Ability to Hit Timelines Key Factor in Satisfaction With Data Archiving Vendors, Finds KLAS

In this insightful interview, Anthony Guerra, Founder and Editor-in-Chief of healthsystemsCIO, sits down with Tyson Blauer, Research Director at KLAS, to discuss KLAS’ latest report on Data Archiving 2024: Examining the Complexity and Content of Archive Deployment. Blauer shares his expertise on the evolving landscape of data archiving, particularly in healthcare organizations transitioning from EHR systems like Epic. The discussion delves into the strategic decisions surrounding data archiving versus migration and explores the scope of applications affected, from rev cycle and ERP to specialized healthcare technologies.

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Anthony: Welcome to healthsystemsCIO’s Interview with Tyson Blauer, Research Director at KLAS. I’m Anthony Guerra, Founder and Editor-in-Chief. Tyson, thanks for joining me.

Tyson: Thanks for having me.

Anthony: Great. We’re going to get into one of your new reports, Data Archiving 2024, Examining the Complexity and Content of Archive Deployment. Very interesting report, hot topic. Everybody knows who KLAS is so if you just want to tell me a little bit about your role, maybe some of the things you’ve been covering since you’ve been there.

Tyson: For sure. Great to meet. I’m a research director here at KLAS. I oversee our research around acuity EHRs, behavior health EHRs and interoperability which is a big bucket term. Data archiving is one of those that fits neatly in all of that, where often times it’s EHR decisions that trigger organizations to make this archival move. I’s looking at how they’re storing data and moving things over so it fits into that interoperability bucket. Been here at KLAS for about seven years, doing research around data archiving for about two years now.

Anthony: Very good. What’s the macro stuff going on here with this topic? You said around the EHR, 99% it’s going to be Epic wins, it’s just a question of what you’re getting off of. How much of this is EHR versus other applications?

Tyson: EHR tends to be the big catalyst for a lot of organizations but usually if you’re archiving your EHR, there are other things as well. You’re switching a lot of different systems. Rev cycle is obviously a key piece of that but it’s a whole slew of different solutions that can be archived. What we see for especially larger organizations, usually there’s north of 20 applications that they’re archiving and for some organizations, they have ongoing things where they say ‘yeah, we’re working on this initial set but we’ve got this long backlog of old legacy applications or things that we know we’re going to be moving away from.’

It covers the gamut, and one of the things that you’ll see in the report is there’s a long list of all the different types of technologies, ambulatory EHRs and acuity EHRs were the most popular, but there’s practice management, EHR, lab, ob-gyn, a lot of different technologies that get archived as well.

Anthony: You mentioned rev cycle and ERP is huge. A lot of organizations are doing ERP. They’re going to Workday, pretty much all of them. I’m assuming that has a lot of archiving that goes with it for whatever system you’re getting off of.

Tyson: When you’re doing archiving, it’s interesting because there’s the question of do you archive it or do you migrate it over to the new systems. We definitely did validate a number of organizations doing ERP but not nearly as much as we saw in the EHR realm. I think that’s an interesting thing. But yeah, we definitely do see a lot of change over happening in the ERP world as well.

Anthony: Any thoughts around the archive versus migrate? Tell me more about that, if you know about that strategic decision people are making. I assume you’re migrating some portion of data but maybe you’re not going back. Therefore, how is that playing out?

Tyson: Each organization kind of makes the determination of how much they feel needs to live in the current system. Do they want to pay for the storage cost with their current system, is this something that’s ongoing and needed or is this something that maybe you need a couple of people to be able to reference for a few patients and so the archive makes sense. Because the real benefit of archiving is it’s cheaper. It’s sitting there, often times it’s static and so you can access it, if needed. But then if you’re migrating it over, usually there’s more cost associated with that. There’s got to be more of that ROI in terms of whether you’re still actively using this information that is pertinent in ongoing business.

Anthony: It’s like you’ve got three entities in something like this. You’ve got the old vendor, you have the new vendor and then you have the company that you’re using to help with the data migration which may also provide an archive, right?

