Reducing unnecessary spending means organizations free up revenue to invest in important strategic initiatives, and in times of slim operating margins, healthcare leaders are doing everything they can to contain costs. While many leaders justifiably strive to reduce supply expenses and leverage automation for improved workforce efficiency, there is one way to cut costs that may go completely under the radar: Reduce the reliance on legacy systems in healthcare, particularly after an electronic medical record (EMR) data archiving project.  

In this article, we’ll identify the hidden and not so hidden costs of legacy systems and explain why EMR data archiving is a better, more economical option. Costs include: 

1. Direct maintenance. 

Legacy systems require software vendors to provide ongoing support, maintenance, and security even if users don’t access the applications regularly or at all. This can easily translate to significant dollars with minimal return on investment that could be reallocated elsewhere—particularly direct patient care-related items and services.   

2. Cybersecurity attacks. 

A single cybersecurity breach could easily exceed the cost of an entire data archiving project. We’re talking about an average of $10.1 million per breach, according to IBM X-Force’s latest Cost of a Data Breach Report. Why so much? Because healthcare organizations recovering from a cybersecurity attack may need to pay a ransom and/or a civil monetary penalty to settle a data breach. They may also need to devote critical information technology (IT) staff time to contain the breach, a task that can take an average of 85 days, per the IBM report. These direct and indirect costs are in addition to any EMR system downtime that could disrupt overall business continuity.   

3. Operational inefficiency and lost productivity. 

When organizations maintain legacy systems in healthcare, they simultaneously impose a huge drain on the efficiency of the entire health information (HI) department. Accessing multiple read-only systems to extract data requires separate logins and intimate knowledge of what data is stored in each system. While this may be difficult at best with a handful of legacy systems, imagine trying to do it with dozens. Responding to requests for information becomes frustrating and time consuming when data is stored in such disparate ways, and it can be easy to overlook information if you don’t know where it lives. EMR data archiving is a much more efficient, effective solution to ensure everyone has access to the right information at the right time. 

Maintaining legacy systems in healthcare also yields a negative impact on IT department productivity. When—not if—the legacy system fails, IT professionals are often pulled away from value-add tasks (e.g., EMR customization, data analytics tools, or critical upgrades) to create immediate workarounds that combat the failure. In many of today’s short-staffed healthcare organizations, IT projects are often backlogged, and avoidable tasks like workarounds for legacy system failure clog the queue unnecessarily. IT staff are also tasked with performing release of information because they’re the only ones who can access legacy systems, which takes them away from critical work. Data archiving helps keep IT staff focused on initiatives most essential to the organization.  

4. Non-compliance with information blocking. 

A single fine for information blocking can negatively impact a healthcare organization’s finances in unexpected and potentially catastrophic ways. Imagine a healthcare organization that switched EMRs 10 years ago, converting only two years of data and continuing to maintain the rest in a read-only legacy system on antiquated hardware that experiences frequent critical failures. Although this method may have worked prior to information blocking requirements, what happens when a present-day patient requests her health information from 2013 during a time when the server hosting the legacy system fails? If the healthcare organization can’t provide the patient with timely access, it could face a significant financial penalty.  

In fact, a new federal rule establishes penalties of up to $1 million per violation of information blocking requirements in the 21st Century Cures Act. To date, there have been more than 40 cases in which the Office for Civil Rights imposed financial penalties for noncompliance with information blocking. Eleven of these occurred in July 2022 alone, with penalties ranging from $3,500 to $240,000. EMR data archiving promotes timely responses to all requests for information and mitigates the risk of costly fines and penalties.  

5. Patient safety. 

When clinicians can’t access data that’s siloed in legacy systems, the risks to safety surge. A single surgical error, poor outcome, or delayed treatment due to incomplete patient information could result in a lawsuit, the cost of which can easily exceed the amount of money necessary to complete the entire data archiving project. Imagine a scenario in which a patient is mid-surgery, and a nurse reads in the chart that there was a drug-related complication five years ago during a previous procedure. When the organization switched EMRs, it only converted two years’ worth of data and decided to maintain the rest in a legacy system. If health information management (HIM) staff can’t access and provide the nurse with the previous operative notes immediately, there could be dire consequences. This scenario and many others are completely avoidable with EMR data archiving because everyone has easy access to information all in one place. 

Don’t forget data retention requirements 

Data archiving is clearly a lower-cost alternative to maintaining legacy systems in healthcare. However, it’s also important for healthcare leaders to perform application rationalization and subsequently understand data retention requirements. Certain business applications, for example, may not require data retention per federal, state, and facility-specific requirements. Data may also be duplicated elsewhere, so archiving may only need to be conducted for one system instead of two. Application rationalization is an important step toward healthcare cost containment, and it should be part of any data archiving project. 

