Breaking Down the Barriers: Tackling Healthcare Data Migration Challenges

According to Gartner, 83% of data migration projects fail, with over half exceeding their allocated budgets. And in a heavily regulated industry like healthcare, where providers manage vast amounts of complex data across various sources, formats, and systems, data migration presents its own set of unique challenges.

Ensuring data integrity, preserving patient records, maintaining uninterrupted care delivery, and complying with regulatory standards all depend on successful data migration. So, how can healthcare organisations achieve seamless data migration while upgrading their digital infrastructure? Whether transitioning from legacy systems to advanced solutions, merging operations, or enhancing compliance with updated regulations, this blog post explores common challenges and how we at MEG overcome them with our industry expertise and best practices.

Key Challenges in Healthcare Data Migration

1. Data Integrity

The Challenge

Ensuring the accuracy and consistency of data during migration is a significant challenge due to the wide range of structured and unstructured healthcare data across multiple sources, different data models, and data quality issues such as missing, outdated, or inaccurate information. Inconsistent or poor-quality data can lead to errors that impact patient care and overall operational efficiency.

The Solution

At MEG, we use a three-step approach to ensure data integrity. This includes:

1. Data Standardisation: Using standardised data formats, field names, and coding schemes to maintain consistency across systems is an effective method to eliminate incorrect and missing data, streamline the migration process and ensure compatibility across systems. Establishing data governance policies and procedures helps enforce standardisation practices and maintain data quality over time.

2. Data Cleansing: Conducting a thorough analysis of the data to be migrated to the new system helps identify inconsistencies, duplicates, or errors within the dataset. Addressing these issues early on minimises the risk of data corruption or loss during migration.

3. Data Audit: Conducting a thorough inventory of all existing data sources, formats, and structures allows healthcare organisations to identify potential challenges, such as data inconsistencies, outdated or incompatible systems, and duplicate data that could negatively impact the migration process well in advance.

2. Interoperability

The Challenge

Different healthcare systems use different data formats and standards, making interoperability a significant hurdle.

The Solution

To ensure compatibility and interoperability between the source and target systems, we recommend developing robust data mapping and transformation procedures that allow different data formats and standards to be accurately integrated.

Data mapping ensures that data fields in the source system (in our case, the existing Quality Management System) correspond accurately to the fields in the destination system (MEG). It involves analysing both the source and target systems, transforming data into the required formats, and ensuring accurate field mapping between systems. This is also where data is converted into the required format or structure. This can involve simple transformations like date formats (e.g., changing MM/DD/YYYY to YYYY-MM-DD) or more complex transformations like combining multiple fields into one.

3. Data Security and Compliance

The Challenge

Healthcare data contains sensitive patient information such as personal identifiers, medical history, and diagnoses and is subject to strict privacy regulations like HIPAA and GDPR. Ensuring compliance with these governance frameworks and preventing data exposure, loss, or corruption during migration is often a challenge.

The Solution

To overcome this, MEG implements the following measures across all data migration projects:

• Clients are encouraged to self-evaluate their internal data, and the MEG implementation team guides them through the best practices for data preparation. This process often involves consolidating data from various formats and sources, such as paper records, Excel spreadsheets, and legacy software databases, into a single secure source.

• Clear data retention policies that dictate how long different types of data should be retained and when they can be safely archived or deleted to ensure data privacy, security, and adherence to legal and regulatory requirements.

• Strong encryption methods and password-protected zip files to protect data during transfer

• Stringent access controls to ensure only authorised personnel can access the data

• Frequently checking and documenting compliance with relevant regulations throughout the migration process

4. Downtime and Disruption

The Challenge

In some cases, data migration of large amounts of data can cause system downtime, affecting healthcare operations and patient care.

The Solution

Some best practices that can be implemented to avoid this include:

• Phased Migration: Performing the migration in smaller, manageable phases allows organisations to identify and address potential issues early on, reducing the overall risk of data loss, corruption, or system downtime. Each phase serves as a learning opportunity to refine processes and mitigate potential problems in subsequent phases.

• Backups: Maintaining backups of all data before and during the migration process allows you to implement rollback procedures to revert to the previous state in case of critical failures or data loss during migration.

