[00:00:02] Speaker A: Welcome to Health Data Talks where industry experts offer bite sized tips and trends for managing legacy data.
[00:00:12] Speaker B: Thanks everybody for joining us today. I'm your host, Eric Johnson, Vice president of marketing here at Harmony Healthcare it.
And today I'm joined by Scott Smizer, CEO of Vism Healthcare.
We are actually going to talk about large scale systems and data migrations today. So really excited to have you join today, Scott.
So with that, would you mind just telling us a little bit more about yourself and what you do at vism and then how did you get into healthcare it? And maybe you can kind of start with your journey, if you don't mind.
[00:00:49] Speaker C: Yeah, thanks Eric. Thanks for having me.
So, you know, a little bit of background about Vism Healthcare. I founded the company about 13 years ago and it's really been my advisory service, consultative service, work of merger and acquisitions, large scale projects, etc. I spent the last four years at Emory Healthcare in Atlanta as the Chief Technology Officer, but back into advising, back into consulting and working with clients on challenges and problems that they've got. And how did I get into healthcare it Eric? That's a million dollar question. So, you know, back when I got out of high school, I had this great idea that I wanted to become a doctor and I thought, well, I'll go work at a hospital because surely hospitals will pay for medical school. That's how naive I was back then. So went into a hospital, applied for a position that was actually in the computer department in risk management, in the computer department and never got out of it. Never went to medical school, went to undergrad and grad, but never went to medical school. So I feel like I'm a failing physician out there, but I've been working alongside physicians and leaders in the healthcare sector for over 34 years.
[00:01:57] Speaker B: So excellent along the way. Scott, what were some of the highlights of some of the projects and technologies you worked on over that time? Because certainly you've had a chance to observe all sorts of technology transitions, meaningful use, you know, up until some of the things that are being proposed today. But you know, throughout that time, what were some highlights of some of those projects that you worked on? You feel like that were, you know, sort of groundbreaking for its time.
[00:02:31] Speaker C: You know, I think back to when I was at Baptist Health, you know, the CIO at the time, he came over and he said, you know, the Internet is where it's going and this is in the late 90s before the boom, and really gave me the space to be able to build out a team that we focused on nothing But Internet and Internet development. So we were doing things that no other health systems were doing at the time. We were actually selling code and product that we had developed for our intranet to companies that were reselling it to other health Systems across the U.S. but we also reverse engineered the clinical database of a vendor that no longer is in the market share. But I mean, you know, they wouldn't give me the database schema. So we reverse engineered the database and actually built a product that ultimately culminated to us showing them that product.
And you know, ironically enough, about 12 months later, a product came out that looked vaguely familiar to that. So, you know, I think we did a good job. But you know, I think the coolest era of my career was probably in the early web days of where this was emerging into the Internet realm, that nobody really knew where this was going to go. And I think a lot were in the opinion that, oh, this is just a fad, it's going to go away.
We can't live 30 seconds now without Wi fi or our phone.
So it's interesting how the industry and how society has moved in that full direction.
[00:03:59] Speaker B: Yeah, absolutely.
You've seen a lot in that period of time, which is amazing to look back on all of the technology transformation that's happened, want to shift gears a little bit and, and maybe talk about transformation around EHRs.
And of course we've seen this over time, prevalence of, of EPIC and shift to adoption of their platform and, and certainly the energy that the market has shown to really drive those technology changes from certain EHR vendors over to epic and with that and, and it continues to happen. Right. And there was a time period there we thought that, you know, maybe Covid might slow that down. In fact, it was an accelerant. Right.
And we still can see that consolidation.
Really interested in your perspective when you talk about organizations that are thinking about an EHR migration, you know, over the next 18 to 24 months.
You know, what would be a few of the things that a CIO that you would tell a CIO that they really should do when they're considering a migration of that magnitude?
What comes to mind in your mind that are things that they should really try to focus on to start with?
[00:05:35] Speaker C: Yeah, that's a good question, Eric. I think when they embark on something that is as large as an EMR install or even these days, you're seeing organizations pivot, they're doing large scale ERP installs that are just as transformational, it really, you got to have the right people in the right roles for the right reasons.
So I think first and foremost, forethought is like getting the right team, whether it's the resources and talent you've got inside your organization or bringing resources outside your organization in to complement the team to be successful. But you know, when I think of EHR EMR installs today, I really too often see clients are thinking about archiving needs and all of that as an afterthought. And I really would like to see them thinking about that on the forefront of what is the data needed to go to the new EHR if they're migrating to epic? What are those migration scripts looking like to pull the initial feeds out?
But more importantly, not to wait to the end of epic's installation period to start migration, because you're obviously running two different vendors, two different support plans, two different contracts.
