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The Stoltenberg Blog

Healthcare technology insights for competitive value-based care strategy

Top 10 Health IT Legacy Support Client Questions and Answers

By Shana Tachikawa

We get it. Handing off support for EHR systems and IT applications can be a scary concept. At Stoltenberg Consulting, we aim to minimize health IT legacy support outsourcing hesitancy, alleviate hospital internal IT team strain, and build trust through consistent vendor partner transparency. That's why we're addressing the top 10 customer questions and answers for initiating a legacy EHR support contract. First, let’s start with identifying exactly what legacy support is.

  1. What is legacy health IT support?
    • Legacy support is the ongoing support of older and/or outgoing software and its associated workflow and data. Hospitals and health systems often utilize external legacy support partnerships to maintain such systems or applications on their behalf.
    • As hospitals and health systems migrate to new EHRs or revenue cycle management applications, Stoltenberg's 3x Best in KLAS legacy support program centers on providing the same, if not enhanced, service levels than end users have experienced with their organization's internal staff to maintain systems like Soarian Financials. Stoltenberg’s 3x Best in KLAS legacy support program alleviates client hospital internal IT staff, so they can focus on priority new EHR system initiatives, training and onboarding, without worrying about legacy budget overspend or support quality degradation.

  2. What systems or applications are typically covered in health IT legacy support?
    • 3M suite
    • Acudose
    • Allscripts CQS
    • Allscripts FollowMy Health
    • Allscripts Homecare / Hospice
    • Allscripts PM
    • Allscripts Touchworks
    • Carefusion / Pyxis
    • Cerner Critical Care
    • Cerner DSS
    • Cerner MAK Syngo Radiology
    • Cerner OPENlink
    • Cerner Pharmacy
    • Connance
    • Cytogenetix
    • DBMotion
    • Docutap
    • Experian
    • GE ADW
    • GE CPM
    • GE CPN
    • GE IDX
    • GE ImageCast
    • GE RIS PACS
    • Ground Zero Lab Tracker
    • HealthWyse
    • Hospira MedNet
    • Hospira TheraDoc
    • Hyland OnBase (LMR)
    • IBM IQ Max
    • Lattice Micropedia
    • MacroHelix
    • McKesson Cerme
    • McKesson OneStaff
    • McKesson ORSOS
    • MedAptus
    • MEDITECH Lab
    • Mediware
    • Metricom LRS
    • Metricom ViewDoc
    • Micro Helix
    • mModal MedQuist
    • MyCareTeam
    • Nuance PowerScribe 360
    • Olive
    • Optum Insight
    • Optum Pulsecheck
    • Oracle PeopleSoft
    • Orion
    • Phillips ICIP / CareVue
    • Phillips Intellivue
    • Phillips Lynx
    • Pulsecheck
    • RALS
    • Recondo
    • Salar
    • ScriptPro
    • Siemens ReadExam
    • Soarian Clinicals
    • Soarian Financials
    • Soarian Financials Reporting
    • Soarian Health Pro
    • Soarian OMS
    • Soarian QM
    • Soarian Scheduling
    • Soarian Document Management (DM)
    • Standard Register
    • Sunquest Lab
    • Surescripts
    • SwissLog
    • T-Systems
    • TDSS
    • Teleforms
    • Tracemaster EKG
    • Viatronix
    • Voicebrook Voiceover
    • Zynx

    • For UMass Memorial Health for example, 90+ applications were supported by eight total Stoltenberg Consulting teams, along with an overarching clinical team lead and financial team lead.

  3. How long do legacy support projects last?
    • If a health system is moving onto Epic, at least an 18-month timeline for transition.
    • If moving to Cerner Millennium, typically 12 months, depending on an organization's size.
    • Typically, we see 1-3 years for managed services legacy support projects.
    • In addition to this timeframe, Stoltenberg often helps support archival work for the legacy data as well.