Tyson: Correct.

Anthony: I think one of the issues here is sometimes it’s very difficult to actually finally shut the old vendor off, right? If you’re shutting it off, you’re getting a component into the new system, perhaps everything else is going to that archive that’s being run by the company you’re using for help and then you’re finally done with the old company. I don’t know if ever that old company just keeps hanging around because you can’t cut the cord. Is that a problem getting fully extracted and being able to not pay that bill anymore?

Tyson: I will say it’s less of an issue now. Usually, we’re talking to organizations about when they’re archiving, they really are officially done. We know that there can be the occasional issue when it comes to doing an archive where they say ‘oh yeah, this information isn’t working the way we need to.’ There can be the occasional snafu where maybe you have to go back to the vendor and try to rework things but oftentimes, vendors will say ‘you know what, we are deleting the data as of this time.’

Most organizations are able to make that cut and move away. But there can be a long one way for that. It depends on how long the archival project takes and are they very confident before they make that switch over that they’ve done everything they need.

Anthony: Right. If you’re able to fully finish with the old vendor, then you’ve got your new vendor and you’ve got your third-party archive that is being provided by the company that’s probably helped you migrate and I assume that’s the company and that’s an archive that you’re using for multiple applications. If I’m archiving 3, 4, 5, 6, 7, 8 applications, do I have one vendor that’s providing that sort of third-party archive where all that data goes there?

Tyson: Great question. I’d say by and large, most organizations – I mean, if you’re working well with one vendor, you want to continue to use them but there can be questions of does the vendor do what you needed to. One thing that came out as we were doing the research for this report is we are seeing more inquiries from provider organizations requesting to actively do AR rundown in the archive, who can help with this? Not every day the archiving vendor has done this. This is something that kind of spiked in terms of request we’ve seen from provider organizations around us specifically.

But there can be limitations where some organizations will say we know that our new vendor doesn’t have those capabilities yet so we’re going to retain a different vendor just for this piece because we know there’s different capabilities. That does happen a little bit. But, by and large, as long as the archive is working well, you want to consolidate with one because you’re used to working with those people. These are the processes and so that’s generally how organizations prefer to do things. But there are still plenty of situations where we see where there are one offs, whether it’s hey, we don’t care about a lot of archiving, we just want to do one thing or we just need something very niche done with the vendor.

Anthony: This is something that I don’t think people are doing this themselves, right. Everybody is using a vendor when they’re doing something like this?

Tyson: Some are doing it themselves.

Anthony: Some are?

Tyson: That’s one of the things that we hear from customers. If they’re going through the process, especially larger groups, they’ll say ‘okay, what’s the cost to do this ourselves? Do we have the expertise? What would the internal expense be to do that versus do we use someone else?’ We do hear from time-to-time organizations will say ‘yeah, the archiving.’ I mean the initial project can be pretty expensive still. I mean, long term yes, you do save money because you’re not paying that legacy vendor but the archival is not cheap.

Anthony: Right. Because you’re paying the archive vendor.

Tyson: Yup. If it’s simple archive or you’ve got the internal expertise, some organizations do say for this part, we’re going to do this ourselves. We see comments pop up like that all the time. I wouldn’t say it’s pervasive but it is definitely one of those options that organizations look at as they’re trying to evaluate if they want to use an archiving vendor or not.

Anthony: When someone is selecting a vendor, what are the main issues or characteristics of the project that will help them decide who to go with?

Tyson: That’s what the report was trying to get at. Because what we usually see provider organizations are asking is ‘okay, I’m this type of an organization and I’m trying to archive this many applications that are of this type, who can support me?’ That’s what we try to have this report do is show there’s a lot of variability. Does a vendor primarily work with larger organizations, primarily work with small, do they cover a wide range of types of applications and what we’ve seen is where things get more complicated is obviously the larger projects for larger customers.

