Azara says they have worked with my EHR system before, why does it still take so much effort to integrate my system to the data warehouse?
The process of connecting an EHR system to a central data warehouse is much more than technology. In fact, the core technology connection to the database is relatively straightforward and very repeatable. It is Steps 2-4 of the implementation process that requires significant human effort and accounts for the bulk of the time and cost associated with a successful DRVS implementation. Our team spends that time learning how you use your EHR, and configuring our system to fit your workflows so you get the maximum credit for the care you deliver.
Who owns the data collected? Does Azara share my data?
The data collected and stored by Azara is OWNED and CONTROLLED by the Patient, Provider and Health Center. Azara is the custodian of your data and takes stringent measures to assure your data is securely stored and protected. Azara does not share your data unless you authorize access. In addition, you have the ability to specify which elements of your data can be viewed by the various entities and roles within organizations you choose to grant access.. The Azara DRVS platform can be extended to supply “bulk” data to other entities, such as Immunization Registries, local, state or national programs and in some cases, act as an on-ramp for a regional, state or national Health Information Exchange (HIE).
Where does Azara store my data and is my data secure?
Azara utilizes a Tier 1 data center owned and managed by Microsoft Azure and located in Virginia. Our servers reside in a fully secure, backed up, and highly available production environment, configured to require user authentication, authorization and encryption for end user access, back end operations, and all data transfers. Our configuration is set to abide by all HIPAA regulations and the facilities are PCI DSS compliant, ISO 9001 certified for physical security and management, and audited yearly for SSAE16 compliance.
Azara employs a range of network and software controls to secure access to its production environment and application and all access and activity within both the operational environment and the DRVS application is logged and available for audit purposes.
In addition, Azara maintains an extensive set of documented Security Polices and Procedures regarding our employees, physical office space, electronic and information security and of course our production environments. Subject to HIPAA, Azara maintains Business Associate relationships with all organizations that provide PHI to Azara and any service providers that interact with our environments. We also conduct penetration testing at regular intervals.
If my data is somewhere on the Internet, how can it be as secure as within my facility?
Actually, the storage of data within any commercial grade data center is significantly more robust than typical, on-premise health center data storage. First, and foremost, our data center has a high degree of physical security, much greater than that of a typical health center or physicians’ practice. In contrast to a health center, the data center has only a small number of employees who work at and oversee the data center. Each of these employees is individually cleared for access and are monitored.
From an Internet storage perspective, the word “cloud” itself implies that your precious assets are out there floating around somewhere, right? It’s an understandable reaction, but one that couldn’t be further from the truth. In fact, the cloud is now the safest place for your data.
Think about this: Data is lost when an organization loses control over it, including how it’s stored, how it’s transmitted, and what end users do with it. Think USB drives. Clouds, and the technologies on which they run, give you back that centralized control, from data center to delivery to endpoint. There are only one or two paths of access, each which is monitored, encrypted, authenticated and authorized.
How can I securely access my information?
All Azara DRVS reporting and analytics functionality is available via a secure web browser connection to the application. DRVS supports access using most current web browsers (Internet Explorer 9 and above, and Firefox, and Chrome).
You describe your DRVS platform as Software-as-Service or “SaaS” model, isn’t that the same as a hosted solution?
Actually, there are differences. While a SaaS model is a hosted model, a SaaS model encompasses much, much more. Typically, a hosted solution model refers to the outsourcing of the supply of computing hardware, some base level software, networking infrastructure and the physical premises in which these reside. The client tends to own responsibility for both supplying and supporting the actual software application running on the servers. In addition, each hosted solution is usually designed to service a single client.
Azara DRVS is a true SaaS application platform. In addition to the lower level hardware and software items mentioned above, Azara supplies and maintains the DRVS Reporting and Analytics software situated on those servers, taking full responsibility for the ongoing development of the platform’s functionality (think upgrades, new reports and analytics), as well as assuring the environment is maintained and will remain safe and secure. Each client benefits from the addition of functionality requests and development on behalf of others and does not end up with a system unique to them, but rather a robust platform that encompasses best practices from within the Community Healthcare sector. On top of that, because all clients are using a common set of application functionality, Azara is able to provide true application level support, answering more than just technical question, but specifically, how to optimize the reporting and analytics functionality. In the SaaS model, clients typically pay an all inclusive, annual subscription fee.
Why does Azara continue to charge the same amount in year two and beyond while other solutions have one, large upfront payment?
Consistent with offering a SaaS product, Azara charges an all-inclusive annual subscription fee. That fee includes all hardware, software, ongoing upgrades, maintenance and full phone and email support. There is no need to purchase the servers, firewalls or other delivery infrastructure required to deploy and maintain most custom solutions or software products, nor is there a need to have a DBA or IT Administrator. All an organizations need to run Azara DRVS is a web browser and an internet connection.
The upfront charges are the one-time fees for attaching your EHR/EPM to the data warehouse and then performing data validation with your staff. This “plumbing” work is necessary no matter what type of solution you chose.
When comparing solutions, it is important to understand the true, long-term cost of ownership associated with each proposal. For instance, if you consider having a custom or semi-custom system created on your behalf, there are costs to develop your application, acquire the necessary hardware and 3rd party software, for network infrastructure and security (or hosting to obtain equivalent), for IT support and there is a significant cost for on-going maintenance and upkeep.
Keep in mind that once a custom system has been handed over, there annual fees to maintain the infrastructure and pay for 3rd software maintenance charges and/or hosting. The large hidden cost is the one associated with keeping the application current and able to meet all of your evolving application functionality and reporting requirements. For instance, as UDS in revised annually and requirements for the later stages of Meaningful Use are published, you, or your solution provider will be required to begin a new phase of development to answer these new needs and provide the reports necessary for you to show compliance.