  4. What does legacy support client onboarding look like?
    • Client onboarding includes mandatory consultant staff form completions, as well as client system and remote access set up.
    • For hospital clients who require on-site work, Stoltenberg's onboarding steps include team health requirements, work room set up, site badge ID activations, and travel logistics.
    • Depending on the project team size and client's response time, onboarding averages 2-4 weeks in length.

  5. How does Stoltenberg staff the legacy team?
    • Stoltenberg adheres to a 50% or higher staff reduction model with a 1:2 ratio of Stoltenberg staff needed to support the same level of work of previous internal resources. The broad team depth of expertise in many applications enables Stoltenberg to deliver this service with significantly fewer FTEs than a client's current support complement, reducing costs during the new system implementation.

  6. What does day-to-day legacy system support look like?
    • Daily support spans 24/7x365 full application support including monthly routine maintenance. The following legacy team responsibilities comprise daily support:
      • Identify new issues, perform root cause analysis and create successful mitigation plans.
      • Provide a daily end-user legacy support health IT help desk for the applications assigned to the support team, as well as after-hours on-call support for applications defined within the contract.
      • Run required operational and system monitoring reports (weekly, monthly, daily).
      • Troubleshoot failed jobs and create mitigation plan.
      • Communicate and assist system vendor on issues as needed using the vendor's ticket system.
      • Coordinate work between the legacy support team and other client teams.
      • Track and confirm progress with strong, detailed notes on open client and vendor tickets, ensuring client SLAs are met or exceeded.
      • Attend issue and status calls with client end users as requested.
    • Because of the trusted client partnerships formed and Stoltenberg's self-sufficiency in these tasks, client internal staff can focus their undivided attention on their new Epic or Cerner migration to achieve greater stabilization across the care continuum.

  7. What steps are included in legacy system maintenance?
    • The following steps are included:
      • Schedule and perform routine system maintenance (monthly and bi-monthly schedule).
      • Apply version updates and/or new releases, perform server patching, monitor server space utilization and add when needed.
      • Troubleshoot server issues. Track and maintain logs of server maintenance work.

  8. What does legacy support client reporting look like?
    • Each legacy team analyst completes an internal weekly time, expense and project status report to track resource management, which coordinates with a team status report.
    • Each client receives a comprehensive monthly report of team performance, including new tickets opened, tickets closed, SLA performance and turnaround time per ticket priority. Each report includes performance trend visualizations to display client ROI and stability of support, while providing project transparency.
    • At a minimum, each legacy team holds a weekly meeting with client stakeholders to identify emerging issues, detail upcoming work and determine how to handle any current issues. Each client also engages with a higher-level monthly executive account management meeting.

  9. How are legacy system issue escalations handled?
    • Stoltenberg coordinates procedure with how each client defines its own process for tickets.
    • For end-user tickets, as they are assigned, they are denoted with a priority (P1-P4 with P1 as the highest and P4 the lowest). Priority is dependent on an issue's impact on patient care and environment exposure. A specific SLA is defined for each ticket priority level.
    • Stoltenberg strictly adheres to each client's defined process for calling a P1 and the responsibilities that fall on a team who calls one. This typically includes bridge notification, required steps, documentation, vendor response, mitigation steps and follow-up post incident documentation.

  10. How can I get additional value from my legacy support partnership?
    • As seen with clients like Mary Washington Healthcare, UMass Memorial Health and HealthAlliance, Stoltenberg's legacy support staff offer flexibility to roll into Epic or Cerner support as needed. At clients who transitioned to Epic, Stoltenberg's team skillset flexibility enabled expansion into conversion extracts for Epic, P2V efforts, storage migrations, data archiving, system re-configuration for non-sunsetting applications, manual backload of patient specific data into Epic, and data center relocation. All were completed without any unplanned downtime to any system.
    • Project expansion can include data archival and system sunsetting, executive cutover strategy, A/R rundown strategy, go-live support staffing and operational command center, or additional hospital or facility support add-on from M&A activity, as requested.
    • Such resource flexibility allows smooth system transition, continuity of thought and maintenance of established relationships without delay when project expansion occurs.

Have additional questions? Schedule a legacy support project consult with a Stoltenberg executive team member through the link below.


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