• Testing: Setting up dedicated test environments that mirror the production environment allows for thorough testing of migration processes without impacting live operations. This enables organisations to identify and address issues in a controlled environment before deploying changes to production.

Conclusion

Healthcare data migration is a complex but necessary undertaking for modernising healthcare systems and improving patient care. By understanding the challenges and implementing effective strategies to address them, organisations can break down the barriers to successful data migration, ensure compliance and security, and pave the way for a more efficient, integrated, and patient-centric healthcare environment.

To know more about successful healthcare data migration, check out our whitepaper, "Mastering Healthcare Data Migration: Challenges, Best Practices, and the MEG Approach".

Interview with Dr Magaly Blas, researcher and epidemiologist

Technological Advances in Maternal Health in the Amazon: The Case of Mamás del Río

In the heart of the Amazon rainforest, where roads become rivers and distances are measured in days of navigation, Mamás del Río emerges as a beacon of hope for communities facing limited medical care. Led by Dr Magaly Blas, with extensive experience in epidemiology and public health, this program has proven to be an innovative model for improving maternal and neonatal health through technology adapted to challenging environments. This article explores how the program has integrated technology to enhance care in rural and indigenous areas, highlighting the importance of public-private partnerships in this process.

CHECK THE FULL VIDEO INTERVIEW HERE

In this video, Dr Magaly Blas, an epidemiologist, introduces Mamás del Río, a program improving maternal and neonatal health in the Peruvian and Colombian Amazon. The program empowers community health workers with tablets for educational content and monitoring tools, transforming healthcare in remote areas.

CC are in English and many other languages.

Dr. Magaly Blas and Mamás del Río

Dr Magaly Blas is a physician from the Universidad Peruana Cayetano Heredia, with a master's and a doctorate in epidemiology from the University of Washington. She currently leads the Mamás del Río program, which aims to improve maternal and neonatal health in remote and indigenous communities in the Peruvian and Colombian Amazon. Besides directing the program, Dr Blas also plays a crucial role as head of the Political Advocacy Secretariat in Medicine and Public Health at the Medical College of Peru.

Using Technology to Improve Maternal and Newborn Health

Mamás del Río has implemented technology directly into the hands of community health workers, who play a vital role in their isolated communities. Each community worker receives a tablet that serves as an educational and monitoring tool. This tablet contains "digital stories," interactive narratives created in collaboration with the communities themselves, addressing specific maternal and neonatal health topics. During home visits, the tablet guides the workers on danger signs during childbirth and promotes safe childbirth practices, using multimedia content that deeply resonates with the local communities.

“We equip our community health workers with tablets that contain interactive educational content and monitoring tools. This not only facilitates education on maternal and neonatal care but also allows continuous health monitoring in communities where access to health centres is limited. We have demonstrated that it is possible to adapt technological tools to function without an internet connection, ensuring that critical information reaches even the most remote communities.”

Examples of Public-Private Collaborations

Strategic collaborations with public and private entities have been fundamental to the success of Mamás del Río. Under Dr. Blas’s leadership, the program has established strong partnerships with the Ministry of Health and regional governments, as well as support from the Ministries of Foreign Affairs of Peru and Colombia. This partnership has facilitated the expansion of the program along the border, significantly improving access to healthcare in previously inaccessible areas. Additionally, the program has received funding from the Inter-American Development Bank and Grand Challenges Canada, which have supported key scaling and impact assessment initiatives.

“We work in close partnership with the Ministry of Health and regional governments, as well as international organisations, to scale the program and ensure its long-term sustainability.”

Research Methods and Impact Evaluation

Mamás del Río has used rigorous research methods to evaluate the impact of its interventions on maternal and neonatal health. Studies have been conducted before and after the program in selected communities, using repeated censuses to measure changes in health indicators. The results of these studies have been published in specialised journals, such as The Lancet Regional Health Americas, highlighting significant improvements in newborn care, the promotion of breastfeeding, and increased institutional deliveries.

“These results not only validate our strategy but also reinforce our commitment to continue innovating and adapting technologies to address the unique challenges faced by Amazonian communities.”