How does committing to the DRVS platform compare with building my own system from an effort, responsibility and on-going maintenance standpoint?
Like any build vs. buy decision, there are many factors to consider including time to market, cost, in-house expertise, time and focus of the business and its leadership, the ability to maintain the systems and the long-term cost, support and resource implications of owning a system.
Some of the primary reasons to choose a pre-built system like Azara DRVS is its proven ability to delivery value from day one and taking advantage of DRVS’s 8+ year history and evolution. In addition, DRVS embodies Azara’s experience working with multiple PCAs, HCCN’s and CHCs by incorporating Community Healthcare’s best practices and packaging the DRVS solution in a form that requires minimal upfront capital. DRVS has been validated for production stability and its subscription model provides long-term sustainability for both the platform and its users.
The biggest advantage of a custom system, is that it has the potential to operate in exactly the manner dictated by the client. It’s built to conform to an organization’s business process and not require adherence to alternatives. Besides the monetary cost of building and operating a custom system, one must take into account the need for requirements gathering and client input to document the desired process. Custom systems also require significant resources for on-going maintenance. Federal and other program measurement definitions change frequently, and keeping up to date with these regulatory changes constantly draws on business analysis skills as well as technical capacity.
How can we be better prepared to help the deployment go smoothly?
The most labor intensive parts of the process revolve around connecting to individual EHR databases and then validating that the data Azara DRVS is pulling out is correct. To make the early part of the connection phase proceed smoothly, have proper access credentials to each relevant data source, a resource who understands your specific network, your EHR system, the data and associated workflow and some documentation of the system and its data format. While we have the ability to analyze the current state of the system and derive the key information ourselves, client preparation and cooperation will put us on the path to exceeding expectations and potentially saving on start-up expenses.
What is Azara’s level of experience with operating these types of systems for Community Health Centers?
Azara Healthcare was formed in 2011 as a cooperative venture with the Massachusetts League of Community Health Centers (MLCHC) to bring to market the analytics intellectual property that had been developed for the Massachusetts health centers starting in 2007 to primary care providers nationwide.
Azara was established to provide a single purpose entity to expand, deploy and operate the DRVS platform for the Community Health marketplace. Leveraging the knowledge, experience, of our staff, partners and clients, Azara has expanded its reach from the initial 9 MA CHC’s to deployment at 175+ health centers across 19 states.
Can I see how all of my centers compare to each other on key metrics?
Yes! Azara DRVS allows comparisons between providers, sites, and centers, with the data visible in either explicit – West End, Greenway Acres or generic format (Site 1, Site 2) – depending on your configuration and security preferences. It is our experience that using as much explicit information as possible increases transparency, introduces a healthy competiveness, and drives overall improvement at a faster rate. We also understand that this does not work in all environments, and therefore DRVS is built to accommodate the necessary data blinding.
How does Azara DRVS help us meet Meaningful Use?
Azara DRVS is certified for Stage 1 and Stage 2 Meaningful Use Clinical Quality Measures. DRVS provides a number of scorecard reports for your providers relating to each of the Meaningful Use Objectives. In addition, The DRVS Measure Analyzer enables center managers to monitor progress over time at each center, location, and/or provider. Use of patient detail reports from the Measure Analyzer allows the identification of patients who are causing non-compliance (ex. Bob Smith doesn’t have full demographics recorded) and creates a “punch list” for either outreach to the patients or remediation in conjunction with an upcoming office visit.
How much will I have to pay for upgrades if the Federal reporting requirements change? What about State requirements?
There is no additional charge. Reports necessary to meet changes in all UDS Clinical Quality reporting requirements are included as part of your subscription. Azara Healthcare will evaluate requests to create additional reports and determine whether they will be included or not.
Note: Reports requiring new or additional data elements may require modifications to current data connectors to collect the necessary data elements.
What are the hardware and IT requirements for Azara DRVS?
Because the DRVS application is delivered using a SaaS model, the only thing a client needs to access DRVS reporting is an Internet connected machine with a current form of web browser Internet Explorer 9, Firefox or Chrome. No servers or IT infrastructure are necessary. To facilitate data transfer to the Azara DRVS database, Azara will need to co-locate the data connector code on or near the EHR database, whether on-premise or hosted.
How many sites are currently using DRVS?
Currently, there are 175+ Community Health Centers across 19 states working with Azara DRVS.
Do you have a User’s Group?
Azara has User Groups in a number of states where there is a large concentration of users, usually in conjunction with the efforts of a PCA or HCCN. We expect additional groups to form as we expand our geographic footprint and work closely with clients to foster idea sharing , collaboration and best practices.
How is DRVS licensed? Are we limited to certain users?
DRVS is licensed on an organizational basis (PCA, IPA, HCCN, CHC or clinic) and priced based on the number of patient medical encounters the entity records in a given time period. Within the licensed entity, ALL staff members are entitled to use the DRVS system and its reports. We encourage our clients to grant widespread access as a way of highlighting both successes and areas needing improvement and enabling an environment where the process of quality improvement is transparent and available to everyone.
You say you charge by the encounter, what exactly constitutes an encounter?
We use the UDS definition of encounter, which is a billable, face-to-face medical interaction with a provider. Based on the types of data currently being reported by DRVS, we do not count dental or behavioral health encounters in the billing metrics.
Can the system be customized and branded for our needs? Who does this?
Yes, the systems is designed to allow PCA or HCCN level branding, so that as these entities deliver Azara DRVS to their clients it looks and feels like it has been built and operated by that entity. Azara Healthcare will work with the client to incorporate branding as part of the setup and deployment process.