Healthcare System Decommissioning - Warning: Computer Geek Article
When assigned my latest project in the fall I was completely lost. Fortunately I had a little experience with system decommissioning but it was in the research world. Research data is much simplier than acute care data for decommissioning. One research study, one data set and one conversion. Not so in the acute and ambulatory care worlds.
With the move to updated Electronic Medical Records the systems previously employed for records management are no longer needed. A few choices are obvious such as leave the systems in place until the data is not needed or turn them off when the new system goes live. Simple answers to a very complex problem.
Issues with leaving an antiquated system in place:
1. Cost of software and hardware maintenance. It's not uncommon for older systems to cost more than $1 million per year for maintenance agreements. It's not that the organization is getting additional capabilities with the system, they are merely keeping them running.
2. Access to the old system is normally not integrated with the new system. This causes the clinician and practitioner to waste valuable time accessing a system for a small piece of historical data necessary to provide care.
3. IT personnel are required to care and feed for a system that offers few technical challenges or service to the customer. Hard to believe but most IT folks want to help the clinicians and practitioners. We realize it may be us in the hospital bed one day.
It's amazing how resistant people are to change when it will require moving away from the familiar. The project I'm on will run through October of 2015 and it will be a minor miracle if we make the timeline. If successful we can hold on to over $3 million in otherwise committed funds. Not a bad payday for a few people and a grand plan.
The basics of the plan are simple.
1. Determine the software to be decommissioned. Sounds simple of everyone debates the merit of leaving "their" system in place. From patient billing reps to the radiologist.
2. Determine if the data housed in the systems is required for the official patient medical record? Beest place to start is your local compliance officer or the state healthcare association. States have varying requirements for medical records but they are similar concerning the basic information.
3. Determine where the official records will be stored long term. Will it be in the new Electronic Medical Records system or will it be in an Health Information Management system?
4. Put all of the information on paper or in electronic form and present to management. Start wil IT management and move on to executive management if all is approved.
5. Determine the best method of transferring the information to a central repository. Sounds simple but things like single record upload versus bulk upload must be considered. Single records can be tested along the way but bulk much go through regression testing for verification.
6. Layout a detailed plan for each step of the process. Starting with the methodology of data discovery through the testing of health records. The customer will want details.
7. Present the plan along with the steps to the key customer groups. The key customers know their information better than anyone. Clinicians want the real and exact story concerning the patient.
8. After the data is moved to the repository, test...test....test more. Confidence will need to be instilled. Clinicians and Practitioners cannot make a mistake concerning the patient. Bad information will result in bad medicine.
9. When the project is complete formally close out the project with a written report. The report should cover the disposition of the data, systems and decommissioning of hardware and software. A representative of each customer group should review and accept the report as final.
If youi are contemplating such a project, my best wishes to you. It is a thankless project at best. Not many will sing your praises or see you as the hero for taking away their systems or changing the way they do business.
Good luck !!