Those are the ones who are the most worried. Can someone support me specifically? Smaller organizations are looking at the price tag and the functionality, do I need to be able to have the data be actively manipulated or can it be a static archive. If you’re trying to make things as cheap as possible, some of the larger vendors in the space, you know the Harmony’s and MediQuant’s, they’re usually a more expensive robust option that has a lot of features. But smaller organizations say that’s overkill, that’s not what I need. Conversely, we’ll see sites saying ‘hey, I need something more robust than what some of the smaller new players have.’

In this space, more than most others we looked at, there’s a lot of different ways to slice and dice and say ‘okay, do they do this? Do they have that? Do they fit with me in this way?’ That’s what we try to show the breadth of ‘hey, this vendor has this many small applications they’ve archived but also here’s the larger ones they’ve done.’ Because the ability to scale, like I said, that’s where we’ve seen some of the lower scores come from customers just when they have many projects that they try to archive multiple applications. It just takes one botched product to really leave a bad taste in your mouth as a customer.

Anthony: What do you think the role of the new vendor is here? I mean, this is one of those things if you think about it – why do we even need these companies? I’m buying a new product, why isn’t the vendor I bought or I’m going to, why can’t they handle this for me? But it’s not part of the deal.

Tyson: Often it’s not part of the deal. Like I say, a lot of times there’s cost involved and this speaks to broader issues we have within our operability in general in healthcare. If all the major EHR vendors could just easily share data back and forth, that would solve so many problems in healthcare. But it just doesn’t happen even when there are standard ways of saying ‘here’s the CCV.’ You look at CCVs from two different organizations and they’re wildly different. There’s a number of these things where organizations customized the way they’ve set up their EHR, they’re on a version that’s older or something like that.

All these factors make it hard to translate things over directly. It’s a lot of manual effort and mapping and things like that are required in order to try to make that happen. Most organizations, again, knowing there’s cost of doing that, cost of storing all that legacy data, it’s just not worth it. It’s cheaper for them to say ‘you know what? We only see a small fraction of these patients still that are in historic record, let’s archive that so we have it purely for compliance reasons.’ That’s one of the reasons we looked at the report, are you getting good ROI. One of the most common things people talked about is doing this because to be compliant. That’s the only reason, we’re archiving because we have to hold on to this information some way. This is the cheapest way to do that.

Anthony: This is one that would give me a lot of anxiety. I wouldn’t want to select the wrong vendor on this. Because I mean, can you really botch this? When we talk about the companies that are not as robust or the scores aren’t as good, are we talking about disasters, are we talking about just it didn’t go as smoothly as it could have been? How much risk is in these projects?

Tyson: I’d say where most of the dissatisfaction comes from is just around that initial archival and the process involved in that. A lot of organizations will go in and they won’t understand all the nuances of their system and so even the vendor has under scoped it where they said ‘oh yes, we can do this easily’ and they get into it and say ‘oh, we didn’t realize how different you had done things or what was involved with this specifically’ or for the provider organization where they didn’t provide the resources needed or they couldn’t understand here’s the list required on our end to say ‘here’s how we want the data that come through, here’s the things that we need.’ That can all factor into really delay the timeline.

That’s probably the number one thing where we see lower scores. Across any of the vendors you see in the report, we have customers who are very happy. They’ve done a great job. They’ve archived everything we needed to. I’d say 99% of the time where there’s lower scores, there’s missed timelines. There are things where customers have said yeah, this took 6 months longer than we thought it was going to. We had to expand things out because of X, Y, or Z. Sometimes the provider organization’s fault, sometimes the vendor’s fault but either way, the timeline stretches on and that causes pain. We don’t see it often where they say we can’t get anything out of this, this was completely botched. We had to move away and we had a different vendor do it. It does come up very occasionally. But by and large, the risk is not can they do it, the risk is can they do it and make it as painless as possible.

Anthony: It’s interesting you make the point about the providers having a role and having to deliver certain things in order for the vendor to be able to execute. Do you try and pick that up in your reports? For example, if I’m a provider organization and it didn’t go well, it might have been partly my fault but I’m going to let the vendor have it in my KLAS report. I’m not going to take any blame on me. Do you give the vendor a chance to defend themselves?

