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Executive Interview: Stress-Free EHR Migration and Education with Abhishek Begerhotta

Plus, they optimize patient eligibility verification to drive better financial results. Want to lead the way in healthcare? Visit 314e. com today.

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.

Abhishek Begerhotta: excited to be here.

Abhishek Begerhotta: That's right. I started in 1996 was really, I'm gonna date myself, but that's when I started working in healthcare. So it's been a while.

Bill Russell: how did you get started in healthcare and then how did it lead to the founding of 314e.

Abhishek Begerhotta: So I was doing a PhD in mathematics at Purdue. And a lot of my colleagues were finding jobs after the PhD that didn't pay too well and there was a whole lot of competition for Getting a university job. So I decided to quit after a master's degree, and I got a job with IBM as a consultant as a software engineer.

Bill Russell: Wow. And how did I mean. an entrepreneur, is that just something that's ingrained in you or did you see a certain problem that existed within healthcare that you wanted really try to solve?

And they selected Epic. And as a result you know, I got the pink slip. Uh, And had to really look for you know, job opportunities. I decided to become an independent consultant and, started helping Kaiser and that's what led to the founding of 3 1 4 E.

Abhishek Begerhotta: That's right. I mean, Epic, it really put Epic on the map and I do not know what the final number is, but it was, you know, several billion dollars. And I think the part that. Essentially I and 314e ended up playing was that we help with data conversion uh, you know, from, the legacy IBM system into Epic.

And that's kind of what got us started into, you know, services for healthcare.

Bill Russell: The data problem in healthcare is really interesting to me. But let's look at what actually happens when a health system decides to move from one EHR to another. What does that process look like and what's really at stake here?

I, you know, when I came into healthcare, one of the things I, I didn't understand is how complex the data is and you really, you can't lose any of it. It's not like you can make a mistake and lose it because we're talking about some really important information.

Abhishek Begerhotta: Right. So as you pointed out, bill, it's a very it's a big decision by an organization to move to another EHR and in general you know, data has to be preserved because of, I, I believe HIPAA rules that essentially require you know, release of information to patients, you know, whenever they might ask for data and, you know, by different states have different laws, but you know, you could, you might need data to, you might need to retain data up to 25 years.

Translated into a form which is ingestible by you know, your future EHR. And even though there are, you know, the federal government came up with the CURES Act and that requires this EHI export and they, you know, but they did not mandate the use of something like bulk FIHR or something, which have made life a lot easier.

So in general, it's a complex problem of taking a boatload of data, you know, and visits, problems, allergies lab results, radiology results, et cetera and, wrangling the data and then, you know, and large volumes of data and ingesting it into the new EHR. So, so we help with that for sure.

Abhishek Begerhotta: organizations underestimate the complexity involved in taking large volumes of data you know, from the database of an EHR vendor, understanding that schema, right? And then massaging it in a repeatable fashion, testing it. Then you know, getting it into their future EHR.

And we are able to understand that, parse that and convert it into HL seven and CCD. To you know, to make make it ingestible by the, you know, future EHR, like Epic. And we do it simultaneously in the context of both archiving data as well as you know, conversion of the discrete data elements into the future EHR.

So, yeah, I mean, we've had many customers where. They start going they underestimate the complexity. They go about it on their own, and then they realize, oops, they need extra help. And then, you know, we're able to at one organization, we were able to move them from Cerner to Epic in a matter of six months..

Abhishek Begerhotta: Yeah, a little bit of both. Mostly it's you know, it's tab data stored in databases of the EHRs, but there's also a lot of unstructured data in healthcare. So there's, you know, you know, clinical notes, , files, you know, in a variety, different formats, FS and BMP, and JPGs and DICOM images, et cetera.

So, you know, we have to deal with all of them. And then to complicate matters further. Oftentimes, at least historically, document data was stored outside of the EHR in a in a purpose-built sort of document management system. And there's a lot of consolidation going on there as well. Epic released a product called Gallery lately, and so we're helping some customers move away from, Highlands on-base product to gallery as well.

So there's a lot of that migration going on as well in the market.

I mean, from your vantage point are you seeing that as well, that we're still seeing some Oracle migrations over to to Epic as well?

Abhishek Begerhotta: We're seeing a dramatic number of those, and I suspect that the Cerner acquisition is not. Working out too well for Oracle, you know, there, Larry Ellison's mind seems to be all around, you know, renting out GPUs you know, in the cloud, sort of becoming another hyperscaler for you know, in the GPU world.

