Inside the world of data archival, there are nearly as many different types of archives as there are vendors. Many of the existing data archival solutions that have gained popularity with large healthcare organizations are ones that are also frequently utilized by other sectors and often claim to be able to “archive anything.” Let’s explore the specific data archival strategies being used in the marketplace:
Raw Data Backups
Pros: Acquiring your data is fairly trivial, underlying data stores almost always offer easy built-in backup mechanisms; Offers “perfect” data fidelity
Cons: When it comes time to access the data, you’ll be forced to fully reverse engineer the underlying database schemas and file system encodings, can lead to mammoth costs and protracted timelines; run the risk of your vendor considering their schema intellectual property and the act of “reverse engineering” could be a direct violation of the original licensing agreement
Useful When: Your source system is not so much being retired as it is being upgraded or otherwise still maintained
Extracted Schema Stores
Pros: This approach allows the solution to archive virtually any type of application. The data is usually exactly the same as it was in the source system, no significant transformation of data types occurs. This makes initial implementation less expensive.
Cons: While many archival vendors utilizing this approach offer some type of basic data visualization tooling, it’s not generally suitable for non-technical end users. This can end up being more work/costlier for the organization as these offerings can still require mapping and transformation work and may or may not be included in the initial licensing. This approach can also potentially run into the same intellectual property issues as the raw database backup strategy.
Bottom Line: A very common and popular mechanism that is leveraged by many of the largest enterprise archival solutions
Pros: Virtually all EMRs support exporting clinical data in the form of a CCD. This approach has good accessibility for clinical users. The implementation phases are often on the shorter side of the spectrum.
Cons: CCDs and similar formats were never designed for archival purposes and, as such, they often miss significant portions of clinical data. They are also generally not supported by standalone practice management solutions or imaging repositories, which means a different archival mechanism is required for those systems
Know Before You Go: The key aspect of this approach is that the document format used is predetermined, and the data being extracted from the source systems must be normalized and transformed to fit the target document schema
Non-Discrete Indexed Document
Pros: It’s reasonably good at capturing data from practice management systems. Provides fairly seamless access to the archived data to organizations with document management systems that have good integration with clinical and other supporting systems.
Cons: Substantial up-front implementation cost and time is usually involved in extracting the data and rendering it. There are often significant limitations as to what data is included. The documents almost never include version history information, making it difficult to handle certain legal scenarios
Fun Fact: This approach is most commonly in the form of a PDF export of data in a pre-rendered format that is suitable for direct consumption.
Hybrid Modeled / Extracted Schema
Pros: Storage is broken up into problems, allergies, medications, claims, transactions, etc. Archival solutions that utilize this approach are therefore industry-specialized. It also allows the vendor to provide a familiar clinical experience as well as a highly focused compliance solution out of the box. Data fidelity is kept high.
Cons: Moderately expensive extraction and load phase. This mechanism requires that the extraction understand key elements of the source system’s data structures which can drive up the cost
In Comparison: Generally less expensive and time-consuming than something like a full data migration or a load into a fully modeled archival solution.
Pros: This approach usually yields excellent clinical accessibility because the vendor can create highly focused clinical workflows just like an EMR vendor can. The extraction and load phase is usually not as expensive as a full EMR data migration.
Cons: The process is typically more time-consuming and expensive than the hybrid modeled / extracted schema or non-discrete document approaches. The compliance accessibility and data fidelity of this strategy can be problematic. Archival solutions utilizing this strategy may also frequently require augmentation by the vendor as new sources of data are encountered.
Know Before You Go: Vendors that have a solid library of extraction processes for various source systems can often offer lower initial implementation costs than would otherwise be possible.
It’s tempting to jump to the conclusion that the Hybrid Modeled / Extracted Schema strategy is the clear winner, but each organization has different requirements that may mitigate the superiority of this particular strategy. Learn more about EMR Data Archival Strategy in our whitepaper.
To find out how Galen can help you in your EMR transition journey, check out our full suite of archival and data migration services, and feel free to contact us below with any questions: