Why archival planning is critical when transitioning EHRs

What is EHR archival planning?

EHR transitions are complex processes that require careful planning. According to Sudhakar Mohanraj, chief technology officer of Access Unify Health, ensuring that data is not lost is a vital part of the process.

He explained that, typically, when a healthcare facility switches from a legacy EHR to a new one, not all of its data can be transitioned. And there are valid reasons for this, including that the data's structure may not be compatible with the new system.

However, several medical record retention laws require facilities to retain data for at least 10 years -- and in some cases, such as for pediatric patients, that timeline extends to 20 years.

"So what happens is these health systems, although they move to the new EHR, they're kind of forced to keep the old EHR just to retain the data," Mohanraj said.

There are also scenarios in which healthcare facilities need to transition from multiple legacy systems to a new EHR, which further complicates the data retention issue, he added.

Archival planning seeks to address this challenge by creating a pathway to consolidate data from legacy EHR systems into a long-term storage solution. Access Unify Health offers an EHR data archival solution that gathers and organizes data into a centralized archive stored in the cloud. Staff can access the archive through an application available in the new EHR system.  

"Users can simply search for a patient and get all the history," Mohanraj said.

In addition to centralizing data from EHRs, Access Unify Health can help organizations digitize any physical records they may have and add that data to the cloud-based archive.

"We provide what we call a single pane of glass so the end users can access both the physical boxes as well as the digital archive data," Mohanraj said.

Archival planning seeks to protect data

Pender Community Health began its archival planning journey to support the organization's growth. According to Jasa, leaders wanted to add more services to the organization's offerings, but to do so, they first needed to upgrade their EHR environment.

However, when Jasa and her team began taking stock of their medical record archive to ensure no data was lost during the upgrade, they realized the data was fragmented across older EHR systems and stored in boxes in the basement. This meant that providers had no easy way to access the necessary data buried in those archives, she said.

So, Jasa started searching for a vendor that could help collate that information. And about a year and a half ago, she came across Access Unify Health. The two organizations joined forces, and the archival planning process began in earnest. The first step was data discovery.

"You have to discover what's out there -- what data do you have?" Jasa said. "And then we started having conversations about what do you want to do with it? For instance, all those records in the basement, yes, there's 70,000 pages worth, but we decided that we're not going to archive all of them."

"So you have to look at state retention laws -- how long are we required to keep them as a facility -- and then also visit with your clinicians and our providers. Are there other pieces of these records that maybe we're not required to keep, but you need for certain reporting that you have to do or for patient safety in other areas?" she continued.

Next, Pender Community Health and Access Unify Health had to categorize and store the data in the cloud application. Jasa noted that they built the centralized archive to mimic the organization's previous EHR system, so that providers could easily and quickly find the information they needed. Pender staff were able to view the cloud environment and provide feedback.

"We don't want to deliver something which the clinicians and the health information management team is not comfortable with," Mohanraj said. "So we want to first deliver a sample, actually load it into our SaaS application, and show it to the end users."

Clinicians and information management teams provided feedback on tags and wording. Once they were satisfied, Access Unify Health began uploading the remaining data in the same pattern, he shared.

Factors for effective archival planning

Given the level of partnership required during the archival planning process, Jasa emphasized the importance of selecting the right vendor partner.

"You have to find someone that speaks the same language as you, someone that understands the importance of data from a clinical standpoint," she said. "And if I don't understand all of the technological terminology, I need someone who can put that in language I can understand as a health information exchange professional."

She shared that configurability is one critical attribute to look for in a vendor, as a partner with a customizable system will allow healthcare providers to retain their workflows and data management processes.

But perhaps the most important aspect of archival planning is thinking ahead. Jasa noted that archival planning -- and the broader EHR upgrade or replacement process -- need to take into account future clinicians and IT staff who may need to access past data. So, the most important factors are storing the data securely and ensuring it can be accessed easily in the future.

"Anything that you do with the medical record, you should be thinking about what is this going to look like in 10 years? If somebody's going to need this [data] down the road, is it going to be available for them?" she said. "That's still very integral to each individual patient. And if you're thinking about patient safety and the best care and what's best for providers, you're going to make sure that history is available when needed."

Anuja Vaidya has covered the healthcare industry since 2012. She currently covers healthcare IT and innovation, including artificial intelligence, digital healthcare, EHRs and interoperability.