Lean more about EMR data archiving 

During a time when healthcare leaders continually search for ways to contain costs, data archiving is a logical solution and clearly financially prudent in the long run. Maintaining legacy systems in healthcare not only adds unnecessary costs, it also increases financial risk. The economics simply favor data archiving. Learn how Verisma’s enterprise archiving solution, Olah ™, can help with its simple, fast, and complete solution for any EMR archive project at https://olahht.com/archiving-plan/.  

An EMR conversion brings with it an assortment of questions: What applications are affected and how many will be replaced? What’s the timeline for the project? How will users receive training? What will it cost?  

One of the most critical questions is this: What will happen to all existing (legacy) EMR data? This is information organizations need to provide safe patient care and meet state and federal compliance regulations like the CURES Act.  

Weighing the options for EMR data during a conversion 

Many healthcare organizations assume there’s only one way to handle legacy data during an EMR conversion: extra, transform, and load (ELT) it into the new system. While an ETL approach for EMR data conversion may be necessary for newer legacy data, it’s less ideal for older data. Why? It’s cumbersome. ETL typically requires a complex data mapping process, the first step of which is to identify the data the organization wants to move into the new system (e.g., allergies, medications, immunizations, surgical history, and other data elements relevant to immediate patient care). Then the organization must determine how it wants to move that data (e.g., through a flat file, HL7, or another method). Finally, it extracts the EMR data from the old system and then tests and validates it.  

Rather than engage in this labor- and resource-intensive process for older legacy data, organizations ultimately decide to simply leave the data in legacy systems, where it’s unfortunately inaccessible from the new EMR.  

But, with the right technology, this patchwork of data availability can be avoided during an EMR conversion. While organizations must use ETL for newer data necessary for direct patient care, they don’t need to use this time-consuming approach for older data. They also don’t need to maintain that older data in legacy systems, which exposes healthcare organizations to potential security breaches and compliance vulnerabilities. The average cost of a breach in the healthcare industry is nearly $6.5 million, according to some estimates. There’s also a significant cost associated with maintaining these systems—potentially hundreds of thousands of dollars a year, according to one recent study.  

Alternatively, state-of-the-art EMR archive technology yields data management tools for secure and easy access to EMR data and minimizes reliance on legacy systems. This technology gives organizations the ability to access their older legacy EMR from within their new EMR without the burden of an ETL conversion.  

According to KLAS Research, 85% of organizations that archive and retire legacy systems report positive financial results. This data suggests there are many reasons why the 69% of healthcare organizations that currently have legacy systems in place might want to reconsider their EMR archive strategy. 

Following are a few dos and don’ts to help healthcare organizations identify the most cost-effective, efficient EMR archive strategy that promotes high-quality patient care before, during, and after an EMR conversion. 

What to do during a conversion  

• DO establish a clear plan for managing older legacy data before the conversion process begins.

  How will older legacy data migration occur? Who will be responsible for managing that data? How long will the organization retain its older legacy data? Work with a data archiving partner that can help identify what you must convert via ETL-type methods and what you can convert using a state-of-the-art EMR archive technology. This partner can also help you identify strategic initiatives, prioritize archiving projects based on clinical and administrative need, and avoid expensive legacy system maintenance fees. 

• DO know record retention requirements. 
  

  This includes state and facility-specific requirements for patient records, billing data, and other important documents. Also consider the sensitivity and importance of the data when thinking about retention. Leveraging a data archive platform enables healthcare organizations to comply with even the most stringent requirements in a cost-effective way.  

• DO think about what end users need and want.

   Physicians need expeditious access to trustworthy legacy data to ensure patient safety. Likewise, health information management staff need the same to comply with patient access rights and release-of-information requirements. An EMR archive solution must provide all of this and more. 

• DO consider legacy system challenges. 
  

  Physical hardware in legacy systems can fail, or individuals with knowledge of how to retrieve data in these systems may have retired. Organizations must decide whether they want to take on the risks associated with not being able to access old EMR data. 

• DO migrate data efficiently.

   
  This may involve using automated tools to transfer data or manually inputting data as needed. 

• DO focus on verification of data integrity.

   Ensure that data transferred to the new EMR is accurate and complete. State-of-the-art technology that omits ETL promotes a faster and easier data verification process. 

What not to do during a conversion 

• DO NOT assume an EMR archive project will be cost prohibitive or operationally burdensome. 
  

