[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: Welcome to Health Data Talks from Harmony Healthcare it, where healthcare leaders explore the real world decisions shaping how data is managed, accessed and trusted across its life cycle. I'm your host, Eric Johnson and today I'll be joined by Ruth Barnes, General Manager for Harmony Healthcare IT in Ireland and a key leader in driving our UK initiatives. Today we're exploring why productivity continues to break down for even after major EHR investments and how legacy systems quietly slow clinical and operational teams down and what healthcare organizations can do next to remove that friction. Drawing on lessons, health care leaders are surfacing in the uk.
Ruth, thanks for joining us.
[00:00:57] Speaker C: Thanks so much for inviting me. I've listened to a lot of these health data talks, so I'm very honored to be participating in one.
[00:01:04] Speaker B: Well, fantastic. We're honored to have you today.
Before we dive in, let's just start a little bit more about your background. Tell us a little bit more about yourself and your role at Harmony.
[00:01:17] Speaker C: Well, both my background and my role at Harmony are quite varied.
I started off in clinical science, academically in pharmacology and biochemistry.
And while I was writing my PhD thesis, I worked in a really large and busy pathology laboratory in a very large and busy acute hospital here in Dublin. And that was my first introduction to hospital systems after a couple of steps after that in pharma research, pretty much since then I've worked in the digital health space.
I spent nine years in Australia in Sydney and I worked with an EMR vendor, as they call them there.
And that was largely as a result of my experience working in the hospital in Dublin.
I came back to Ireland then with my young family. We were all young at the time and I spent about 13 years with an Irish software company who developed digital medical records.
They had international clients. So I've been to some really interesting places as a result in Africa, in the Middle east and then several times back to Australia again.
As you know, Eric, I've just recently joined Harmony. I'm really delighted to be here. I'm based in Ireland as general manager, as you said, and my role includes, well, building brand awareness, developing the European market, building local relationships with potential partners, amongst many other things.
It's varied, it's interesting and the team I've met is fantastic.
[00:02:52] Speaker B: Welcome.
We're really happy to have you as a part of Harmony Healthcare IT and certainly joining on our podcast today. So thanks Ruth.
[00:03:00] Speaker C: Thank you.
[00:03:01] Speaker B: Well, let's jump into the first question for you, Ruth. You spent a Lot of time in the UK having conversations about productivity, particularly why many health systems still feel slowed down even after major EHR investments, or eprs as they refer to in the uk.
What are some common themes you're hearing right now in the UK market?
[00:03:24] Speaker C: Well, Eric, first of all, it's important to note that this is not really a UK specific issue.
We've heard common themes in many jurisdictions, but what is interesting in the UK is that they're calling it out. They're calling it out and they're taking action, which is why the Frontline Productivity Program has been launched this year. So the overall theme is improving clinical and operational productivity and really strengthening the financial and operational discipline there as well. So, in answer to your question, one theme is that there is recognition that while the digitization of medical records has gone a long way to improving these frontline challenges, simply having an EPR in place is not the panacea.
So those frontline challenges are admin overload, fragmented systems with which they have to carry out their functions, the users, and an inefficiency that's associated with looking for patient information.
So the theme is optimizing the EPR environment, getting the most from it, and making space to strive towards achieving the objectives of that EPR that presumably formed part of the business case in the first place. And what I mean by making space is understanding and recognizing those hidden barriers to productivity and set about addressing them. So I suppose to summarize the common themes, having an EPR is helpful, but it often translates into just having another system to use.
And forgive me if I'm interchanging the terminology, EPR and ehr, they are widely both used. But despite almost all nhs trusts having EPRs now, fewer than one third of them have the data integrated, as it should be. And this is really seen as limiting productivity. And that's according to NHS England. That's not according to me. So there's the theme, the emerging theme is looking at how the legacy data and the legacy systems are managed.
There's also another theme that we're hearing, and that's about learning from success.
So some hospitals and trusts have done this really well, you know, have managed this really well. So another clear theme that I'm hearing time and time again is learning from success in one region and ensuring that it's mirrored in other regions. So benchmarks have been set, top performing trusts have been identified, and therefore, you know, objectives and goals have been laid out for other providers to strive towards. So, you know, and part of that absolutely is addressing the legacy Systems.
[00:06:24] Speaker B: Absolutely.
Thank you for that overview.
Let's dive deeper a little bit into the productivity side of those themes.
And sometimes in our conversation, I've often heard you use the phrase productivity drag when explaining the toll of legacy systems.
Tell me a little bit about what that actually looks like on the day to day for frontline teams in your experience in the uk.
[00:07:03] Speaker C: It is quite funny actually, Eric. I've heard that word drag used so many times in recent months, but it's always said as if there are 10 or 20 A's in it. You know, drag, it's really used in a very descriptive manner, but joking aside, it's really used in the context of slowing things down at the front line.