New Ideas from Collaborations

Successful collaborations have led to new initiatives within Mamás del Río. For instance, an innovative approach is being developed to address teenage pregnancy, a growing concern in the communities served by the program. Dr Lisa Lebita Woodson has worked on this line to understand why teenage pregnancy occurs and how to address it. Additionally, community empowerment has been strengthened through the creation of the Association of Indigenous Community Health Workers (AACOSIL), a platform that promotes local leadership and participation in health-related decision-making.

“Our goal is to ensure that every mother and child in the Amazon has equitable access to safe and effective healthcare.”

- Dr. Magaly Blas, Epidemiologist and Researcher, Director of Mamás del Río

With the right combination of technology, collaboration, and commitment, Mamás del Río has shown that it is possible to significantly improve maternal and neonatal care in the most remote and vulnerable regions of the continent. Despite initial challenges such as technology training and limited connectivity infrastructure, the program has implemented effective solutions in remote environments without constant internet access. The offline-operating application has facilitated adoption by community workers, allowing them to access essential educational resources and monitoring tools.

In conclusion, under the direction of Dr. Magaly Blas, Mamás del Río highlights the crucial importance of technological innovation and strategic partnerships in improving maternal and neonatal health in remote areas. Through public-private collaboration, the program has not only transformed lives and strengthened communities but also established a replicable model for regions with similar challenges. Continuous commitment to research and rigorous evaluation remains essential to guide future interventions and ensure a lasting impact on public health, thereby improving patient safety and quality in healthcare systems.

From Insights to Action: How EWS Can Transform Sepsis and Patient Care

In the ever-evolving world of healthcare and patient safety, the journey from awareness to action is crucial. Today, it simply isn't enough to recognise potential risks, threats, or issues — what truly matters is how effectively we respond to them. One area where this is particularly critical is in patient care, where early detection of deteriorating health conditions can be a matter of life or death.

The equivalent of the Emirates stadium full of people die of sepsis each year in the UK. Over 1.7 million people in the United States develop sepsis every year, with a mortality rate of 15-30%. However, what's more unfortunate is that 1 in 8 sepsis deaths are preventable with early detection, timeliness, and competency of clinical response.

This is where the concept of Early Warning Scores (EWS) comes into play, offering a transformative approach to sepsis and patient care practices.

Understanding Early Warning Scores

Early warning score (EWS) is a systemic tool that healthcare teams, specifically frontline workers, can use to recognise the early signs of clinical deterioration and initiate intervention and management.

Typically, this involves assessing seven physiological parameters—respiratory rate, oxygen saturation, supplemental oxygen temperature, systolic blood pressure, heart rate, and level of consciousness — and assigning a score to each vital sign. The aggregated score is used to identify whether the patient is at risk of deterioration or not. It also empowers healthcare teams to take decisive actions such as initiating closer monitoring, adjusting medication, or activating a rapid response.

Fig: Example of a National Early Warning Scoring System

The Transformative Potential of Early Warning Scores

Integrating Early Warning Scores into Sepsis and Patient Care is crucial in transitioning from reactive to proactive healthcare delivery. While enhancing patient outcomes and improving the overall efficiency and effectiveness of the healthcare system at large, it also contributes to:

1. Timely identification and intervention: As discussed earlier, the most significant advantage of the EWS system is the ability to detect subtle changes in a patient's condition, which might otherwise be overlooked, in the early stages. This allows healthcare providers to promptly intervene and prevent further patient deterioration, which is arguably one of the most critical steps in the early management of sepsis.

2. Standardisation of care: Implementing a standard EWS system, such as NEWS (National Early Warning Score), assures standardisation of care practices across various healthcare settings. This, in turn, allows providers to ensure consistency in assessing patient status and initiating appropriate interventions, which mitigate variability and reduce the likelihood of errors.

3. Data-driven decision-making: Key to elevating patient care, EWS systems provide objective criteria that healthcare providers can use to assess patients' conditions in real-time and inform their decisions. This approach enhances clinical judgement by promoting evidence-based practice, ultimately improving patient outcomes.

