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[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,