The reality is that so many hospitals and trusts, not just in the uk, but so many hospitals and trusts, have a myriad of systems all over the world. It's the same case. You have your, his sis, your ris, your lis, your epr, your erp, all of them clinical and non clinical. But if patient information is scattered across all of those systems, it's so time consuming for clinicians and administrators to find what they're looking for. So day to day, is that your questions about day to day? What we're hearing is that day to day staff often have to log into between five and 10 different systems, or make phone calls, or rummage through paper to find what they need. And each of those systems in itself requires training and different logins and more clicking.
So imagine being able to remove some of that burden. It would make a huge difference to those on the front line and ultimately to the patients too.
So that's what I mean when I say Dragon.
[00:08:29] Speaker B: Yeah, absolutely.
Taking a little bit different direction here and introducing the notion of archiving and legacy data management into this equation.
You know, lots of times when we think of or hear about archiving, the first reaction is purely just storage.
But in terms of how we might think differently in a notion of having an active archive, something that is built in into a clinical workflow, you might say, how often do you frame it as a productivity enabler?
And what changes when leaders adopt that type of mindset when they're looking at that kind of legacy technology?
Particularly when, when we are talking about that productivity drag.
[00:09:35] Speaker C: Yeah, good question.
It's more than just terminology. Right? You mentioned storage there and the mindset, the different mindset. It is storage in a sense, but there's a big difference. It's active storage, it's usable hot storage, rather than what some people think of it being cold storage, locked away in a bunker, that kind of thing. And it's a really, really important distinction to make. But with regard to the word mindset that you mentioned there, mindset's really important.
When people recognize that an archive, and, well, in particular Harmony's archive, that it's not just storage, they see it as a way to unlock productivity, to save time, to save time for frontline workers, to ease their workflows, and to give them the confidence to know that they can access the data that they need when they need it.
So that mindset switch provides a certain kind of freedom and reassurance to clinicians and administrators that they can go ahead and decommission legacy systems in the knowledge that the data that's captured in them, which is obviously rich and useful information, that that will be at their fingertips when they need it. So that reassurance is key and in itself lifts a burden of sorts in that it removes the stress and the worry associated with having to retire these outdated systems.
So when I refer to it as a productivity enabler, it's because this mindset allows for those hidden barriers and that additional burden to be removed.
[00:11:18] Speaker B: Excellent.
I want to maybe focus a bit more in on this notion of legacy data transformation now. Right. So we've talked about a productivity angle now we've introduced these concepts of archiving legacy data management, and you started to touch on a few of those use cases. But maybe we can expand that a little bit.
And can you talk a little bit more in depth about some of those common use cases where this legacy data transformation can help improve productivity and reduce that burden?
[00:12:04] Speaker C: Sure. So where is it used? Where might it be used? So when do clinicians and administrators access data? We all know that healthcare is so data heavy and it's so data reliant. Right?
So any workflow that requires the sourcing of patient information is a use case. And that's a use case that benefits from legacy application rationalization and this data transformation.
So we're hearing right across the board that the burden on the front line is significant.
Time is precious, and the constant chasing of information increases. What I'm hearing a lot refer to now as cognitive burden.
So cognitive burden is so frequently accompanied by burnout. They're words that you often hear in the same conversations with people. So if we're looking at use cases, let's think of freedom of information or subject access requests, where there's the gathering of patient information for release.
Ask anyone in a clinical environment.
These requests are plentiful and the time that they take to complete is really great. So simplifying access to data, having it in a unified record, reduces the time to do this and we're hearing often from days. It might take a day and a half, it might take two days to gather information, reducing that right down to minutes in some cases. So there's a brilliant use case for that.
Next, think of care provision where it's so important to have access to information, longitudinal information, so timely and seamless access to that to enable better clinical decision making is really game changing for clinicians and potentially life changing for patients.
And then you can take it to another level.
Think about how having structured and discrete data, that really opens the potential for things like robotic process automation. And as you know, Eric, we have a whole team dedicated to RPA at Harmony and they build tools to embed and create more efficient workflows. And the result of that is, you know, reduced admin burden, more time for patient care.
It can also having structured historical data can also support and feed into AI modeling, population health analytics and any other data platforms that may be there. So that really, I suppose, paves the way for better insight for system wide efficiency gains. And that all feeds back, of course, into the goal of increasing productivity.
So also I suppose to consider here we should, when we're talking about improving productivity, we must not forget that there's a financial aspect to this too.
If you can decommission systems and reduce the annual operational costs of maintaining and supporting them, that allows for reinvestment in people and in services that will also improve productivity. So it's always really important to remember that financial aspect and the return on investment as well.
So they're a bit jumbled, but many use cases where I think this is really, really beneficial.
