Chapter 2: Data Tiers — Operational, Registry & Archive
Chapter Overview
Every Betasky migration splits data into three tiers. Understanding this helps you know what to export and **what to expect in Betasky on day one.
2.1 Tier B — Patient registry
Who: All patients on file, including discharged and deceased.
What we load (structured):
- Patient record with correct status (
ACTIVE,DISCHARGED,DECEASED, etc.) - Demographics and intake (contacts, payer, physicians, referral)
What you provide: Patient list export + Profile PDF per MRN.
Purpose: One record per person. Readmits attach to the same patient.
2.2 Tier A — Operational (go-live census)
Who: Patients who are in care as of your cutover date — not everyone your old EMR labels "Active."
What we load (structured):
- One current care order (certification dates, OASIS vs Non-OASIS)
- Active medications and open physician orders (when in scope)
- Forward visits scheduled in Betasky after go-live (not bulk-imported from legacy "Not Yet Started" rows)
What you provide: Active census list, Medication Profile PDFs, joint curation of current episode dates.
Purpose: Your staff can schedule, document, and bill on day one.
For Axxess agencies, Tier A is often smaller than Tier B because much clinical history lives in Tier C.
2.3 Tier C — Historical archive
Who: Closed episodes and historical rows for every patient (retention window agreed at kickoff, e.g. 3–5 years).
What we load:
- PDF bundles per episode (OASIS, POC, visit notes, physician orders)
- Episode shells (cert dates) for timeline lookup on migration care orders
- Archive visits — when a PDF is a visit or OASIS type, Betasky registers a completed archive visit linked to that document (date, type, clinician when extractable from the PDF)
What you provide:
- PDFs printed from Axxess Patient Chart → Schedule Activity (printer icon on each row)
- Quick Link prints (Medication Profile, Plan of Care Summary)
- Files organized by MRN and cert period
Purpose: Chart lookup, surveys, and timeline history — not live editable workflow. Archive visits show what happened; staff document new care in Betasky going forward.
2.4 Visual summary
Tier B (registry) → every patient + intake ← patient list + Profile PDFs
↓
Tier A (operational) → go-live census + meds ← active list + Med Profile PDFs + ONE current episode
↓
Tier C (archive) → episode PDFs + archive visits ← Schedule Activity PDFs uploaded per episode
2.5 What we do not bulk-import
| Data | Default | What we do instead |
|---|---|---|
| Every Axxess Schedule Activity row as a live visit | No | Print PDF per row → upload → archive visit when extractable |
| Paid claims from old years | No | Billing starts fresh in Betasky |
| Legacy OASIS as editable new assessments | No | Archive PDF + archive visit on historical episode |
| Full medication reconciliation history | No | Current med list + signed profile PDF |
2.6 Example Agency (illustrative)
A mid-size home health agency might look like:
| Tier | Illustrative scale |
|---|---|
| B | ~70 patients (mix of active and discharged) |
| A | ~15–20 active patients, each with one current episode |
| C | Hundreds of historical episodes with PDF archive and registered archive visits |
Your numbers will differ. We agree scope at kickoff.