  With novel EMR archive technology, the amount of money saved on maintenance fees and lost efficiency far outweighs the cost of the solution used to archive old EMR data. Note that these cost savings are immediate. Novel approaches to data archiving often result in the completion of entire projects within a single billing cycle for legacy system maintenance.  

• DO NOT rely on your EMR vendor to validate EMR data and conversion-related information.

  Even big EMR vendors don’t have the resources necessary to do this, and some may even require organizations to sign attestations acknowledging that at least 20% of the data has not been validated. 

• DO NOT assume your legacy system is—or will remain—secure after a conversion. 
  

  Legacy systems are not kept up to date with the latest security tools and techniques. In addition, these systems may not even function on the latest versions of operating systems. This prevents important upgrades necessary to ensure security. 

• DO NOT forget about EMR data that’s no longer needed.

  Healthcare organizations may need to securely delete data from storage systems or shred physical records after an EMR conversion.  

Reach out to discuss your archiving plan 

Deciding how to handle older legacy EMR data is an important part of any EMR conversion. Although the decision is facility-specific, there is one commonality: The importance of engaging in conversations about legacy data as early in the conversion process as possible. Communication between stakeholders helps identify and address potential challenges to ensure long-term success. Learn how Verisma can help with Olah™, its simple, fast, and complete enterprise archiving solution for any EMR archive project at https://olahht.com/archiving-plan/.  

In the complex world of healthcare, a wide array of business challenges constantly create opportunities for smart solutions. For organizations wishing to promote financial sustainability, managing disparate electronic medical records (EMR) is one such challenge.

Providers want—and need—to share healthcare data to promote continuity of care for their patients. However, many do not use the same EMR, and the interoperability between disparate systems continues to fall short. While larger organizations may have the budget and other resources necessary to purchase and deploy an integrated Epic EMR system, smaller hospitals and physician practices often don’t. These financial and operational disparities are a barrier to achieving interoperability and moving the needle on value-based care.

Therein lies the opportunity to leverage Epic’s Community Connect platform.

The benefits of the Epic Community Connect program

With Epic Community Connect, health systems and hospitals can license their Epic EMR and extend its functionality to independent physician practices and other health facilities at an affordable cost. Community Connect implementations improve interoperability and help ensure patients have a seamless care experience.

There are other benefits for organizations participating in Epic’s Community Connect model as well. Some—but certainly not all—of them include the ability to:

• Coordinate care and promote continuity of care across diverse geographic markets by leveraging an Epic EMR

• Leverage years’ worth of Epic best practices and experiences via the Epic Community Connect host
• Utilize Epic’s robust reporting and metric capabilities to not only improve patient care, but enhance staff productivity and efficiency
• Retain patients within the network through bidirectional referrals that occur when providers use the same EMR
• Actively and accurately review financial information across facilities
• And more

Organizations participating in an Epic EMR conversion through Epic Community Connect also receive the help of dedicated experts in implementation, training, and application support once the system is deployed.

Legacy considerations when converting to Epic

However, with Epic’s Community Connect and similar programs, there are several considerations for both the organization hosting the Epic EMR (often referred to as the “Epic Hub” site) and the organization using it (often referred to as a “Spoke”), one of the most important being: what to do with the old legacy system data.

For example, licensing organizations must decide whether they will retain their data in a read-only mode on a legacy system indefinitely, convert some (almost never all) of it into the Epic EMR, or archive it into an easily accessible platform. These considerations are equally important for hosting organizations looking to roll out the Epic Community Connect program across multiple hospitals and clinics. To best support Spoke organizations, Hubs need timely access to legacy data and require an archive partner that provides a consistent, efficient, and predictable experience.

Consider the following questions when deciding what to do with old legacy system data.

1. Do we want to reduce our long-term costs and mitigate risk? While there are no true benefits to maintaining a legacy system after joining a larger system’s Epic EMR, there are risks—starting with increased costs over time and data breaches that can occur when systems aren’t built using the latest security tools and techniques. In some cases, it may be impossible to incorporate up-to-date encryption, as legacy systems may not even be eligible for critical infrastructure upgrades.

   In addition to data security problems, loss of access to EMR data is also a risk with legacy systems. Physical hardware in legacy systems can fail, and individuals with knowledge of how to retrieve the data may have retired long ago. Moreover, these outdated servers and databases do not promote interoperability, leading to users having to remember various workflows and credentials outside of their Epic EMR.

2. Do we want easy access to the comprehensive medical record or only mission-critical data? A non-ETL (extract, transform, load) approach to data archiving ensures accurate conversion of all legacy system data without intensive testing and validation.
3. Do we want the ability to augment or create reports? A non-ETL approach stores information in a data lake and replicates the entire legacy system database into the cloud, making it easier to mirror reports.

