By Kel Pults, DHA, MSN, RN, MediQuant
If you want something done ask a busy person. And if you need help transitioning to a new health information system (HIS), ask a nurse. A lifeline to patients and doctors alike, nurses were early health information technology (HIT) adopters and continue to be on the frontline of its efficacious use in the clinical setting. That is why they are invaluable partners as hospitals move to a new HIS and figure out how best to archive legacy clinical data.
Data Is King
As the daily tracking of the COVID-19 pandemic has brought to life, in healthcare, data is king. Not only are pandemic statistics vital in informing the public, they also provide insights that inform health policies and patient care as well.
But to harness healthcare data’s true potential you must know how to manage it, especially given its growing quantity. Between the rise in the global population, and more specifically, the aging population, the demand for healthcare services is growing almost as quickly as the amount of data produced. The amount of healthcare data available today is estimated at 25 million terabytes. To put that in perspective, a single terabyte can digitally store the contents of an entire library about 10 floors high, with wall-to-wall, fully-stocked bookshelves.
Nurses: Early IT Adopters
The push to digitalize healthcare, requiring hospitals and physicians to implement electronic health records (EHR), started several decades ago. According to HealthIT.gov, in the U.S., hospital EHR system adoption rose from about 10 percent in 2008 to above 80 percent in 2015 because of national regulations and incentives. Nurses, hospitals’ largest clinical group and subject matter experts on patient care and administration, were early HIT adopters as far back as the 1960s. In fact, they led to the creation of a new specialty: Nursing Informatics.
Nursing Informatics pioneers understood the importance of managing healthcare data to help health systems create holistic views of patients, personalize treatments, improve communication, and enhance health outcomes. In 1992, the American Nurses Association (ANA) recognized Nursing Informatics as a distinct nursing specialty.
The Data Storage Dilemma
Whether the result of mergers and acquisitions, the need to consolidate multiple facilities’ systems or replace an old HIS, at some point, hospitals have to move to a new HIS and decide how to conscientiously manage their legacy data. The task can be daunting.
While hospitals typically migrate about three years’ worth of patient data to the new system, the remaining data needs a reliable and accessible home. Beyond providing a view of historical information at point-of-care, this data is essential for other uses. Health Information Management (HIM) needs it to provide a complete, legal medical record upon request. It is integral to successful legal and compliance audits, and it is used for research, analytics, and much more.
Knowing what, when, and where to store clinical information always has been a tough challenge for healthcare service providers. There are so many things to consider: process; strategy; the volume of data; the number of systems; ensuring compliance; maintaining (or instituting) information governance policies; security; insights; tools; technology; and cost. How do hospitals meet the challenge?
Ask a Nurse
This is where pairing clinical and HIT knowledge pays off and why nurses and nurse informatics play an important role on the hospital’s clinical archiving team, which should also include doctors, pharmacists, and lab technicians, as well as IT, HIM and legal staff. Ideally, the archiving partner should also include nurses on staff that have clinical and informatics experience. These specialists speak the same language as hospital nurses. They know what questions to ask and how to avoid rookie errors that waste time and resources and disrupt care.
There are several key areas in the clinical archiving process where nurses – on both the hospital system and archive partner teams – can make the most impact:
The application and data gathering stage. During this data stewardship, scope, and planning stage, nurses can help with data inventory and usage. This helps uncover systems for potential archive, or archive and conversion to the new HIS.
The data extract and analyzing stage. Before moving the data to an archive platform, a “checkup” is done to assess data integrity, clarifying its context and significance. Having a nurse’s trained clinical eye is essential to vetting the data because that eye will help detect any missing, incomplete, corrupt, or inconsistent data.
The discovery stage. When deciding what data needs to migrate to the archive, we know that most clinicians like to keep as much as possible, and nurses can help with prioritization by referencing historical demand and predicting future use.
The validation stage. Before decommissioning old legacy systems, nurses on both the hospital and vendor teams parallel test the data so that the organization has all it needs going forward – and the IT department can confidently shut down the old legacy systems. The result reduces the cost of maintaining multiple systems and maximizes return on investment of the new HIS.
As healthcare data continues to multiply, so do the reasons to keep it. Legacy data archiving is complex and nuanced; including nurses on both the hospital and archive partner teams will result in effectiveness, efficiency, and economy. Plus, it ensures complete medical records are accessible when and how clinicians need them, resulting in more informed patient care.
About The Author
Kel Pults is Chief Clinical Officer for MediQuant. The first nurse to be hired by the company in 2014, she began helping to build the company’s clinical archive offering. Today she is one of 12 nurses and multiple others at the company with advanced degrees and both clinical and informatics experience.
1. Brown, N., 2015. Healthcare Data Growth: An Exponential Problem. [online] Nextech.com. Available at: [Accessed 5 June 2020].