Tyson:  At the end of the day, the position we take is the perception of the vendor is the vendor’s responsibility. If the customer is under prepared, there’s usually things the vendor could do to better prepare the customer. That’s where we see there are vendors who have higher scores because they are much more consistent in how they deliver. They put a lot more of those processes and checks and balances in place.

It’s funny you mentioned that, I do talk to the provider organizations where they will flat out admit, ‘yeah, things went long. It was at least partly our fault.’ But again, like you say still going to ding them because it was still painful. A lot of times though what they’re looking for is someone who can be a partner with them. Because they haven’t done this archive before so they’re saying ‘you’re an archival vendor, you do this all day long, tell me what it is we’re supposed to do and make sure that I don’t walk through any of these potholes’ and if they do, then like I said they’ll usually ding the vendor even if it is self-inflicted.

Anthony: That’s the Epic way, right. That’s what they’re known for is not letting you fail. They’re going to make sure you‘re going to do it their way because they know how it’s going to work well. Now, they’ve got the clout now that that works. If you’re a different vendor or maybe I’ve been around that long, that’s a culture that can be hard to implement when you’re trying to sell stuff and get going, right?

Tyson: We’re seeing a growing trend where more organizations are trying to say ‘first off, we want to shop for an archival vendor who can be a long-term partner but also we know that the archive vendors would prefer to have that long term partnership with customers. It’s not we’re doing one big project or a handful of projects and we’re done, it’s we’re working and we’re growing and we’re scaling with you so that the customer can be part of that getting the experience knowing what’s involved so then they can be able to hit things at a more consistent basis because it’s not just some foreign thing that they do one time and move on.

Anthony: That makes a lot of sense. It definitely sounds like really long-term partnership. If you’re going to be, just think of the word, you’re going to be my archive, right. As I go off applications, I’m going to try to put as much as I can with you. I’m going to have you manage these. We’re going to be together a long time. I don’t know when that’s going to end, right.

Tyson: Yeah.

Anthony: I don’t know if anybody has done that. Has anybody transferred from a Harmony to a MediQuant or…

Tyson: We do see those replacements happen. Sometimes it’s due to mergers and acquisitions and sometimes it’s because they’ve become frustrated. Like they say, they have a couple of botched projects where they say this is not what we wanted to be or they think they can find the solution that’s cheaper. Some of the newer entrants on the market get mentioned as hey, we chose them because they were more affordable than these others, and so…’

Anthony: I’m guessing if user’s satisfaction takes a hit, that’s going to be a big problem. It’s one thing if there’s dissatisfaction that’s just hitting the IT shop. If the CIO manages the project, it’s going slower, whatever. But if those problems bleed to user clinician facing, that’s when the CIO is going to get phone calls. These are going to be tricky because you’re switching applications, clinicians are busy, they want to know how to access the information, they have to access it differently, ‘oh, it’s not in the new application, it’s in the archive. Where’s the archive? How do I get to the archive?’ Those things really need a lot of change management around them.

Tyson: They definitely do. Because, to your point, if the clinicians can’t access the information they need, but oftentimes they can’t – we know that just in terms of external data, they oftentimes are not getting the information they need. If you can’t get that from things that you knew were in-house, that’s incredibly frustrating, and so it does take some of that internal change management to say ‘here’s what we’re doing, let’s make sure we’re executing this well, let’s make sure we’re implementing it on time.’ Because like I said, oftentimes this is paired with a new EHR implementation. That’s a pain free process. It’s not like users are going in with this where things are a wonderful calm place. They’re in turmoil. They’re trying to figure things out. They’re working with new workflow. That change management is crucial.

Anthony: It’s a lot. You’ve got the new vendor that’s got a role. You have your archive vendor that has a role. You’re trying to separate yourself from your old vendor which there is work there and then as we just talked about, the internal change management piece which maybe on you as the CIO, your new vendor may not be doing that. You have to manage your users through this whole thing and make sure they’re set up for success and they know where everything is going to be when it’s supposed to. That may not be covered by any of the parties we just discussed. Is that accurate?