Data archiving best practices

The case for a non-ETL approach to data archiving when converting to an Epic EMR is clear. The following are several ways physician practice administrators, hospital CIOs, and health information leaders can maximize the strategy:

• Identify an executive sponsor. This person can spearhead the effort and provide ongoing support.

• Involve health information management (HIM) early in the process. A data archiving solution should be part of the conversation well before selecting an EMR or enterprise content management (ECM) system and ideally during demo and planning discussions.
• Assign a provider champion. This person is a clinical user who can ensure the archived data is useful and meaningful, or whether views and filters could benefit from improvement. Usually, you’ll need this individual’s assistance when providers need to view information directly from within their EHR of choice.
• Leverage a project team. Be sure to include the executive sponsor and physician champion as well as a project manager, application administrators, network administrators, and HIM. HIM can weigh in on whether views of the Epic data meet release-of-information-related requirements and obligations.
• Involve your IT team. Identify the appropriate technical staff necessary to obtain access to the often inaccessible and disparate systems.
• Consider the number of archives required. Multi-facility organizations need to ascertain how many archive instances will be used. Will all archives be placed in one shared database instance, or will each facility have its own? This decision will be informed by factors from the individual provider level (which users need to see the data) to the facility level (which facility should own the data) to the organizational level (what are the costs and maintenance involved with managing separate instances).
• Identify system contracts. Begin discovery efforts for all contracts and maintenance agreements as soon as possible to expedite scoping and internal business case preparation.
• Leverage economies of scale. It’s often less expensive and less risky to archive as many legacy systems as possible at the same time. Organizations also realize a faster return on investment when taking this approach. Tackling only one or two applications a year only adds to the cost and complexity.

There are many benefits to an Epic Community Connect model; however, questions about legacy data and systems must be at the forefront of these projects to ensure a smooth transition and accurate total cost of ownership (TCO) analysis. Hosting organizations can provide valuable insights and steer smaller hospitals and physician practices toward cost-effective and efficient Epic data archiving solutions.

To learn more
Want more information? Learn about how Verisma’s enterprise archiving solution, Olah™, helps remove the problems associated with archiving: https://verisma.com/our-solutions/data-archiving/. All you need to do is fill out an intake form with applications you use and need to archive. Then we’ll let you know how long it will take to archive your legacy applications into the cloud using Olah’s unique lift-and-shift methodology. Finally, we’ll present your custom archiving plan so you can get back to doing what you do best: Providing first-class patient care.

The challenges associated with holding on to legacy systems are numerous. They increase cost, complicate audits and release-of-information workflows, and frustrate users who need timely access to healthcare data so they can take care of patients. They can also be a major roadblock to data security in healthcare. Yet 69% of healthcare organizations still maintain at least two of these systems.

Why?  Fear. Change can be scary – and a large transformation like data archiving is intimidating for any organization, particularly those facing a growing pile of legacy systems that add financial burden and compliance risk. The good news? Verisma’s approach—and its ability to archive an organization’s entire pile of systems (e.g., EMRs, ERPs, and lab systems)—is highly efficient because it validates extracted documents against patient information and extracts additional metadata to help identify patients quickly. Its non-traditional, lift and shift strategy is also scalable and merges all archived systems into a simple, easy-to-search viewer that integrates with leading electronic health records. That’s why now is the time to consider archiving your medical records storage. Providing easy access to healthcare data doesn’t need to be costly, complex, or disruptive.

Here are seven signs archiving should be one of your top priorities:

1. Providers and others continually voice frustration about a lack of access to healthcare data.

Hospitals that haven’t undertaken an archiving effort often rely on several systems to maintain healthcare data outside of their electronic health record (EHR). In the wake of an EHR conversion, this could include two to five years’ worth of patient data. This puts the onus on users to remember where that data is stored and how to access it—contributing to provider burnout and medical errors. Imagine a scenario where a patient presents for surgery, and the surgeon can’t access information about a side effect from a drug used in a previous surgery. Why? It’s because that information is stored in one or more legacy systems. To get what they need, healthcare providers must log into multiple browsers and systems. Even then, there’s no guarantee they’ll find the answers. Archiving provides those providers and others with timely access to healthcare data so they can make informed decisions and provide high-quality patient care.