4. Quality improvement initiatives: Data, trends, and outcomes obtained from the EWS system can be used by healthcare organisations to identify areas for improvement in patient care processes, such as better staff training, the implementation of digital quality management systems, and refining protocols. Implementing these initiatives can go a long way in preventing and managing adverse outcomes like sepsis.

EWS Governance Audits and Their Role In Sepsis Care

Early Warning Score (EWS) Governance Audits are assessments conducted to evaluate the effectiveness and adherence to protocols regarding the implementation and use of EWS in healthcare settings. They primarily focus on:

• Whether EWS protocols include specific criteria for identifying patients at risk of sepsis

• Whether healthcare staff are trained to recognise the signs of a deteriorating patient promptly

• The effectiveness of protocols for escalating care and initiating appropriate interventions

• Documenting vital signs, interpreting EWS scores accurately, and following predefined pathways for sepsis assessment and treatment

• Whether there are clear processes in place for communicating EWS scores, escalating concerns, and activating rapid response or sepsis teams when necessary

MEG's Deteriorating Patient Bundle

To help organisations with their quality assurance process for patient deterioration, we've compiled a collection of assessments and audit tools, including various Early Warning Score forms such as standard, paediatric, maternity, and emergency medicine, each tailored to specific patient populations. The bundle also includes associated escalation pathways following the ISBAR model.

These are governance audits that organisations can use to ensure that their processes are working as designed and that staff are following the necessary protocol to prevent patient deterioration and the likelihood of events such as sepsis.

It also comes with a Quality Improvement Plan (QIP) tool to identify and address any issues or gaps in the assurance process. To see the tool in action, reach out to our team.

The CQC’s New Assessment Framework: Everything Providers Need to Know

The Care Quality Commission (CQC) in England plays a significant role in assessing and regulating health and social care services to guarantee adherence to fundamental quality standards and ensure safe, effective, and compassionate care.

In 2021, the CQC announced updates to its inspection framework and assessment methodology, changing how social care services are evaluated.

While these changes have yet to be fully implemented, it’s important to understand what's coming. This blog post provides an overview of what we know so far —what's changing, what's staying the same, and how you and your team can prepare for the new assessment framework.

Why is the CQC changing its assessment framework?

The CQC's ultimate aim with the new assessment framework is to enable a simpler and smarter regulatory approach that meets the needs of a changing health and social care sector. This entails a streamlined process geared towards prioritising the needs of individuals accessing care services and their families, timely and holistic assessment of care providers, and a robust learning and safety culture to improve the quality of care where it's most needed.

What's staying the same?

The 5 Key Questions

These are the same questions that the CQC asks of all care services they inspect and are at the heart of their regulatory process:

1. Are they safe?

Are all individuals protected from abuse and avoidable harm?

2. Are they effective?

Does your care, treatment, and support achieve good outcomes? Does it help maintain quality of life and is based on the best available evidence?

3. Are they caring?

Do staff involve and treat individuals with compassion, kindness, dignity, and respect?

4. Are they responsive to people's needs?

Are the services organised so that they meet the needs of all individuals?

5. Are they well-led?

Do the organisation's leadership, management, and governance ensure that it provides high-quality care based on every individual's needs? Does the organisation encourage learning and innovation and promote an open and fair culture?

While these five key questions remain the same, how the CQC assesses health and social care services in accordance with them will be changing.

The 4-point rating scale

The CQC will continue to give an overall rating for care services as one of the following:

• Outstanding

• Good

• Requires Improvement

• Inadequate

However, how this rating is calculated will be changing.

What's changing?

CQC's Single Assessment Framework

Until now, the CQC has had three separate assessment frameworks—one for hospitals, one for adult social care, and one for primary medical services. The Single Assessment Framework streamlines and simplifies the assessment process by combining all three frameworks. The new model will consist of only one set of expectations that clearly define 'quality' care and 'good' service.

How the 5 key questions are used in inspections: KLOEs to Quality Statements

Historically, each of the five key questions was dissected into a further set of questions called the "Key Lines of Enquiry" (KLOEs), which served as the focal points during CQC inspections.