Tyson: Yeah, it may not. The good news when it comes to archiving is that oftentimes this is old data. If you made that move to say ‘hey, we want to move away from it,’ the number of times you need to use it goes down dramatically from that first year on. Usually, as we talk to organizations who archived, is about three years old, they’re rarely having to go back and use it. It really is just that initial ‘we’ve made the switch over, wait a minute. I forgot I still need some of this information, we’re still seeing some of those patients.’ That’s where that can be the most painful, it’s just that first little bit.

It is definitely something where you need to make sure there is good change management. I think most organizations that we talked to, we don’t hear a whole lot about rebellions from the frontline staff and how things are rolling out. Like I say, when the implementations are going long, it’s just the increased cost of that and the fact that they’re saying ‘we’re going to have to re-up our contract with our legacy vendor because we didn’t get this done by the time you said and so it’s going to cost us another million dollars or whatever it is to renew that access.’ Because usually that vendor being replaced does not make it cheap.

Anthony: That’s one of the big issues here is meeting timelines so that we can stop paying our older vendor.

Tyson: Yup.

Anthony: If my archive vendor, if my conversion vendor for whatever reason is not hitting timelines, you just explained it very well, I could be on the hook for some significant cost with my old vendor. Do you know if the contracts with the data archiving vendor have any stipulations – are people putting stipulations in there such as here’s our expectations on timeline, if we run long, you’re covering my cost.

Tyson: I haven’t heard anyone making those specific stipulations. But I do know that some vendors will have a little bit more concessions in terms of ‘yes, we should have scoped that out a little bit better so that we as a vendor will charge you more for the initial resources required to get this done.’ But I haven’t heard anybody saying ‘we’re going to cover the cost of continuing to keep your legacy product up and going.’

Anthony: Right.

Tyson: That’s where I say that can be a major pain point for some where they say ‘we have to get off this by this time.’ If that pushes at all, it’s extremely painful.

Anthony: Well, let’s hope I didn’t give any health systems any ideas or they’re going to start sticking that in their contracts. I’ll be really unpopular with the people in your report.

Tyson: Yeah.

Anthony: Any final word of advice? Let’s say I’m a CIO at a large health system and it’s time for me to look at your report. What would be one piece of advice on how they can get that selection right?

Tyson: In terms of making the selection, like I said, what we’ve seen is every vendor that’s in this report has customers that they have done well with. The main thing is going to be making sure can you get some more of the specifics – I’m a large organization, how well have they done with large organizations as a whole or how well have they done with these types of applications. Try to get some of those specifics. But a big thing is really making sure that your organization has that appetite to say we know what’s involved with this because it’s so easy to get distracted by we’re moving to Epic, throw everything at that, oh, and we’ll do this archive thing whenever, however. You want to make sure that it is properly staffed so that you can get that done in the time you need.

But also as you think about your archiving strategy likely there are things that they are not archiving but they should and/or could but they just don’t have the time. We’re seeing more organizations start to think holistically and say we know we’re continuing to grow, we’re continuing to apply new practices in hospital, we need to have a strategy for when we archive. Historically that wasn’t very common but we’re seeing that happen more but making sure if you do have those plans, is this a vendor that you can scale or that they can manage all the projects you’re going to have. But also, do you have those internal processes of identifying ‘yes, we can turn these things off,’ or do you have a big drawer of old legacy applications that you continue to run because they’re a little bit back of mind and you haven’t got to it.

Anthony: Well, I love that big drawer analogy. I think everybody has that in their house and every once in a while, you look at it, and you say ‘you know I’m going to clean that out. I’m going to figure what’s in there’ but you never do.

Tyson: If you never do, you’re going to continue to just pay extra for that data.

Anthony: But the drawer is free, leaving stuff in there doesn’t cost.

Tyson: Except for those ongoing maintenance contracts if we’re talking about the data.

Anthony: You’re absolutely right. Tyson, thank you so much for your time today. I really appreciate it.

Tyson: Thank you for having me.