Via VPN connections and whatnots and and make current data available at the day of the Epic Go Live. And not just the archive, but also within Epic.

Bill Russell: and you said in the example you gave, you said about six months I mean, is that six months from when you started working on the data to the migration For an Oracle? For a Cerner client?

The organization, the more the data. So we've had customers who have 200 terabytes of data that that we archive. And, you know, not all of that makes its way into the future EHR, but quite a bit of it does the last, you know, three to five years. So it takes time. And a lot of processing bandwidth to to actually make all of that work as well.

So, and we've essentially productized the whole Cerner to Epic or most legacy EHRs to Epic migration process, right? Rather than, you know, a bunch of analysts getting together and writing a script here, a script there and kind of, Jerry rigging it together. we have industrial grade battle tested process using, you know, you know, latest and greatest hardware to do it really fast and effectively.

Abhishek Begerhotta: Yeah, so stepping back a little bit, bill, around five years back, we decided to really transition to becoming a product focused company rather than remaining a IT services company. You know, as I said, my background in software engineering and product is a lot more fun. and. From a business standpoint, it's stickier revenue.

And you know, we think we can add more value to our customers by being a software oriented, intellectual, property driven organization. And one of the products that, you know, we obviously started you know, on the archive, but. The the other product that we started developing is a learning and training platform.

Right, so they don't have to watch a whole video. They could just ask questions and get [00:14:00] answers. So, you know, you, if you're familiar with Notebook, lm, there's a little bit of Google's notebook, lm like functionality baked in there. we also allow for users to. Watch courses. So if they really wanna, so in the industry parlance, it's called a SCORM file, swarms a format for courses.

So instructional designers to upload SCORM files and those even courses could be wash our platform. So it's a learning management system or it's a just in time training platform evolving into a healthcare focused learning management system.

Bill Russell: I would imagine you could use that for security training. You use it for. Any kind of training really across the board.

But no one ever goes and watches that. It is not accessible. So we're. We're kind of solving the accessibility problem and kind of meeting the users where they are to solve their problems. And what we think and what we know it's also doing is reducing the potential number of calls to help desk

we've recently introduced modules in our software that allow for human interaction, you know, essentially escalating. So you're interacting via chat bot with your organization's content, getting your questions answered. But if you're not satisfied with it, you can quickly escalate to you know, to speaking with a human.

So the idea is. Facilitating the move away from, you know, a end user picking up the phone, logging a ticket with help desk and getting resolution hours, maybe days or weeks later to sort of more just in time, real time resolution of their problems.

Abhishek Begerhotta: so it is an OnBase, it like it is like an OnBase, so it can serve as a system of record or an organization's documents, right? It tightly integrated with the EHR via a smart app launch. So, a smart on FIHR type integration. So, but what we're realizing is that it is difficult to penetrate in the market where, you know, the incumbents are large companies like Highland Epic also recently you know, actually it's been two years now, they announced this gallery product.

Do extraction of key information from the document. Then execute, I'm gonna call it n innate N style, you know, or Zapier style sort of, if this, then that type functionality on top of, right, like, I probably a bad example, but if the patient is X, Y, Z, do this, or if the document type is is a consent, you know, send it over to Epic

So what we've done is combine that with baked in facts, capability and you know, the ability to take documents from all different sources and operate on them with conditional logic and rules. And, you know, and they, you know, with HL seven and X 12 to essentially. automate enterprise workflows and turbocharge humans who are kind of doing this more mundane work now.

So we think that we can bring down, staffing levels you know, where say 10 team of 10 people is doing indexing to say two or three. So, you know, so we think it's incredible technology and and the time for it is now.

Bill Russell: I love how you in infused AI into that. It's pretty interesting for you know, just closing up here, I mean, for CIOs who are

thinking

about an EHR migration or dealing with legacy data, I would assume out of any kinds of systems what's the one thing you want them to know about? Approaching this the right way or how you would approach this?

If you think about all those things and for most CIOs, conversion and archival is super important, but it's not their, it's not what they want their own team to, to be focused on because they have to support the new software. and their team is really excited about learning the new system.

So, you know, we think that it's best left to specialists who know what they're doing. And we strive to be one of them.

Bill Russell: Absolutely. I wanna thank you for your time and I wanna thank you for your for your work in the industry.

Abhishek Begerhotta: Thank you so much. Thanks for having me, bill. Thanks for having me, bill.

Thanks for listening. That's all for now.