With the introduction of the single assessment framework, the KLOEs are being replaced by quality statements framed as "we statements," demonstrating the provider's commitment to being safe, effective, responsive, caring, and well-led. Unlike the extensive 330+ prompts associated with KLOEs, there are only 34 quality statements, simplifying the assessment process for both regulators and providers. They set clear expectations for providers based on people’s experiences and the standards of care they expect.

Evidence Categories

Until now, care services were monitored primarily through in-person inspections, scheduled based on the previous rating and the CQC’s risk assessment.

Moving forward, the CQC will employ a dual approach to monitor services, combining in-person inspections with ongoing assessments and evidence gathering. To determine a service's adherence to each quality statement, the CQC will now evaluate evidence from six distinct categories:

1. People's experience of health and care services

2. Feedback from staff and leaders

3. Feedback from partners

4. Observation

5. Processes

6. Outcomes

Each category outlines the types of evidence used to assess both the quality of care provided and the service's performance against each quality statement. This restructuring aims to enhance the transparency and consistency of the CQC's evaluations.

Scoring System

While retaining the 4-point rating scale, the CQC is introducing a scoring system to improve the clarity and consistency of their assessments concerning:

• the quality of care within a service

• the efficacy of a local authority in delivering its duties under the Care Act

• the performance of an integrated care system

Each quality statement will be assessed based on the evidence gathered from each key evidence category. Depending on the findings, a score will be assigned to each evidence category as follows:

4 = Evidence shows an exceptional standard

3 = Evidence shows a good standard

2 = Evidence shows some shortfalls

1 = Evidence shows significant shortfalls

The scores from evidence categories are combined to determine the score for the corresponding quality statement. These quality statement scores are then combined to calculate a total score for the relevant key question. This cumulative score generates a rating for each of the five key questions, and the collective scores for all key questions determine an overall rating based on the 4-point scale: outstanding, good, requires improvement, or inadequate.

This scoring methodology provides providers with clear insights into which specific quality statements require attention to boost their total score for a key question and, consequently, improve their overall rating.

As the CQC transitions away from conducting assessments at a single point in time, future evaluations will likely occur periodically across different areas of the framework. This approach allows for updating scores for various evidence categories at different intervals.

What can providers do to prepare?

• Stay up-to-date with the CQC

Keeping abreast of the latest developments as the new framework unfolds will enable providers to navigate the transition smoothly. Here are some valuable resources to assist you:

• CQC's provider guidance on their new assessment approach

• Videos and webinars on the new regulations

• CQC's digital engagement platform to share feedback

• CQC's email newsletter for all updates

• Review and understand the new framework

As an organisation, take some time to thoroughly review the CQC's new Single Assessment Framework. Understand what's changing, what's staying the same, the scoring criteria, and the new key evidence categories. This will help you align your practices with the updated expectations.

• Conduct Internal Assessments

Perform internal assessments of your services based on the new framework's quality statements and evidence categories. Talk to internal stakeholders, gather feedback, and identify areas where you excel and areas where you can improve. This proactive approach can help you identify and correct shortcomings long before the official CQC assessment.

• Improve Data Collection and Documentation

Strengthen your data collection and documentation processes to ensure accurate and comprehensive evidence collection. Consider implementing a digital auditing system to replace cumbersome paper-based processes. These systems streamline processes, ensuring you efficiently capture all the necessary information and evidence for your regulatory and accreditation requirements.

How can MEG help?

MEG, with its comprehensive digital auditing and management capabilities, can help care providers prepare for and navigate the new CQC Single Assessment Framework through:

1. Customisable Audits

MEG allows for the creation of custom audits tailored to the specific requirements of the CQC framework. Providers can design audit forms based on the quality statements and evidence categories, ensuring that they gather relevant data during internal assessments.

2. Real-time Monitoring and Reporting

MEG monitors compliance status in real time and generates comprehensive reports on care quality. This allows providers to quickly identify areas of strength and those that need improvement, aligning with the CQC's emphasis on ongoing assessment and improvement.

3. Comprehensive Document Management

MEG offers a centralised platform for managing and storing policies, procedures, protocols, quality statements, and evidence categories in alignment with the new CQC guidelines. This ensures that care providers can readily access all the necessary documentation whenever needed.

