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Executive Interview: Why Your Legacy Records Are an AI Goldmine with James Hammer

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Speaker: I'm Bill Russell, creator of this Week Health, where our mission is to transform healthcare, one connection at a time. This is an executive interview

quick powerful Conversations with Leaders Driving Change. So let's get started.

Bill Russell: All right. Today we have another executive interview, and today I'm joined by, uh, Jim Hammer with, uh, harmony Healthcare it, the COO for Harmony Healthcare. It. Jim, welcome to the show.

jhammer: Bill, I appreciate the opportunity here today.

Bill Russell: I'm looking forward to the conversation. You know, a lot of people think that, uh, every EHR migration that is gonna happen has happened.

Like there's no more to happen and then you turn, turn the page and all of a sudden you have Northwell doing one and you, I mean, you have really large health systems doing, and you realize we're, we're not done with this by, by a long shot. There's still an awful lot and there's a lot of things. That I think people learn as they're doing them and things they can do wrong.

So I'm looking forward to this conversation. Um, before we get into that a a little bit, I'd, I'd love to hear your [00:01:00] background, like, where, where'd you come from and, and, and how'd you get involved with, uh, with Harmony.

jhammer: Yeah, you bet. So, uh, started out at a school basically helping what, what now is an IDM, so, uh, business office processing and director of billing and back office. Uh, quickly learned that, uh, healthcare, it is where I wanted to be. So transitioned into a company that went through a lot of variations, but ended up being WebMD, practice services.

Uh, ran about 14 product lines while at that organization. And, uh, today folks would be familiar with Intergy, uh, you know, Greenway, suite of products and so forth, and medical manager back in the day, ambulatory. And really, uh, when we started Harmony, which was 2006, uh, it was really at the impetus of acquisitions really in high speed.

So IDNs buying ambulatory practices, and to your point, migrations were pretty costly and timely like they still are today. And folks felt there had to be a different opportunity. So we were kind of one of the early pioneers of data archiving in the space. So yes, there's a vital place for data migration, but also.

A lot of that data's left on the floor if you don't have a comprehensive [00:02:00] strategy for archival. And it's really been a hockey stick since then from what was a niche market to really almost everybody, to your point, going through mergers, acquisitions, divestitures, everybody's got migration and or archival needs for that legacy retention.

Uh, both for patient care as well as just, you know, release information, legal and compliance.

Bill Russell: you know, what's, what's the problem set? What are people looking at? Is it, is it primarily, primarily that, uh, that migration from an EHR or are, I mean, we're hearing about application rationalization across the board.

We're, we're hearing a lot of need to. Uh, reduce the overall, uh, application portfolio, not only from a cost perspective, but also a security perspective. Is that, is that what's driving this?

jhammer: Yeah, a lot of that is, uh, as well as patient care, right? There's a lot of value of data and not all of that gets migrated. Certainly there's a, a higher propensity of data now. Uh. Moving to migration as well. Uh, but it's really all the above cost reduction of legacy applications in a portfolio that are expensive for retention, period, it [00:03:00] infrastructure costs, all that goes with that.

Um, so what we've really been kinda experiencing is a. A push to a single source vendor being ourselves for not only at the archival but on the front end of migration. So over the last 24 months specifically, we've seen a lot of folks who used to look to maybe augmentation or bringing on team members internally to perform the data migration example, um, to looking for a single source vendor like ourself that can do both.

There's great advantages to that, as you can imagine. So our team gets access, gets comfortable and familiar with that data set. Uh, typically, again, in a, a typical migration, uh, you're, you're looking at anywhere from five core applications to hundreds within the portfolio ultimately, that are getting displaced by an integrated solution.

So our team has real good expertise on discovery, uh, as well as, like I said, they know that application through migration and then we can help give best practice on what should be migrated versus what has to be retained fully for retention. Uh, and that's been a, a great consolidation of, of. Basically consolidated services over the [00:04:00] last, like I said, really heavily 24 months.

Bill Russell: That sounds to me like one of the mistakes people would make is not involving. Your organization soon enough in the process.

jhammer: It's always a challenge, right? So yeah, so what happens typically is selection of their go forward application vendor, and then. Downstream is what, what other activities. So planning and, you know, working that as early as possible in the process of who will be your partners. Because if you can have those partners around the table, it makes the downstream activities so much better and more efficient.

Bill Russell: Having done this for 19 years, there's part of me that thinks. Uh, I, I, I like the fact that your organization has that much experience and there's probably not many migrations you haven't seen, or data structures you haven't seen, and you're gonna make sure that all those edge cases get addressed and handled, I would imagine.

jhammer: Yeah, I, you know, we're proud to say we've, we've migrated or archived now 715 plus unique source applications. So whether it be a [00:05:00] single provider developed, you know, on their own product all the way to the largest, you know, products that are, are in place today. Your Cerner's, epic Meditechs as well. So, uh, yeah, we've got best practices.

We also have. Uh, technology. We're, we're a product company by nature. So anytime we see a service, we'd like to see what we can do to turn in to a product to automate things. So again, we'll start with our best practice approach, make recommendations, and then at the kind of final mile, here's always tweaking and customization based on that unique application.

Uh, we also like to say certain applications. You've seen one, you've seen them all. And they're pretty straightforward and efficient. In other cases, you've seen one, you've literally seen one, and it's widely customized and we have to process it to backwards engineer and get that data out of the source application, and then transform to whether it be migration, to go forward applications, or for the archive platform.