[00:15:34] Speaker B: Absolutely. You've covered a ton there and I loved how you addressed that. In particular, Ruth, what you talked about right there is indicative. When we use the terms archive or legacy data management, it sounds like an IT project, Right.
But what you talked about is highly clinical and that blending between the clinical impact, the frontline impact associated with these kinds of projects. I'm curious if you wouldn't mind elaborating a little bit in that perception of this notion of the belief that again, we think about archiving, think about storage, and you talked a lot about the clinical notion of, of what these projects can look like. And being a clinician yourself, I'm curious, as you see these blending, you know, where this blending of roles starting to transform, you know, a bit, how do you see that in the uk and maybe do you mind talking A bit about, you know, what that leadership role now looks like in the uk, you know, for somebody that's leading like a cio, how have you seen that role change?
When you start to think about an initiative like this that you just talked about, I'm curious on how you've seen that change over time.
[00:16:55] Speaker C: Well, just based on my experience, how I've seen is really the collaboration between IT and clinical. So you're right in saying historically people would have seen this, as well as epr, emr, dmr, ehr, whatever you want to call it, they would be seen traditionally as IT programs. And that's become more evident over time that they're not. They need to have clinical input, they need to be clinically led, because ultimately the business of what these organizations do is clinical care for people. So you have to have that influence. And how we're seeing that change is the appointment of clinical members on the oversight teams that are running these projects. So you'll now have the cmio, so it's the Chief Medical Information Officer, you have the cnio, the Chief Nursing Information Officer, and you will have representatives from all the clinical departments who are having an input into running these projects, into identifying what information is important for them, what data will need to be kept, what data will need to be archived. So there's very strong clinical influence now in these projects, and rightly so, because it impacts the nature of the business of these organizations.
[00:18:25] Speaker B: Yeah, absolutely.
Thanks, Ruth.
Okay, one more question, and talking about productivity challenges that you've been describing surfacing very clearly in the UK right now, as you think about US health systems, where do you see the same productivity drag playing out, or even if systems and timelines look different?
[00:18:54] Speaker C: So, yeah, as I mentioned earlier, these issues are very similar the world over, so we're seeing it in a lot of different places. The us from what I understand and from what I've seen, the US is so digitally mature in comparison to many countries in Europe.
But notwithstanding that the same barriers exist, they just might look slightly different, they might have a different name. But American clinicians and administrators are experiencing the same friction, the same frustrations as their European counterparts. And in many ways, because of your digital maturity in healthcare, the problem could even be considered in some ways as being bigger.
You've had EHRs in place for longer, you have more digital data, you have larger health systems, you've larger population.
So theoretically, your drag is in some ways heavier.
The technology, for example, in many cases may be older. So we're very much laggards here in Ireland. But the technology that we implement now will be modern technology, so we will have that benefit.
But that technology, being older, that can lead to other risks which directly impact productivity, too. So these impacts, these things can't be considered in isolation.
So as well as operational and financial productivity, which we've already mentioned, it's really important to keep security and compliance in mind, too.
So older tech, as we know, is less secure.
Keeping systems up and running for data access really is increasing the security risk and it's taking more resources.
So the productivity drag translates very clearly in the U.S.
but again, we're seeing that that's being recognized as health systems migrate from one EHR to another, they are addressing the data strategy in parallel.
And that's really, really important. That's a very important learning from our experience at Harmony that these projects that have run most successfully and they're most smooth and seamless are those which treat the data strategy with the appropriate focus from the outset and not as an entirely separate initiative. So it's really important that we take those significant learnings across the Atlantic and into Europe to. Because you guys are ahead, but it doesn't mean that you didn't have the same problems or the same drag or the same productivity issues.
[00:21:32] Speaker B: Yeah, absolutely.
Ruth, thank you so much for joining us. We really appreciated your insight on this episode.
[00:21:42] Speaker C: You're very welcome. I might finish with one more point, Eric, if I may. I'd like to finish with one analogy, but that I heard quite recently, which I thought was really lovely in its simplicity. And it was about moving house, that implementing an EMR EPR without a data strategy is like moving house without packing up any of the contents of the old house. So you're starting afresh, you're starting clean, but with any of the key items to allow you settle in and hit the ground running in your new house.
So that is without any of your information to continue your operations or make decisions. So that doesn't really sound very productive, does it?
[00:22:25] Speaker B: No, it doesn't.
Ruth, thanks again for joining us on this episode. Really enjoyed it.
[00:22:33] Speaker C: Thanks so much, Eric. I did, too.
[00:22:36] Speaker B: That's it for today's episode of Health Data Talks. Thanks to Ruth for sharing your perspective and thanks to everyone that listened in if this conversation resonated. Be sure to tune in for future episodes as we continue to examine how healthcare organizations keep their data and their teams in sync through change.
[00:22:54] Speaker A: That's it for this session of Health Data Talks. Check out helpful
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