2. The Office of the National Coordinator has fined your hospital for information blocking.

The 21st Century Cures Act mandates immediate access to, and portability of, personal electronic health information for patients, providers, and payers. However, if your healthcare organization hasn’t archived its medical records storage, well-intentioned Health Information Management (HIM) staff may not have easy access to healthcare data – or they may not even know where that data exists. Data omissions can easily lead to costly fines and public relations nightmares. Archiving medical records storage provides simple, consolidated access to all legacy medical records, streamlining the work of HIM staff.

3. You’ve had a data breach.

For three years in a row, healthcare has been the industry with the highest number of data breaches, according to the Identity Theft Resource Center’s (ITRC) 2022 Annual Data Breach Report. In 2022, 344 healthcare data breaches affected more than 26 million people, the ITRC found. The data compromised most frequently? Medical history, medical condition, treatment, and diagnosis information. Medical insurance account numbers and medical provider accounts were also high on the list.

These breaches come at a cost: $429 per stolen or lost record. This is three times more per record than for all other (non-healthcare) sectors. For the ninth year in a row, the healthcare industry also had the highest cost of a breach – $6.5 million on average, which is 60% more than all other sectors.

Legacy systems pose a significant cybersecurity threat because they’re not built using the latest security tools and techniques. Many may not even function on the latest versions of operating systems. These systems may expose hospitals to enterprise-wide consequences, including damaged reputation, violation of regulatory requirements, patient mistrust, lost loyalty, lawsuits, litigations, financial penalties, and increased insurance and legal costs. Archiving your medical records storage enables you to maintain optimal data security in healthcare, ensure HIPAA compliance, and reduce your organization’s overall risk profile.

4. Your old server is beginning to fail.

Modernization isn’t easy, especially when you’re not prepared for it. If you have outdated tools and processes, too many competing priorities, or lack of executive buy-in, the moment when you realize your server needs replacing can cause a scramble. Before you get to crisis mode, save yourself by planning an archiving project. This proactive approach saves you headaches and also safeguards you against trouble in the future, such as data loss. By not archiving your data, you risk having an incomplete and/or inaccurate view into patient histories, leaving you open to poor care delivery and even malpractice litigation.

5. Users and administrators of the legacy system are nearing the end of their careers.

If you don’t have the right technical expertise to manage legacy systems and help people view and use legacy data, the systems become black holes. What good is the information in a legacy system if it’s inaccessible? Archiving medical records storage makes information immediately accessible to everyone. You aren’t reliant on a specific person.

6. You’re looking for ways to cut costs.

Healthcare organizations often pay a recurring licensing fee to retain access to healthcare data. In addition, there are unexpected costs such as time spent updating the legacy systems and productivity loss associated with slower hardware. Archiving enables access to healthcare data at a fraction of the cost and provides a cost-effective path to eliminating expensive software licensing fees. In fact, 85% of organizations that have archived and retired legacy systems report positive financial results. This is money that organizations can reinvest into patient care, staff retention, and much more.

Your hospital or clinical practice is joining a health system.

Although hospital and health system mergers and acquisitions slowed with the COVID-19 pandemic, the 17 transactions in the fourth quarter of 2022 marked a post-pandemic high, and transactions in the first quarter of 2023 were not far behind, at 15. If your hospital or clinic is being acquired, it’s likely you’ll be required to migrate to a different EHR, so archiving should be catapulted to the top of your priority list. You’ll need a top-tier solution to ensure timely access to healthcare data in the old system.

Taking next steps

Once you understand the inherent dangers of maintaining outdated systems, the next step is to act:

• Identify systems in your portfolio that are most vulnerable. Be sure to include electronic medical records; EHRs; clinical, lab, and pharmacy applications; financial applications; enterprise resource planning systems; and anything else in your collection.
• Compile a comprehensive list of applications to archive. Only archiving one or two applications per year can increase your costs and the complexity of your plans. To achieve greater success, aim to archive as many applications as possible, as quickly as possible.
• Investigate the latest offerings available on the market. Look for a partner that makes the process easier for your staff and your wallet.
• Identify contracts for scoping and business case efforts. Discovery of these documents can take time, since systems are sometimes 10+ years old. Looking for them early on can expedite discussions later.
• Outline a plan to begin reducing your register of legacy systems. Be sure to include health information management (HIM) staff in planning decisions, as they are (arguably) the largest consumer of archived data and typically have knowledge of applications and workflows unknown to others.

To learn more

Want more information? Learn about Olah ™, Verisma’s simple, fast, and complete solution to archiving. All you need to do is share some basic information on the systems you need to archive. Then we’ll provide a timeline to archive your legacy applications into the cloud using Olah ™’s lift-and-shift methodology. Finally, we’ll present your custom archiving plan so you can get back to providing first-class patient care.