Data needs to be free and readily shared, but that's nearly impossible in today's siloed healthcare environment.
Clinicians often require access to older data to track patient progress over time, view previous images or track populations of patients with common conditions. This data remains available, but it's often stored in legacy applications that are difficult to access and combine with more current information. Through strategic application retirement, however, hospitals can aggregate the disparate data locked in siloed, out-of-date systems in one place, make that data available as part of the longitudinal patient record and, consequently, derive clinical value from having more complete, accessible patient information. An independent clinical archive (ICA) can also be called a next-generation VNA or VNA 3.0, but more hospitals are calling it the answer to their data management needs while increasing the utility of the data they have.
While compiling a complete longitudinal patient record is of primary importance, supplemental benefits of a centralized, integrated data repository include interoperability of both structured and unstructured data, better data security, and lower IT costs for running and maintaining older legacy applications.
Benefits of an ICA
Clinicians are often frustrated by having to gather information from multiple applications to access all the data required for the diagnosis and ongoing treatment of patients. This is especially the case when working as part of a multi-disciplinary team.
It's important that a full diagnostic record be easily available and accessible to those who need it to make care decisions. An ICA can aggregate a patient's current and historic data from disparate systems across the organization, storing that data in a standards-based format so it can be incorporated into such applications as the EHR, clinical portal or viewer. And, as the data is fully indexed and date stamped, patient and treatment specific information becomes easy to find.
Consider the following benefits of an ICA, which extend well beyond a more complete and shareable patient record.
1. Search structured and unstructured data. A central repository such as an ICA can include both unstructured and structured healthcare data. Examples include test results, clinical reports, medical images, scanned paper documents, HL7 broadcast messages, proprietary application data formats, audio files and video files. Essentially, any data types that exist within a healthcare enterprise can, in the majority of cases, be ingested successfully into an ICA. Additionally, any relevant patient meta-data can be identified, harvested and indexed in the database.
2. Elevate historic data to interoperability standards. Hospitals increasingly are responsible for facets of patient care beyond the four walls of the facility, and interoperability can help clinicians get a more complete view of the patient to make better care decisions. Interoperability standards include HL7, for the exchange, integration, sharing and retrieval of electronic health information; DICOM, for the storage and transmission of medical images and medical imaging data; and XDS/XDS-I, for the sharing of clinical documents, images, diagnostic reports and related data. In addition, the archive should have the ability to index both meta-data and content to make that data easily searchable, by both applications and end users.
3. Eliminate application silos. Many legacy systems were procured departmentally, which creates silos of information that can only be accessed through that system instead of across the enterprise. Breaking down barriers among departments will not only allow data stored in departmental solutions to be shared more widely, it will also elevate control of disparate systems to the IT department, which is best-suited to maintain such systems.
4. Better protect data. Centralizing control of data and storage also facilitates a more strategic approach to data protection. A healthcare archiving solution must provide safeguards against data loss and security breaches. It may do this by methods inherent to the solution, by leveraging the features of specific storage devices, or by a combination of both. Older, out-of-date application technologies have security loopholes that compound the problem as each connection point and login represents a potential security risk to the hospital—from systems that are rarely (if ever) accessed. These ancillary and little-used IT systems can provide an open or weak backdoor to cyberthieves.
The chance of a data breach is greater than you think. The Ponemon Institute's latest annual survey on healthcare data privacy and safety1 found that nine out of 10 healthcare organizations had reported a data breach within the past two years, and 45 percent of the respondents reported more than five such data thefts in that period. And if you're a private practice or a general hospital, it's more likely that you'll sustain HIPAA violations that any other categories of healthcare providers.
1Sixth Annual Benchmark Study on Privacy & Security of Healthcare Data (2016, May). Ponemon Institute, LLC. Retrieved from http://lpa.idexpertscorp.com/acton/attachment/6200/f-04aa/1/-/-/-/-/Resources%20-%20Sixth%20Annual%20Benchmark%20Study%20on%20Privacy%20and%20Security%20of%20Healthcare%20Data%20.pdf?sid=TV2:vKip8ii8I
5. Save money on legacy application costs. Healthcare IT departments can spend up to 75% of their time maintaining legacy applications, not counting the significant costs for licensing, servers, power, cooling and training on outmoded systems. That's a lot of money and a lot of manpower devoted to keeping ever-archaic systems up and running. An ICA can not only streamline data and make it more accessible, it also can streamline IT operations, freeing up staff to perform more value-added tasks for the organization. We estimate that an average-size hospital has between 100 and 300 legacy systems, so you can see how IT staff time can quickly add up with routine maintenance tasks.
6. Optimize storage assets. Hospitals often pay for storage they don't need. Raising data storage up from the department level so that it can be utilized across the enterprise allows health systems to optimize usage of their available storage assets. In addition, it enables a more holistic look at their data needs across the organization, paying for what's required and thus saving money.
Creating application-agnostic data is the goal
Data underpins consultancy, diagnostic and treatment decisions, as well as the smooth running of hospital operations. Data is the strategic asset, not the application that creates it. Every time you change either the application or the physical storage, you have a data migration to perform, introducing cost, time and potential risk to future data access.
The critical factor is maintaining continuous access to the data, without the fear of being locked into an application or a hardware vendor. To achieve that freedom, the data must be separated from both the application that creates it and the storage on which it sits, which is where an ICA comes into play.
About the author
Michael R. Ball, PhD is senior vice president of BridgeHead Software, Inc. He can be reached at mike.ball@bridgeheadsoftware.com.