DIS overcomes tight deadline to provide state-of-the-art health-care data storage, retrieval
By Bruce Coleman
It was a race against time with millions of dollars at stake.
Following the University of Mississippi Medical Center’s successful conversion to the Epic electronic health record system in June 2012, the institution’s information technology focus quickly shifted to decommissioning UMMC’s mainframe-based legacy data management system and all of the applications tied to it.
With approximately 20-25 contracts due to be renewed at the end of the year, the Division of Information Systems had scant months to complete the project. Failure would require the Medical Center to pay another round of application support, worth approximately $9 million over three years.
The overwhelmingly complex project also would necessitate the assistance of hundreds of employees from several departments at the Medical Center. The parameters were so tight that the assignment seemed cut from an episode of “Mission Impossible.”
“In terms of our institution, aside from a major system application launch like Lawson or Epic implementation, this was as large a project in scope as has been undertaken,” said Tom Smith, chief technology officer. “The entire department was involved.”
For two years before the EHR go-live date, legacy information had been loaded into Epic from Siemens Invision and Siemens Signature – the institution’s primary billing software – and Siemens Lifetime Clinical Records – the Medical Center’s clinical information database – along with several other applications. The avalanche of data amounted to approximately 1.7 million distinct medical record numbers, 19 million patient account numbers and billions of dollars of total charges.
“Our challenge was to eliminate the expense associated with keeping these applications running and the equipment on which they were running,” Smith said. “Our major concerns leading into the transition were the availability of the data, the security of the data, the reliability of the repository to hold the data and the ability to extract the data and get it to the repository.
“We had to find a place that was secure, functional, reliable and able to get information from several systems into our system.”
Throughout the transition, the data also had to be made available in real-time.
“It was not just a matter of storing data,” said Monte Luehlfing, senior IT project manager in charge of the transition, “but retrieving it when appropriate and having the system have functionality through which the release of information could take place.”
“We had a variety of demands on the system from many different constituencies at the Medical Center,” Smith said. “We had to provide a portal that needed to work while we were designing and building the new system and transitioning the data. Doctors needed to access the information on an ongoing basis.”
Smith’s team investigated several possibilities, including developing an internal repository, but the severe time limit restricted options. That’s when Ellen Swoger, chief applications officer, suggested a product called DataArk, a centralized software framework for accessing legacy data from disparate systems. In late August, the Medical Center acquired the software from MediQuant, the DataArk developer, and the race to the Dec. 31, 2012 finish line began.
“MediQuant had experience with data repositories,” Smith said, “and their staff understood the technology and were able to propose a solution that worked for us - technically and economically.
“And then we got lucky – it actually worked.”
But not without a tremendous effort from DIS staff and employees from several other Medical Center departments, Smith said. For instance, he said it required hundreds of people just to validate data and test the system. Many employees had to work through the December holiday season to ensure their tasks would be completed in time.
“Everyone in IT and everyone with whom we worked accepted our deadlines and wanted to meet them: the Central Billing Office, Revenue Cycle Management, the physicians group and Health Information Management were all extremely cooperative.”
Luehlfing said almost every DIS staff member had a significant role in the transition.
“We had people involved from all the technical and application areas,” he said. “Our contracts team reviewed the contracts and worked with legal to transition the agreements and not incur additional costs.
“There were so many pieces that if anything didn’t work just right, we could have missed our deadline. We were concerned about it, but we also looked at the risks, analyzed them and came up with contingency plans.”
Thanks to the diligence of the DIS staff, no one ever had to dust off those contingency plans.
“We set up the system, validated it, tested it, sent the data, loaded it and tested it again, and it didn’t have a hiccup,” Smith said. “We were always operational – we never went down. That was amazing.”
David Chou, chief information officer, said the project was an unqualified success, not just for DIS, but for the institution as a whole.
“A successful project would be a project that benefits both the organization and the department completing the project,” he said. “This was a project that achieved both in the sense that the organization had a multimillion-dollar savings and the department also unloaded a huge system that required a lot of maintenance and support.
“Everyone came out a winner. This was a project that most IT departments would not undertake due to the high complexity and high risk, so the team should be extremely proud of that accomplishment.”
“I don’t think I was ever concerned that we weren’t going to get it done,” Smith said. “Even though the complexity was significant, we were dealing with different types of data, many different users and all these different systems had different data tables, different ways of using the systems, and the time constraint was daunting.
“The fact that it came together showed tremendous cooperation among the various departments of the Medical Center. And it proved we can handle major projects with significant detail.”