Since the inception of EHRs, the demand and cost of electronic storage has been a problem plaguing most healthcare organizations. Iron Mountain, a global data storage and protection company, reports that some healthcare applications, like EHR, are growing up to 70 percent per year in data storage.
The only way to completely stop the growth of electronically stored patient data is to stop seeing patients. Yes, we don’t want you to do that either. There are ways, though, to slow the growth of your storage needs. Here are a couple strategies we help organizations employ to curb their storage needs.
1. Understand document retention requirements.
One of the easiest ways to curb your storage costs is to research, understand and act on document retention requirements. The policies for retention are established by state regulatory bodies, generally Departments of Commerce, but in healthcare, sometimes also set by Departments of Health and/or Human Services.
In addition to variations by state, there are also different laws for different types of record. For instance, in Minnesota, long-term care facilities need to retain medical records for at least five years after a patient’s death or discharge (MN ADC 4658.0470). For hospitals, that extends to seven years. In the case of a minor, the record must be retained by the hospital for seven years after the patient reaches age 18 (Minn. Stat. 145.32).
We find many practices employ a “when in doubt, keep it” theory with regards to their medical records. When working with hard-copy records, this puts strain on physical storage space. When working with EHR’s, this amounts to a significant excess in electronic storage costs.
While retention laws can get cumbersome and maybe even confusing, understanding your practice’s obligation to retain records can be a great way to curb your storage costs.
2. Use tiered storage.
Tiered storage is a relatively new concept in healthcare IT. Practices using this strategy are seeing significant benefits and a much-desired deceleration of their storage requirements.
Tiered storage simply means storing data and media based on its speed and availability requirements. As the speed and availability of the storage increases, so does the cost.
A clinic needs current patient-diagnosis records to be highly available with a quick recovery. So this data would be stored on Tier 1 storage, the highest-performing with the quickest recovery and availability.
The rate of availability and speed of recovery required for medical records stored at a long-term care facility for the years following a resident’s death or discharge, on the other hand, is low. These records can be stored on Tier 2 or Tier 3. It would take longer to recover them, but that’s okay, because they don’t need to be as readily, quickly available. It should be noted that in most cases, the difference in performance we’re discussing here is still measured in seconds, not minutes….but that’s relevant also when you consider the frequency certain types of records are recalled.
Check with your EHR software provider to see if they support the use of tiered storage within their platform. We’ve worked with many EHR providers that incorporate tiered storage effectively, like NextGen and SRSoft.
Tiered storage also requires significant involvement and knowledge from your IT department or your service provider. The IT Professionals within either group should be comfortable not just with the technology employed in digital storage, but the business requirements and how to mate those to the technology.
3. Implementing business rules and workflows.
Once you understand your record retention requirements and your IT environment is properly set up for tiered storage, you can begin implementing business rules and workflows.
Most organizations look to their software or IT provider to help develop these workflows. In some cases, organizations have the technical expertise on staff to outline and implement workflows.
These business rules and workflows automate the process of telling data where to go and at what point. In a pediatric practice, a workflow could be set up such that once a patient turns 18, the record can be moved to a lower tier of storage, since the likelihood of that patient returning to the practice is low. This ensures that the record is retained, per state law, but not occupying the storage space of the quickest and most available storage.
A special note of concern here – if your practice utilizes an EHR that doesn’t support any tiering of data storage, or use of business rules to control patient record-archiving, be cautious in implementation. A three-party “meeting of the minds” (Practice Management, Information Technology, and EHR Vendor) is needed before you start moving records somewhere (and by inference, deleting them elsewhere).
Old records will continue to be digitized. New records will continue to be created and will grow as notes, images and diagnoses are added. Because of this, the storage need and costs in healthcare will continue to increase exponentially in the next 5-10 years. Has your practice found other ways to curb your storage costs?