My family recently moved across the country and in that process we discovered something about ourselves; we have too much stuff. I’m not talking about things we use rather, things that we store which, for the most part, really falls into two main categories: things I have to store, old financial records, and things my wife wants me to store, christening gowns, cherished toys my children have long-since outgrown, tokens from our own childhoods, memories really. It occurred to me that my stuff, thank you Mr. Carlin, isn’t really that different than the legacy stuff that I had to deal with in healthcare.
Legacy [stuff] systems are a problem for every healthcare organization in this country. How could they not be? In the years before ARRA and Meaningful Use the medical record had become, for many, a hodge-podge of semi-connected systems and processes. If you checked into an ER then your medical record may have been electronic but, if you were admitted, then it could have been on paper, unless you spent time in the ICU, in which case it could have been on yet another electronic system.
Matters get even more complicated when you consider that this data is regulated. Individual states require the maintenance of a patients’ legal medical record for between 7 and 28 years, depending upon the state and the age of the patient at the time of treatment. Oddly enough, the need doesn’t stop there. Remember your clinicians? They’ve been documenting SOAP notes for years, not just on paper but, electronically as well, and have an expectation that they are going to be available for future episodes of care.
According to the ONC we’ve made massive progress at the provider level towards the adoption of highly integrated electronic medical records that meet the new federal standards. We’ve gone from a 13% adoption rate to over 56%, as of the latest published data. That’s fantastic progress but, in the wake of that transition, we’ve left behind a virtual graveyard of systems with shards of critical data still clinging to their disk drives; systems that have to be maintained – personnel, equipment, licenses, support – for a long time and are standing squarely in the path of achieving your clinical integration objectives and OpEx dreams.
How do we address this problem?
George suggested buying a bigger house but, as he points out, that rarely works. We need to address it head-on with a strategy that considers all of the risks, garners buy-in from in-house legal and compliance, as well as the clinical oversight, and IT. So, much like my personal problem with “stuff,” healthcare organizations face the same dilemma: data you have to maintain for legal and compliance reasons and data that your clinicians want you to maintain because it will one day be useful.
Stay tuned for more notes from me as we dig deeper and examine different alternatives to address this challenge and meet your organizational responsibilities: archival, common repository, and how tying these strategies into the right cloud might really address this problem once and for all. I look forward to the discussion.