Regardless of how universal health care legislation now being debated by the U.S. Congress turns out, it is a certainty that the coming decades will be characterized as the age of health care, where an increasingly older population will demand a greater number and variety of medical services, offered in a more cost-effective way. In spite of the rancor associated with the health care debate, just about all parties agree that a significant source of cost in health care delivery is associated with simply managing medical records -- by some estimates, as much as $1 billion to $2 billion annually. Reducing cost associated with electronic medical record (EMR) retention and manipulation, therefore, is attractive to all parties. Management and storage of EMR data, consequently, have become of increasing interest to storage solution providers, who through economies of scale and scope can promise lower storage costs. There are, however, several significant considerations that may make EMR storage services problematic for some providers.
Security. It goes without saying that medical records are not like ordinary business data. In the first place, such records must be absolutely secure. There is an increasing body of regulation such as HIPAA as well as a judicial record of successful lawsuits that make the penalty for revealing personal medical data very painful and expensive. As a result, the potential liability of providing EMR storage services can be very high. And while liability insurance is available for such breaches, liability prevention -- having the appropriate security protocols and data integrity checks to prevent data leakage in the first place -- is critical. Hardened storage with extensive access restrictions is a must, as is extensive background research on every employee having access to such records.
Retention period. Medical records also have very high retention requirements. In many cases, they may outlive the patients whose health care history they represent. Storage arrangements will need to recognize that such records will have to remain viable for many years or decades. This includes ensuring that the storage media are consistent with existing technology, through regular audits of existing and industry-standard media and storage techniques, as well as ensuring that, if necessary, storage can be assumed by a third party. Depending on how viable in the long run you believe your operation to be, this may involve contractual arrangements with long-term archival providers or obtaining insurance that would pay for such long-term storage should your company fail.
Data integrity. EMR data can literally represent life-and-death information. Data integrity is paramount, especially if such data represents files such as high-resolution imaging. Introduction of errors can corrupt images that will need to be reproduced, sometimes in ways that may threaten a patient's health. As with any data type, ensuring integrity can involve hot backups and routine consistency checks -- even if the data is encrypted.
Scalability. Medical records can be voluminous, with each record set containing many megabytes of information. Patient databases can be very large, running to terabytes for even a modest hospital. Such volumes demand a great deal of available storage and, since every visit to the doctor can generate large chunks of new data, the storage has to be very scalable.
For VARs and systems integrators, the opportunity around EMR storage services can be substantial. Since an offsite data storage facility can leverage scale and scope to drive down the cost of storage significantly, you can generate a more-than-reasonable margin while still showing significant cost reductions to a customer over the long term. However, as noted above, you must be in a position to guarantee data security, longevity, integrity and scalability, and these considerations aren't trivial. Storage facilities need to be hardened and include redundancy. Service offerings must include strong security guarantees, and service providers must carry sufficient liability insurance to provide protection in cases of disclosure or data destruction.
One option for you is to avoid much of the liability concern by simply reselling storage services offered by others and layer on customer service and support for these services to generate margin. In fact, total solution packages that provide the necessary on-site infrastructure combined with third-party-provided EMR storage services can leverage existing customer relationships while offloading much of the sensitive aspects of health care storage support.
Another approach, if you already have a sufficiently robust storage capability, is to partner with EMR application vendors to integrate their software with your storage to offer solutions that offload software support as well as storage. EMR vendors such as e-MDs, Allscripts, NextGen Healthcare Information Systems, GE Healthcare and others provide solutions that would fit nicely in an outsourced service environment.
The bottom line is that EMR storage services are ones for which the channel can offer effective alternatives. Paying attention to your sensitivity for liability and the extent to which you can assure security and latency are necessary first steps to determining whether health care services are for you.
About the author
Mike Jude is a program manager at Stratecast, a division of Frost & Sullivan, and can be reached at [email protected]