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A Primer on Health Information Governance

A Primer on Health Information Governance. By Sandra K. Kersten, MPH, RHIA. Objectives. Define enterprise information management and information governance for healthcare Review trends driving the need for information governance

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A Primer on Health Information Governance

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

  2. 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 organization’s IG maturity • Explore the role of HI Professionals

  3. 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

  4. Enterprise Information Management and Governance

  5. Enterprise Information Management and Governance

  6. Enterprise Information Management and Governance

  7. Enterprise Information Management and Governance

  8. Enterprise Information Management and Governance

  9. Enterprise Information Management and Governance

  10. Enterprise Information Management and Governance

  11. 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.

  12. Types of Governance IT Governance Information Governance Data Governance

  13. 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

  14. So What Is Information Governance? • Technically defined, information governance is the exercise of authority and control over the management of an organization’s data and information assets—including 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

  15. 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

  16. Specific Drivers of Information Governance • Technology • Cost • Meaningful use • Innovation • Safety • Healthcare consumers • Legal and compliance pressures Source: AHIMA HIM Functions in Healthcare Quality and Patient Safety

  17. What Are the Potential Benefits? • More accurate data and information;Data-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

  18. 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

  19. 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”

  20. 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

  21. IG Model

  22. Creating the Vision Raise awareness of the “value of the organization’s information assets” • Do you/can you measure the actual and potential value generated from your organization’s information assets? • Consider positive and negative values

  23. 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

  24. Assessing Your Organization’sIG 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?

  25. 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?

  26. 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 Source: 2011 AHIMA HIM Core Model

  27. “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?

  28. 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

  29. 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 Source: AHIMA Health Data Analysis Toolkit

  30. 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

  31. 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?

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

  33. Resources AHIMA Resources — InformationGovernance Webpage Source: http://ahima.org/resources/InfoGov.aspx

  34. Information Governance Events • Watch for presentations and workshops at future AHIMA conferences and meetings • Atlanta, GA, October 2013—IG Workshop

  35. Questions

  36. 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 Info’”TechTarget, 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.

  37. 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.

  38. 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.com/hhnmag/HHNDaily/HHNDailyDisplay.dhtml?id=5530008606 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.

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