You know, getting that work stream started in the beginning or near the beginning of the launch of the project and not let that become an afterthought afterwards. I've seen organizations do that and it's a costly mistake if they wait a year and a half, two years.
You know, you and I've worked on these conversions. I mean, those conversions can take a year or more just on their own.
So it's just lost time. And I really would like to thank that the migration scripts and the archiving are not two separate functions, that they're one. One function that's together. But I mean, organizations really got to get really zoned in on what's your data governance on retention. Do you have. Organizations should have risk management compliance, the legal team at the table to make sure that we're all congruent with our policies, federal, state, regulatory retention laws, that it's all good before you start converting. Because another thing I see is people start the conversions. And I'm sure you're seeing this more than I do as a consultant. They start the conversions and either midway they realize they don't have all the data, they have to stop, they got to edit the script. So let's start back at the finish line. So it's again, not to let that become an afterthought, put it front and center, build out an archiving decom team and have that as a separate work stream that's working alongside your ERP or EMR installation teams.
[00:08:26] Speaker B: Along those same lines, Scott, what would you say is the reason that some institutions perhaps don't do that up front? Right.
Would you say is it just lack of visibility? Is it lack of understanding, is it lack of maybe vendor options or considerations there or Other considerations where they're maybe trying to do that in house. But yeah, why do you think that at least it's, you know, there is that notion that it's an afterthought in store instead of a forethought.
[00:09:01] Speaker C: You know, I don't know what causes it. It just seems to be that the size and scale and depth of these projects is so huge that, you know, there's certain things front of mind. Obviously they've asked the board or their executive team for a large sum of money to do this initiative. They need to be good stewards of those resources. They're hyper focused on getting the team built and getting the project started on time and meeting milestones that a lot of times they just, they kind of hop in the car and go on vacation and they don't think about like, oh yeah, we got to archive out and lights out, all these other systems that are going to go dark on, go live.
I think they're hyper focused on putting the new system in, which is the cooler thing that we're doing. Right. We're bringing new transformation to an organization. And it's not as cool to talk about the legacy systems that are going lights out, but I can tell you that those legacy vendors are still under contract. They still will invoice you for maintenance and what you owe for hosting. So, you know, look at that as something that you need to start early on in the chapter and not think about it at the end, like, oh, we've got to get rid of the system. And that's a quick process because it's not.
It's a complicated process. You need the right partner at the table, in my opinion, to navigate that.
You know, I've dealt with EMRs where there's presidential records involved in it and 30 years worth of data. You know, those kind of sensitive conversions have got to have the right partner at the table. But, you know, you, you've got to build out a roadmap of what you're going to get to the point where you can just cut it off and say, okay, we're converted, we're done.
[00:10:42] Speaker B: Along those same lines too, Scott, because you, you mentioned talking about finding that right partner.
When do you think a CIO should start talking to a potential migration or archiving partner?
You know, when should those conversations early, you know, should, when should they start to focus in on those conversations as part of that discussion and overall project plan?
[00:11:11] Speaker C: Yeah, I think it should be again at the beginning. So as soon as they're signing a contract for a new EMR or new ERP system, and they're building the team. Again, I think they need to think about the archiving because I've gone into client sites where we're doing an active install and I've asked about, well, who's running archiving in decom?
And they're like, what's archiving in decom? And I'm like, there's got to be someone, hopefully there's someone in this organization at a program management, project management level that's running that work stream of, okay, these are the systems that are lights out the day of go live. And these are all the data sets that we need to extract out and archive.
But I think more importantly, not to look at the migration or extract scripts that are needed to build the new system as a separate function of archiving, because the right partner, I mean, we work together, Harmony, can do both of those functions where they can help you with the extracting and the build of the new system, but also be there day one to help with the archiving.
Super helpful.
[00:12:21] Speaker B: Scott. When you thought about, in looking at different types of archiving and migration partners, and this might be even just vendors in general, but what goes into your thinking process or what do you really look for when you're evaluating a really good technology partner? In this case, we're talking about data migration, but in general, you know, as a, as the CEO of ISM and you know, in your CTO role in your past. But generally, what are some of those qualities you look for in a great technology partner?
[00:13:00] Speaker C: You know, I look at the complement of the team. You know, I look at who they've got on the team. But I think the biggest thing that always sticks out is I look for partners that truly want to be a partner, that they're not looking at a quarterly transaction to just book a deal or book a book of business and move on, that they're there for the long haul, that it's someone that is truly a partner in the good times and the bad. But then it's also someone I can turn to, to say, look, we have a data extraction need, a data archiving need. Because I think as you get deeper and deeper into some of these systems, there's these blind spots that you pick out, that there's different systems or data stores that we didn't think about initially when we scoped out the project.
