A Primer on Health Information Governance

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A Primer on HealthInformation Governance
By Sandra K. Kersten, MPH, RHIA
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Objectives

• Define enterprise information management and
  information governance for healthcare
• Review trends driving the need for information
  governance
• Distinguish between information governance (IG),
  data governance, and information technology (IT)
  governance
• Assess your organizations IG maturity
• Explore the role of HI Professionals

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Basic Definitions

• Enterprise Information Management (EIM) involves
  the infrastructure, policies, andprocedures to
  ensure information is trustworthy across the
  organization
• Information governance (IG) involves the
  accountability framework and decision rights to
  achieve EIM

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Enterprise Information Management and Governance
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Enterprise Information Management and Governance
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Enterprise Information Management and Governance
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Enterprise Information Management and Governance
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Enterprise Information Management and Governance
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Enterprise Information Management and Governance
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Enterprise Information Management and Governance
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What Is Governance?
In the case of a business or organization,
governance relates to consistent management,
cohesive policies, guidance, processes, and
decision-rights for a given area of
responsibility.
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Types of Governance
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Data and IT Governance

• Data governance refers to the overall management
  of the availability, usability, integrity, and
  security of the data employed in an organization
  or enterprise.1
• IT Governance primarily deals with connections
  between business focus and IT management.
• 1The Data Governance Institute

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So What Is Information Governance?

• Technically defined, information governance is
  the exercise of authority and control over the
  management of an organizations data and
  information assetsincluding planning and
  monitoring data, and the enforcement of data
  rules, and management of the information systems.
  
• Information governance is a system of decision
  rights and accountability that encompasses the
  information lifecycle and information systems of
  an organization.
• 1The Data Governance Institute

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Why Now?

• Increasing focus on healthcare data and HIT to
  drive improved care
• Rapid adoption of technology shift from
  paper-based processes is needed
• Mergers and acquisitions new organizational care
  models

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Specific Drivers of Information Governance

• Technology
• Cost
• Meaningful use
• Innovation
• Safety
• Healthcare consumers
• Legal and compliance pressures

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What Are the Potential Benefits?

• More accurate data and informationData-driven
  decision-making, atincreased speed
• Better security of data and information
• Organization is prepared to advance
  interoperability and HI exchange
• Potential of achieving lower costs related to
  data and information management

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Information Governance Goals

• Improve decision-making
• Reduce operational friction
• Protect the needs of data andinformation
  stakeholders
• Standard, repeatable processes for dataand
  information management
• Ultimately Lower costs andincreased efficiency
  of information management processes

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Justification

• ...the business costs of non-quality data,
  including irrecoverable costs, rework of products
  and services, workarounds, and lost and missed
  revenue may be as high as 10 to 25 percent of
  revenue or total budget of an organization.
• Larry English
• Father of Data Quality

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What Does IG Look Like?

• Three Layers of Governance
• Executive Leadership drives strategic direction
  for information management
• Multidisciplinary Steering Groups address
  specific priorities
• Working groups address operations

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IG Model
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Creating the Vision

• Raise awareness of the value of the
  organizations information assets
• Do you/can you measure the actual and potential
  value generated from your organizations
  information assets?
• Consider positive and negative values

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Assessing YourInformation Assets

• What are the main repositories of information in
  your organization?
• Classification
• Visibility
• How are they used to drive business value?
• Clinical or business decision-making
• Reimbursement or financial
• Measurements of quality or other performance
  goals
• External reputation

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Assessing Your OrganizationsIG State

• For each repository
• Policies and procedures addressingEIM
  components?
• Are they followed manually or through technology?
• Is there an organizational leader with
  responsibility for the domain?
• Is this repository covered by an overarching
  governing body?

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Assessing the Health of Your Clinical Information
Assets

• Do you know where the data are?
• Who controls the data?
• Do you know who will use the data?
• Does your organization need to better safeguard
  information?
• Does your organization need to keep auditors and
  regulators satisfied?
• Does your organization need to improve data
  quality?
• Are you ready for meaningful use and data
  sharing?

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Benefits of a Mature IG Program

• Optimized access to information through processes
  and technology that maintain confidentiality and
  security
• Decreased liability through maintenance of an
  accurate and complete clinical record
• Better and faster data-driven decision-making
• Decreased risk of litigation based on appropriate
  retention of data
• Decreased liability and enhanced reputation
  through reduction of breaches

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Lead from Any Seat

• Data Administrator
• Data Mining
• Clinical Terminologies
• ICD-10-CM/PCS Classification codes
• Governmental Audits
• Privacy and Security related to Access
• Quality/Compliance
• Chief Knowledge Officer
• EMPI Manager
• Others?

