In support of the 2020 Cerner Health Conference shifting to a virtual experience, Trinisys would like to share a few thoughts that we had hoped to communicate in person. These included addressing legacy systems, best practices for archival projects, components that are key for organizational success, and dealing with the ever-growing ransomware threats.

Trinisys is a Nashville-based technology company focused on providing software solutions that materially improve our client’s operations. Founded in 2004 and privately owned, Trinisys is a pioneer in the healthcare IT space and continues to be recognized for its commitment to innovation. Its ClearView product suite excels in delivering reliable solutions for legacy data archival, health information management, and patient financials. Trinisys strives to assist organizations with their application rationalization, vendor consolidation, and cost containment strategies.

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In healthcare, it is common for hospitals and health systems to maintain numerous legacy systems because of the need to be able to access and deliver information to regulatory organizations or patients upon request. This is often a labor-intensive and challenging task, especially for organizations who have completed mergers and/or acquisitions in the recent past. Trinisys has put together meaningful best practices for legacy data archival and how to manage that data efficiently and securely.

Challenges with Legacy Systems

Each department in a healthcare facility operates differently and is faced with its own set of challenges. It is not uncommon for legacy systems to be a root cause of these challenges as they can pose critical issues to the organization, including:

• Security – over time, legacy systems do not receive the security patches and updates necessary to protect the data being stored leaving potential access points for hackers. Additionally, it is common for these systems to lack appropriate monitoring, allowing for inappropriate access and activity.
• Data Completeness and Quality – data siloes result in gaps in the information provided at the point of care which can affect patient how a patient is treated.
• Costs – high maintenance and support fees often eat up a large chunk of the IT budget, negatively impacting the bottom line.
• Productivity – toggling back and forth between systems to find information is cumbersome and time-consuming, impacting the efficiency of the providers and staff.

Legacy Data Archival Strategy

When considering a data archival project, creating a strategy is crucial. After successfully completing legacy archive projects for some of the largest healthcare organizations, Trinisys has put together a few Best Practices to assist in your project planning.

The first step is determining what data is important to preserve. Engaging the appropriate departments is helpful to best understand what data is needed and what the required retention periods are (i.e. Compliance Risk or Legal Counsel for legal health records and Patient Financial Services for patient financials). This will determine the goal of the project.

Next, it is best to prioritize the systems. Doing this requires a list of the applications and who owns them (a department or person), so the respective owners can see the list of non-production systems. From there, it can be determined which system(s) need to be decommissioned immediately. Typically, the systems that are unsupported by the vendor, or are on an aging hardware or operating system, need to be high on the list, as they are the ones with the highest security risk.

Then, look at costs. Once you have identified which systems are candidates for archival, put together a budget showing the 5-year future costs. Don’t go crazy but get an idea of application and infrastructure support costs including application, OS, and hardware maintenance costs, as well as some overhead. By taking the costs you put together, as well as the price quoted by an archival vendor, you will be able determine what the ROI will be.

Finally, when deciding on an archive vendor, be sure to get key stakeholders involved in demos and meetings to ensure everyone has all of the information. An archival vendor is not a short-term decision, and as healthcare data continues its explosive growth, the need to have an efficient and effective archival solution is more important than ever.

Managing Data with the Right Tools

ClearView Legacy Archive Solution is the core of the ClearView product suite. Built on our data integration and workflow automation platform, Convergence, ClearView LAS excels at eliminating manual tasks associated with legacy systems. Utilizing ClearView LAS, documents and data from legacy systems can be archived and placed into a consolidated viewer that can be accessed directly from the current EHR or EMR system, providing clinicians immediate and secure access to patients’ full medical records. This single source of truth delivers advanced reporting capabilities and a detailed audit trail for administrative monitoring.

Building on the foundation of the legacy archive solution, ClearView HIM and ClearView PFS were recently added. The health information management (HIM) module is designed to solve the challenges HIM professionals face when managing health data and processing requests for information (ROI). Advanced search capabilities provide users with a comprehensive view of a patient’s Legal Health Record (including financial), so information can be updated, reviewed, amended, or sent quickly and efficiently. Keeping data privacy and security at the forefront, ClearView HIM is equipped with end-to-end audit trails and document tracking that can be reported on or exported to compliance management applications like FairWarning and others.

ClearView PFS enables the Patient Financial Services (PFS) department to regain control of legacy billing records and continue collection efforts from decommissioned legacy systems. Just like electronic health systems, it is common for organizations to keep legacy billing systems running after migrating to a new application to access records, which is often time-consuming and expensive. This patient financials module has the ability to provide users with the details necessary to respond to audit requests, increase staff productivity by eliminating manual tasks, optimize collections from aged accounts receivables, and gain a better understanding of historical trends per payor, diagnoses, or procedure with the robust reporting and analytic tools. From a static PDF archive to detailed billing functionality, ClearView PFS is available in a tiered model depending on the organization’s goals and needs.

ClearView Security Measures

With the ever-increasing presence of ransomware attacks, it is necessary to address the risks of maintaining status quo legacy environments. Trinisys addresses these risks through the ClearView application by consolidating legacy system environments into a singular archive. This greatly reduces the legacy system footprint (access points, multiple and redundant user access to systems, etc.) while providing a security layer for all associated historic data.

ClearView Security Measures:

• Platform-level security
• Security scans of all associated software
• Static code entry software
• Up to date on OWASP Top 10 Security Vulnerabilities
• Coding practices designed to minimize vulnerabilities
• Well-known and proven security libraries and techniques
• File-level encryption for all documents with unique encryption keys per environment/customer
• Disk encryption for all data and application disks
• Document storage cannot be infected or ransomware-encrypted while at rest – this storage is not physically connected or mapped to any hosts that could execute malware
• Environments are self-contained with no connections between unique customer environments

Client Use Cases and Success Stories

• One national hospital corporation was able to save over $10 million using ClearView LAS in its hospitals. The organization was able to eliminate maintenance and support costs by sunsetting their legacy EHR systems and increased staff productivity by 60%.
• Trinisys successfully retired 165 clinical and financial legacy systems from a prestigious academic health system using Clearview LAS and PFS. This saved the health system hundreds of thousands of dollars per month, and now has millions of fully reportable records that are compiled into one secure viewer.
• Trinisys was able to develop and execute on an archival strategy with a health system operating 90 facilities in Tennessee. The project included extracting, migrating, and converting health data into the ClearView platform, integrating with the organization’s Active Directory, and integrating FairWarning with ClearView. The health system was able to save over $500,000.00 dollars by eliminating maintenance and support costs for all static databases using ClearView LAS and was able to streamline workflow processes across the organization.