that record will be delivered to the patient.

(7:03) Next, other ways in which Harmony enables clients to respect privacy laws is discussed. Group explains Harmony follows HIPAA privacy principles, along with state laws applicable to customers data, and it is incorporated with Harmony’s standard operating procedure around data handling, all employees are trained on.

(7:38) Features built into HealthData Archiver^® to allow Harmony’s customers to do their own data management such as audit logs, break the glass functionality, role-based access, and purge functionality are brought to light in detail.

(8:46) Group and Larkin end the episode with discussion around Secure Record Delivery and Record Release. Harmony is now able to engage with patients on behalf of their customers. With Secure Record Delivery, Harmony is able to send archived historical patient charts to a designated EHR endpoint.

Speakers

Host:
Shannon Larkin, VP of Marketing and Business Development at Harmony Healthcare IT, utilizes her 25+ years of health IT experience to connect healthcare organizations with a team of experts that consolidate and modernize data storage to reduce cost and risk.

Guest:
Bridget Group, JD, Corporate Counsel and Privacy Officer at Harmony Healthcare IT, brings over 6 years of health information technology experience, working in solution planning, project and program management, and legal analysis.

Related Resource Links

Learn more about data archiving options

Explore HealthData Archiver^®

Learn how we serve compliance and legal teams

Follow us

LinkedIn: @Harmony Healthcare IT, the Makers of HealthData Archiver^®

Twitter: @HarmonyHit