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Best Practice Commit from the Top Down

• Executive Leadership (CEO, CIO, CFO) are
  criticalstakeholders, and must take
  responsibility for the information management.
• Steering Committee should include individuals
  frommany areas
• Revenue cycle
• Patient registration
• Health information
• Clinical
• Data quality/compliance
• Information technology

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Best Practice Work from the Bottom Up

• Data Dictionary A tool for supporting
  documentation that provides a descriptive list of
  names, definitions, and attributes of data
  elements to be captured in an information system
  or database
• Supports data sharing, exchange, and integration

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Best Practice Keep Training

• Share the results of your efforts
  withoperational teams
• Registration/access staff can use data dictionary
  as a training resource
• Reporting staff can use the data dictionary to
  better understand data meaning

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Best Practice Communicate

• Communication may include questions such as
• Are we making progress?
• Are we improving our data integrity?
• Are we reducing our error data-related tasks?

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Certification Opportunities

• Be a leader
• Make a statement
• AHIMA Certified Health Data Analyst (CHDA)
• AHIMA Certified Documentation Improvement
  Professional (CDIP)

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Resources
AHIMA Resources InformationGovernance Webpage
Source http//ahima.org/resources/InfoGov.aspx
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Information Governance Events

• Watch for presentations and workshops at future
  AHIMA conferences and meetings
• Atlanta, GA, October 2013IG Workshop

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Questions
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Resources

• Strategic
• Casonato R, Lapkin A, Beyer M, Genovese Y,
  Friedman T, Information Management in the 21st
  Century Gartner, Inc. 2011 Sept. 2 cited 2013
  Feb. 7.
• Abstract
• The growth in information volume, velocity,
  variety, and complexity, and the increased
  importance of information to the business makes
  the discipline of information management
  radically different from the past. Old techniques
  are no longer adequate a dramatically different
  approach is needed.
• Stackpole B, Information Governance Strategy
  Developing a Roadmap for Managing Corporate
  InfoTechTarget, 2012 Sept. 5 cited 2013 Feb.
  21.
• Abstract
• Utilizing best practices and practical advice on
  developing an information governance strategy are
  included in the article a checklist of what to
  do and what not to do as part of a successful
  information governance initiative.
• Sallam R, Cearley D, Advanced Analytics
  Predictive, Collaborative Published Gartner,
  Inc. 2012 Feb. 16 cited 2013 Jan. 23.
• Abstract
• Organizations that deliver next generation
  advanced analytics to an expanded set of users
  will realize significant value in terms of
  innovation, productivity, and growth. A lack of
  skills will be the biggest barrier to success.

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Resources

• Logan D, IT Cost Savings With Information
  Governance Gartner, Inc. 2012 Apr. 17 cited
  2013 Jan. 29.
• Abstract
• By systematically eliminating redundant
  information, Cisco has retired multiple legacy
  systems, eliminated "shadow IT," reclaimed
  storage space in its data centers and saved 12
  million in IT costs. Its approach demonstrates a
  number of best practices.
•  
• O'Kane B, White A, Bugajski J, Logan D, Sholler
  D, Predicts 2013 The Nexus of Forces Boosts
  Information Governance and MDM Gartner, Inc.
  2012 Nov. 28 cited 2013 Feb. 7.
• Abstract
• Gartner predicts that the Nexus of Forces
  (mobile, social, cloud, and information) will
  lead to unprecedented levels of enterprise data
  being exposed to the public. The trust required
  for corporate data will lead to major
  improvements in information governance and master
  data management practices
• Kloss, Linda L. Healthcare Data Life Cycle
  Governance and Stewardship. In Health
  Information Management Concepts, Principles, and
  Practice. 4th ed. Edited by Kathleen M. LaTour,
  Shirley Eichenwald Maki, and Pamela K. Oachs.
  Chicago AHIMA Press, 2013.
• Abstract
• A rich discussion of enterprise information
  management, information governance, and the
  components included in each.
•  

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Resources

• Core
• Glaser J, Preparing for the growing role of
  analytics and business intelligence Hospitals
  Health Networks Internet 2012 Oct. 9 cited
  2013 Feb. 14. Available from http//www.hhnmag.c
  om/hhnmag/HHNDaily/HHNDailyDisplay.dhtml?id553000
  8606
• Abstract
• Providers will need to enhance their measurement
  and reporting so they can implement strategies
  with new care models at the individual patient
  and population levels to manage diverse payment
  arrangements using both business intelligence and
  analytics as tools to help assess quality measure
  and metrics real-time.
• Management
• Independent Information Governance Review Scope
  NHS Future Forum Summary report Internet 2012
  Jul. 9 cited 2013 Feb. 14. Available from
  https//www.wp.dh.gov.uk/caldicott2/files/2012/06/
  20120712-Approved-Scope.pdf
• Abstract
• Information governance should aim to balance
  sharing usage of information along with
  protecting information to improve patient care to
  reduce data breaches under the new landscape of
  organizational structure and technology.