So, you know, not finding a vendor or a partner that just only swims in a couple of those lanes, you want somebody that's got a wide breadth of knowledge.
And again, it's not a transactional relationship, it's truly a partnership. Because if you think about it, the vendor that you're picking for this, I mean, it's a long term, it's a marriage. Right.
You're going to have to store this data for decades and away after, you know, it's been converted. So you, you've got to make sure you're picking the right people that truly view the relationship as a partnership and not just as a transaction.
Absolutely.
[00:14:24] Speaker B: How do you utilize, how do I say this?
What, what are some of the sources of information that you've used in your past. Right. To make technology vendor decisions?
And I'm curious about that, whether that's through your own network.
You rely on third party sources. But, you know, as you're looking to, you know, find that right vendor that is going to play such an important role in a project of this size and scope and level of complexity, how do you go about that decision process and what are some of the sources of information you usually rely on to help make a good decision in that regard?
[00:15:07] Speaker C: Yeah, I would always tell people, don't go just off the references that are provided to you because those are going to be, let's face it, those are going to be references that are going to be the most favorable for me. The two things that I heavily lean on, not that I'm negating those because those are important to do that are references provided by the vendor that's proposing the work, but it's really your network and word of mouth and just talking to people in the industry about who they're using, what they're using.
And the other thing I keep an eye on is class ratings. I look at class and who's, who's excelling in that quadrant in that specialty of archiving in decom and looking at those class reports to make decisions. So those are the two things that I lean on the most, is my network. And class is top of mind.
[00:15:54] Speaker B: Excellent. Thank you.
This is a question that may or may not make the podcast, but I'm curious just to ask it anyway.
But as it relates to partnering with Harmony and as you look at, you know, some of the strengths in particular at Harmony, I'm curious, Scott, there too, you know, what was, when you, what were, when you looked at deciding to partner with Harmony in your past, what were some of the real strengths that stood out that Harmony could provide in helping your team be successful in their archiving and migration, what stood out to you?
[00:16:38] Speaker C: Fair question. I think the two things that stood out to Me is not only the product that you all were offering of just the archival and just the methodology of archiving the data and then the portal from which to serve the data and then truly integrate it for the end users that really need one click away access into that archival data. They don't have to leave a screen necessarily to go find that data. The way Harmony has developed, that really to me speaks to. They've done their research of how clinicians and physicians want to get access to this archival data.
But the other part was just the people.
You know, Harmony has got a lot of people that have been veterans of the industry. They've got a lot of institutional knowledge in these institutions. So it wasn't kind of a fly by night company that popped up that like, hey, you know, everybody needs to do this, so let's run after that business. It truly was, you know, people that have been in the health care sector for decades that saw the need, but then also were able to bring value to the client with a product that works.
Excellent, thank you.
[00:17:52] Speaker B: Back on kind of the EHR ERP sort of talk track, when you're thinking in similar types of terms of doing a migration or archiving project, do you see that much difference? Or let me restate this. What differences, if at all, are there when you're looking at a migration or archive for an ERP system versus an ehr emr, are they holistically that similar or what? Do you see some of the differences between those kinds of projects? And if so, how does that impact kind of that same migration or archiving strategy?
[00:18:36] Speaker C: Yeah, so I mean, what's interesting with EMR migrations, extractions and then archival of those data stores is that you're legally bound to that data. You're the custodian of that data. In a court of law in the United States, if it's ever brought up like they need results, you need to, the organization will respond to a request by the court. So they're legally bound to keep those records. I think when you get into erps, that's where it gets a little gray in some areas where, you know, maybe the organization is not legally bound to keep some of those data sets, but they want to keep it for archival or analytics or interpretation for their own use of their own business, where it's a little more sensitive on the front end with EMRs, because you're dealing with patient data. And not that I want to dilute what an ERP conversion is, but you've got to make sure that you've got the right Data being converted because people are going to interpret that data for clinical decisions.
Excellent.
[00:19:43] Speaker B: Yeah, thank you.
Last couple of questions here.
I'm curious, beyond migrations and archiving conversions, do you see any other kinds of patterns out there in healthcare? It where this reactive nature is kind of similar. Similar in that regard. Right. So meaning, boy, these projects are, are massive.
They're a huge undertaking.
I'm curious if there's other areas where you've seen this kind of play out before and if so, you know, how, how has your, your wisdom of your experience, you know, helped apply to other technology areas where, you know, those CIOs can really learn from, you know, the benefit of history repeating itself a little bit. Right.
And where we might take a chapter of wisdom, you know, from, you know.