Bill Russell: you're doing the archive platform, I would assume that not only do you make sure that it goes well during the migration itself, but you're with them then ongoing to make sure that the data's [00:06:00] available and, you know, any additional information that needs to come in, any additional ways to access it, uh, get addressed and those kinds of things.

jhammer: Yeah, absolutely. At the end of the day, they need to be able to shut off that legacy application confidently, so when they shut it off, it's not coming back on. We've gotta have routines and processes to make sure that everybody's comfortable along that pathway, both iteratively through the process and then at the end, so, absolutely.

Bill Russell: How do you make sure that there's, there's not a lot of friction, so that, that's one of the things that people are concerned about. It's like, look, we don't wanna turn off the application yet 'cause we still want to have access to the thing, and I don't want seven clicks to get to this. And two, I want it integrated into the workflow.

Or, or those kinds of things. How, how do you address those concerns?

jhammer: the platform health data platform has been built intuitively. Purpose focus from day one to make sure that A, it's very intuitive and easy to use to your exact point. The more applications you archive, the least your team members are gonna re realize and remember what the source application was.

So we make sure that [00:07:00] user workflows are one, two, maximum three clicks away for efficiency. So same look and field, no matter what the application is that we're decommissioning. Uh, and then depending on the user base, like I said, clinicians are looking for single click. You know, to get to their data.

Whereas some of your more comprehensive workflows for the HIM release compliance risk teams, um, there's definitely comprehensive workflows for them to make sure they get the right data at the right time to the right, uh, recipient of that data post archival.

Bill Russell: is the model client a health system? Uh, because I'm thinking about when I was at St. Joe's, obviously if we were shutting down, uh, a hospital, EHR, that was something we would call you on. But we also did an awful lot of consolidation around the medical practices. We had hundreds and hundreds of EHRs. And we were shutting 'em off. Um, that wasn't a project where we were shutting off a hundred, we were shutting off a massive thing. We were shutting off literally like 10 every month kind of thing. Is that, is that something you, you guys do as well?

jhammer: Really the full spectrum. [00:08:00] So we started back in 2006, really focused on the ambulatory side, so we had to be efficient, cost effective, quick, um, and then we really have scaled up to being in the largest IDNs. In the country, frankly. So, and in those cases, any system acute through, you know, speci specialty specific systems as an example, you know, we've gotta be able to handle 'em all.

So, exactly to your point, it could be a five doctor practice who's leaving one EHR to another. We can handle that as a, as an offering and solution. Conversely, a lot of customers, uh, started out, let's say an acute, uh, you know, hospital situation where they're decommissioning going to an Epics an example, and there's 130 applications.

Uh, as far as that goes, um, you know, in, in their portfolio. So really anything and everything.

Bill Russell: what's changed over the last 19 years and what do you suspect will change over the next four or five?

jhammer: more involvement and understanding that data is an asset. So where it was spot specific to, I've got this project. IEA data migration. And then let's move on. Uh, there's a lot more with the introduction of [00:09:00] the CDO role as an example, looking strategically across the data set itself, so not only for data migration, for immediate patient care as an example, but longer term use of data, things like research or analytics, and, uh, amazingly AI and ml right open opening doors to what that data asset could be.

And really an overarching look at that from a strategic point of view early as opposed to. If it's too late, we already did something, sunset a product and maybe I don't have the data that, uh, I really like to have for that.

Bill Russell: It, I think it is gonna be interesting, especially with AI and where it's going, uh, and the, the, like, we have unlocked marginal amounts of value of the data that we've had over the last 15 years, and I think the tools have started to emerge that are gonna allow us to unlock data and that 15 years or unlock, uh, insights and, and, uh, oh, discovery, if you will. It, it, and that those 15 years of data that we have, if we've taken care of it correctly, if we've migrated correctly, if we stored it [00:10:00] correctly, it's gonna become context for these engines to. do really interesting things. So I, I, it, this, this is going to be one of those things that I know people put it in the not sexy category, but data all of a sudden and insights, um, context now are becoming sexy when you start to play with these AI tools and you see what they can do with the right data.

jhammer: I think the data's gotta be useful, right? And those tools are providing usefulness to that. Back to your question about, you know, what's changed, it used to be cost driven really only, right? So I need to reduce cost in my environment. When I basically decommissioned systems to, what can we do with that data set, uh, in a.

Again, research or other purposes. That's pretty exciting. Uh, and that's really ignited over the last, you know, two to three years, really the last 12 months heavily that we've been seeing where we've been asked, you know, additionally, our prime use case was retention for legal purposes as well as clinical care.

It's now what else can we do with the data? Can you help us with the [00:11:00] identification? Things like that. If it's, you know, some of our largest, uh, research institutions handle that on their own. But some of your mid-market and, uh, smaller customers are going, we don't have the team to do that. What can you do to help us?

So some of those doors have been opening as well, which is, which is very exciting.

Bill Russell: I have a little PTSD when you said e-discovery, so I just, I, the, the legal stuff's kind of crazy how much work that that generates. Um, you know, Jim, I I, I really appreciate the work you guys are doing. How, how can people get more information if they are heading down this path?

jhammer: People can look at our website and social media. We're pretty prevailing out there. Um, uh, you know, as, uh, you know, LinkedIn as well and, uh, harmony Healthcare

Bill Russell: Hey, I wanna thank you for your time. Hopefully we'll, uh, run into each other uh, at one of these conferences. Maybe at hims. We'll see.

jhammer: Sounds good. Appreciate.

Bill Russell: Take care.

Speaker: Thanks for joining us for this executive interview with me, bill Russell. Every healthcare leader needs a community they can lean on and learn from. Subscribe at this week, health.com/subscribe and share this conversation with your team. Together we're [00:12:00] transforming healthcare.

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