Can Vendor Management Be a Challenge in Data Archival and Application Sunsetting Projects?

Ever wondered what has caused the rapid increase in Healthcare Mergers and Acquisitions (M&As)?

The shift of focus to value-based care could be one contributing factor, owing to the belief that integrating data and resources could add more value to the provision of care. The rapid increase is accompanied by concerns about sunsetting legacy applications and archival of legacy data. When the sunsetting of software applications and archival of legacy data is considered, the management of multiple vendors involved in such projects, is one evident challenge amidst all the challenges that shoot up.

HealthsystemCIO and 314e recently hosted a panel discussion with top CIOs - Chuck Podesta, CIO at Renown Health, Saad Chaudhry, CIO at Luminis Health, and Abhishek Begerhotta, CEO at 314e, along with Anthony Guerra, Founder, and Editor-in-chief at healthsystemCIO; these experts discussed some of the best ways to minimize risk and maximize ROI in data archival and sunsetting projects. One key aspect they stressed is the means to deal with vendor problems that arise out of such projects, and this article attempts to summarize all the guidelines provided.

If your organization is going through application sunsetting, here’s what you must do to ensure appropriate vendor management:

Customization Is Key When It Comes to Dealing With Different EHR Vendors or a Single Vendor With Different Instances

Application sunsetting and data archival driven by M&As, bring about a lot of data into question. There is no assurance that dealing with data and vendor management is going to be made simple, even if only one EHR vendor comes into play. In the case of healthcare M&As, especially when you are on the acquiring side, it is key to remember that there are not just different EHRs or EHR instances coming into the picture but also a lot of legacy data that accompanies them. In fact, in a recent panel discussion organized by healthsystemCIO and 314e, Saad Chaudhury, CIO at Luminis Health, pointed out that even if all the hospitals in a health system that are a part of the M&A have the same EHR vendor, it does not guarantee the same EHR instance and this means for each EHR instance, the version, and data structure are going to be different, and this is not going to make data archival and application decommissioning easy. The major problems that could come in the way of hospitals while dealing with different EHRs or different instances caused by version differences, according to Chuck Podesta, CIO at Renown Health, are:

• The difficulties in translating the old data fed into the system and challenges with deciding what data values are normal and abnormal, are mainly caused by the lack of adherence to standards
• The challenges with respect to data interoperability and the implementation of standard code sets, and the normalization of data
• The challenges in data translation leading to complexities in data governance
• The lack of ability to present actionable health data

The key to navigating this is the willingness on the part of the CIO to be open to adopting custom-made solutions by innovative archiving vendors that can help in archiving; so that the EHRs and legacy data involved can be operational in a healthcare setting. Something that is also important to note here is that it is not necessary that every M&A would involve just sunsetting an old system and replacing it with a new one. There is going to be a great deal of extraction, transformation (with customization brought in through a degree of data manipulation to meet the needs), and loading into the archival system. Doing all of this stresses the importance of data integration.

Due Diligence When Signing SAS Contracts With Vendors Could Help Solve Some of the Major Problems With Outgoing Vendors

In sunsetting projects, securing the cooperation of an outgoing vendor could be one of the most challenging tasks ever. This is very true, especially when the vendor isn’t available on the premises and the valuable patient data is hosted on the cloud. While waiting on extracts from other vendor partners could be an option here; however, that by itself is going to be time-consuming and cause a lot of delays. Most vendors try to hold hostage and often have unreasonable requests of their customers to provide them with their own data.

The difficulties further escalate when there is no standardization of the EHR database despite the presence of the Meaningful Use requirement.

Abhishek Begerhotta, CEO at 314e, believes that the best way to navigate this and reduce risks would be to pick the most suitable vendor after evaluating them on multiple levels and then sign a SAS contract after careful consideration. He also added that it would be better to have the price points, the terms and provisions for data availability and data transitions, and the ability to meet healthcare-specific standards reviewed by the hospital’s legal team.

Some of the questions that could be asked of the EHR vendor are:

• What regulatory standards are you meeting to avoid security risks?
• How scalable is the system to meet the growing needs of the healthcare organization?
• How often would the system undergo upgrades?
• What kind of access and control over the data does the healthcare organization have?
• What kind of support is provided to aid with disaster recovery?

The Choice of a Specific Archival Vendor to Become a Vendor Partner Must be Made by the CIO After Considering the Following

It is crucial to pick a vendor partner that would make archival and sunsetting easy to deal with, considering the inborn challenges that come with every M&A. One of the determining factors of an excellent vendor would be foresight or the ability to look at the big picture. This is something that is very crucial in every M&A data integration, especially in healthcare, where data has the power to determine life and death.

Other key aspects that would help with differentiating an excellent vendor from the rest would be:

• The top priority and the most important differentiating factor has to be the technology used for data discovery and data delivery
• The compliance with health data standards like FHIR, the Cures Act, and so on
• The experience of serving in the market for a decent amount of time and the ability to customize based on the experience gained over the years

Bonus Tips on Dealing With All Kinds of Vendor Problems in Archival and Sunsetting Projects

• Archival and sunsetting driven by M&As require a great deal of data transformation involved, so it is better to be prepared for it
• When it comes to working with archival vendors, it is fundamental to build relationships and work in coordination, as archival and sunsetting can never be turnkey projects
• Experienced archival vendors might initially start with some level of custom solution to meet your specific needs and later transition to standardized operating procedures based on their previous experience; as a CIO, it is important to accept this to achieve success in the process

As far as the CIO’s involvement is concerned, it is important not to get to the depths of such matters and let the Subject Matter Experts who best understand the ground reality, handle it. However, the key role of a CIO when it comes to such projects is to join hands with archival partners and equally be invested in partnerships. It is crucial for the CIO to evaluate how a specific archival solution can meet the data strategy of the organization based on the need to meet the set healthcare standards and also ensure easy access to health data upon request. Having all of these in mind could help a CIO drive a smooth data archival and application sunsetting process in a hospital.

If you are on the lookout for an archival vendor, and finding it difficult to pick one, here’s an Evaluating Secure Healthcare Data Archiving Vendors Checklist to help you.