[00:20:49] Speaker C: From the past, you know, I think we've gone through several rounds at least I've been around for several rounds of just consolidation in the market where larger health systems have bought up smaller community hospitals through a merger acquisition strategies. And you know, a lot of times it'll go one of two ways. When I come in as a consultant, it's either gone that they converted every single system over to the mothership enterprise and it's done, or they did part of it or none of it and they just brought them into their data center and to their cloud and they've got to rationalize those applications out long term.
I think with what the government's doing right now with health care, we're about to see another round of consolidation.
So I think having the right partners at the table as a senior leader of like, I hate to say it, but I mean, merger and acquisition of smaller hospitals to keep them alive with reimbursement changes from them shuttering their doors, organizations are going to have to have archiving and decom partners that can get in there and work with them and do a rinse and repeat pretty quickly because they're going to be under a time crunch and they're not out there necessarily looking. CIOs aren't looking to acquire those hospitals. Those decisions are made by the excellent.
[00:22:10] Speaker B: Last couple questions here. And these are more future looking, if you will.
I'm curious, Scott, just with all of the technology evolution that's happening out there right now and a kind of a contrast when it comes to healthcare, IT and innovation, what keeps you awake at night? Right.
[00:22:33] Speaker C: You know, I think the thing that keeps most executives in these healthcare organizations, and especially IT shops, is just the advent of ransomware attacks.
Security has got to be top of mind with these Organizations. I mean too often you flip open a browser and you read about another health system that's been attacked and locked out of their data and, and locked out of their systems. So just having a very strong security posture on protection of those networks, protection of those data, data sets. But ransomware, it seems like healthcare is just an easy target right there in the market.
[00:23:11] Speaker B: Where do you see the level of importance of archiving playing a role in helping provide a level of security around that foundation?
[00:23:23] Speaker C: You know, it's interesting because I think most people would look at Harmony or some of the portals and services you will offer is just a one and done. It's just an archival type solution. But I mean I could see very easily where Harmony could potentially pivot to be a near line or you know, a doctor type instance of certain data sets that it's not just read only, it's read, write. And then once those original systems are restored, they can potentially play, you all could potentially play those transactions back into the host system.
It'll be interesting to see where that goes. But I think there's potential market share that a lot of organizations are looking at. Okay, the what if situation, what if this system fails? Could we live without it for three weeks or a month?
And there's some of those systems, Eric, you just can't live without. I mean you can't function. That, you know, we've seen too often where if it's a block of time, more than a couple of hours.
Clinicians don't necessarily have that muscle memory of how to do things manually that they have been.
They are so dependent on these systems and the automatic alerts and the scanning that when they have to do it manually, it's not something that's fresh muscle, muscle memory for them. Yeah, absolutely.
[00:24:44] Speaker B: Last question. What's got you the most excited about technology innovation that you see in healthcare today?
[00:24:53] Speaker C: I think with that question right now it's artificial intelligence.
The way it's moving and the speed at which it's moving in the industry and in the world really.
It makes me pause some days that I'm seeing. I was talking to, you know, a company, a startup company out of Stanford a couple days ago and they literally have got an AI assisted caregiver for long term chronically ill patients that it will call them on a phone and have a conversation with them. And I've played some of that and I'm like, it is scary and exciting at the same time how real some of this stuff feels.
And I feel where AI is really going to change the game is hopefully, in my opinion, is making healthcare more accessible and friendly to patients.
You know, I've always joked that it's like the only industry, and I've been in it for 34 years, the only industry that's 24 7, that we operate like a bank Monday through Friday, 8 to 5, that, you know, there's some services until, you know, we've really gotten into mobile apps and accessibility of things because patients want to do stuff at 10 o' clock at night or 2 o' clock in the morning sometimes or Saturday afternoon at 3.
Those services need to be accessible to them. But what AI is doing for patient access and interaction of healthcare is exciting. But I'm really hoping that AI will change the way nurses and doctors have to interact with these systems, that they're not slaves to the keyboard and the mouse, that they're really interacting with AI bots that are guiding them. And AI is looking at the data set in a very holistic way that maybe finds anomalies that the clinician could miss.
But I think a lot of clinicians are worried, like, well, is AI going to replace? I don't ever see that happening. I think AI, if used correctly, is going to make them work smarter and not harder.
But I'm really excited about where AI is going. But there's days that I'm thinking, who's in charge of. There's nobody in charge of AI. It's growing and learning and getting better each and every day. It's cool, but it's also fascinating to me.
[00:27:07] Speaker B: That's it for this session of Health Data Talks. Check us out for helpful
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[00:27:19] Speaker A: That's it for this session of Health Data Talks. Check out helpful resources at harmonyhi. Hit.
Com and follow us in your favorite podcast app to catch future episodes. We'll see you next time.