Book a call with our team to know more!

Interview with Jafet Arrieta, VP at IHI

Transforming Healthcare in Latin America: An Exclusive Interview with Jafet Arrieta

In the realm of healthcare, where equity, quality, and humanisation are imperatives, Jafet Arrieta, Vice President of the Institute for Healthcare Improvement (IHI), offers an inspiring insight into the challenges and opportunities in Latin America. With a passionate and systematic approach, Jafet leads initiatives to enhance the health of populations and transform healthcare systems in the region. In an exclusive interview, she highlighted several key points summarising her approach and vision for the future of healthcare in Latin America.

CHECK THE FULL VIDEO INTERVIEW HERE

In this interview, Jafet Arrieta, Vice President of the Institute for Healthcare Improvement (IHI), shares her unique perspective on the challenges and key strategies for improving quality, humanizing care, and ensuring equity in healthcare institutions in Latin America. From identifying areas for improvement in patient experience to addressing common errors in medical risk management, Jafet provides a comprehensive insight into leveraging technology, enhancing care quality, and preventing medical errors in the region. Join us to explore how principles of healthcare humanisation intertwine with patient safety and medical risk management, and discover how these practices are positively transforming the healthcare landscape in Latin America.

Recognising Challenges and Embracing Opportunities

She emphasises the importance of understanding the scope of the problem to properly prioritise resources and make a real impact on populations. She also underscores the need to adopt a systemic perspective and address the five fundamental goals:

• Improving population health

• Patient experience

• Healthcare staff well-being

• Resource efficiency

• Equity in access to and quality of care

“It is important to be able to truly assess not only what the problem is, but also what impact these problems are having on the population, and on the communities we seek to serve.”

“And in that sense, I would tell you that besides seeing many challenges, I see opportunities. I see opportunities to work, to address those challenges.”

MaximiSing Technology to Enhance Care Quality

When it comes to harnessing technology to improve care quality, Jafet staunchly advocates for a systemic approach. She highlights how technology can enhance medical care by closing access gaps and increasing patient safety, especially during the pandemic. It is crucial to adopt it as part of a comprehensive strategy that includes active patient and family engagement.

Another significant example highlighted in the interview is that of the Hospital Israelita Albert Einstein, which has implemented telehealth to reach remote communities in the Amazon, improving access and health indicators at the population level.

Technology also facilitates communication among medical staff, patients, and their families, creating efficiencies and enabling real-time data tracking to identify important events and understand their causes.

"...there is a lot of room to maximise technology, and it is important to understand that technology is a means to an end and not an end in itself. So, there, I think it is very important for technology to be adopted in the context of a much broader, much more comprehensive strategy to improve quality, patient safety, and to humanize care..."

Addressing Areas for Improvement in Patient Experience

Jafet points out the need to adopt a holistic approach to identify and address areas for improvement in patient experience. She emphasizes the importance of working from risk management towards risk prevention, integrating elements such as planning, quality improvement, and quality control. She also underscores the fundamental role of effective communication between healthcare staff, patients, and their families, and highlights how simple strategies can have a significant impact on reducing pain and fear in children with cancer.

“The third aspect proposed by Juran's trilogy, which is quality control seeks to generate mechanisms so that once the systems, the processes are set in motion, they reach the desired performance level and can be sustained over time, allowing us to control quality."

-Jafet Arrieta, Vice President of the Institute for Healthcare Improvement (IHI)

A Story of Transformation in Pediatric Healthcare

Jafet shares an inspiring story of transformation in pediatric care, highlighting a collaborative project with St. Jude Children's Research Hospital. Through the "Global Comfort Promise" project, Jafet and her team work with hospitals worldwide to reduce pain associated with medical procedures in children with cancer. She highlights how the systemic approach and improvement science can generate transformative results, not only in patient experience but also in the culture and satisfaction of healthcare staff.

In summary, the interview with Jafet Arrieta offers an inspiring and practical insight into addressing healthcare challenges in Latin America. With a focus on equity, quality, and humanization, she demonstrates how technology, effective communication, and improvement science can transform healthcare systems and improve people's lives in the region.