Information governance is more than a passing buzzword. It’s becoming a competency needed to meet health care’s growing challenges. Yet, in many organizations, the concept is not clearly understood. What is information governance and why does it matter?
Understanding Information Governance
Information governance, or IG, according to the American Health Information Management Association, is an organizationwide framework for managing information throughout its life cycle and supporting the organization’s strategy, operations, regulatory, legal, risk and environmental requirements.
According to Linda Kloss, M.A., R.H.I.A., author of Implementing Health Information Governance: Lessons from the Field (AHIMA Press, 2015), “Effective governance is a dynamic process focused on improving organizational performance through the use of trusted information. Organizing for IG begins with clarity in vision, mission and a charter, and it always requires support from senior leaders.”
The principles of IG matter because information is health care’s most valuable asset. Information that is accurate, complete and timely supports patient safety, quality of care, population health, positive outcomes and accurate reimbursement. Effective IG drives profit and growth.
Today’s health care challenges call for a new playbook at the executive level. The status quo is insufficient to manage increased security risks, audits and compliance, new reimbursement models, the push for patient engagement and more. Information governance serves as a practical guide — one that aligns with organizational goals and recognizes the value of IG.
Accountability is central to the business value of IG — helping hospitals and health centers to achieve their goals based on reliable information. As IG initiatives gear up, health care leaders have a responsibility to advance efforts that support enterprisewide priorities. Trusted information is the foundation for sound decision-making aimed at improving clinical and financial performance. And it’s up to senior leaders to invest in IG.
Implementing Practical Strategies
Most organizations are still in the infancy phase of implementing an IG program. At the 2015 Annual HIMSS Conference & Exhibition, the session “Seven Opportunities for Stronger Info Governance” attracted 800 attendees. When asked about the status of IG in their organizations, only a few said they were beyond the initial stage.
Challenges include proving the need for IG and making it a priority — securing leadership, education, funding for technology and other resources. Knowing how to begin is perhaps the biggest hurdle. For those who have taken the leap, an integrated approach has proved beneficial. Here are six strategies to consider:
1. Assemble a multidisciplinary team. Make sure all disciplines — information technology, health information management, compliance, C-suite, legal, revenue cycle, risk management, quality, finance, security — are represented. Define everyone’s role in managing information throughout its life cycle. Identify a senior champion who can help with buy-in and provide a financial perspective. Create a charter aligned with organizational goals and priorities. Is population health an issue you’re trying to resolve? Patient engagement? Focus on what you want to accomplish and decide which issues to tackle, one at a time.
2. Assess the current information landscape. Take an inventory of existing policies, procedures and systems for capturing, processing, delivering and storing data. Get a handle on all data from different departments — accounting transactions, coding data, billing information, and operational and clinical data. Consider all entry and access points. Identify gaps, issues, new priorities. For instance, how are you incorporating patient-generated health information, information from other hospitals and other external information into your system?
3. Make the case for IG. Educate the entire organization on the role and mission of the team. Conduct in-service training using infographics, key performance indicators and real-life case studies of organizations that have initiated IG programs. Engage health information management along with clinical, financial and operational staff to show the importance of IG. In her book on information governance, Kloss profiles health care providers at various stages of IG implementation. This is an excellent guide for getting started and gaining support for IG.
4. Map your data. Ensuring data integrity through data mapping is essential. Work with IT, health information management and other departments to determine which data elements are being mapped. When various data elements are flowing from one system to another, you need to ensure that the information transferred has the same meaning and intent. Are data definitions consistent? How will you consolidate data from different systems and make sure they are accurate, complete and accessible? Look at your source data — where it flows, how it’s handed off, how it’s used. Consistency of data entry on the front end is critical to quality and integrity.
5. Apply guiding principles for creating an IG program. ARMA International has developed Generally Accepted Recordkeeping Principles that health care organizations are adopting as the building blocks of IG. Collaborate with team members, particularly with health information management professionals who have the expertise to advance enterprisewide IG. As the stewards of health care information for decades, they understand the guiding principles and they’re preparing to assume leadership roles. Invest in health information management training and development.
6. Invest in advanced technology. Acquire tools to ensure that information is accessible and useful — easily converted into actionable data for strategic initiatives. Invest in data analytics to capitalize on information, improve care and reduce costs. Clear and consistent accounting up front requires data analysis — it’s part of IG. Health care executives need the ability to do business analysis in all care settings and all systems. However, technology alone is not enough — information governance practices are needed to realize the full value of technology. That means having the right people and processes in place along with the right tools to manage information on the front end and ensure reliable information on the back end.
Making the Case for IG
At Parrish Medical Center in Titusville, Fla., the IG journey began with implementation of the electronic health record. Suddenly, there was a wealth of electronic information in the system, prompting more questions than answers: How will data be centralized and used meaningfully? What information do we have? Where is it going? How is it being used to support our mission and strategic plan? Parrish identified the need for information governance to increase data standardization, data quality, information reliability and timeliness.
In making the case for IG, Parrish saw an opportunity for senior leaders to understand and view IG as a valuable asset. Hospital executives need trusted information to make informed decisions about patient care and reimbursement.
In August 2014, an interdisciplinary team oversaw the approach to information governance. The team included representatives from health information management, clinical informatics, financial planning, process improvement, IT and physician group practices. Soliciting feedback from the C-suite was the first step. Parrish began the conversation based on the current state of the data — siloed in different departments. The focus had to be on enterprisewide organizational use rather than individual departmental use.
To show the value of IG, the controller presented a charter to senior managers. Convinced of the potential benefits, the CFO became the executive sponsor. Through data mapping, the team determined what data they had, where it was located and how it should flow between departments. As a result, Parrish gained trust in the data extracted for quality reporting, which affects quality ratings, reimbursement and patient engagement.
One year since establishing the charter, Parrish is expanding IG efforts — constantly evaluating objectives, roles and responsibilities. The team meets weekly to discuss projects such as purchasing reporting tools and identifying data sources. With support from senior leaders, the team continually measures information to identify priorities. The next steps are to automate dashboard metrics and to improve clinical care and organizational performance.
Preparing for the Future
The future of health care depends on collaborative leadership to overcome increasingly complex challenges. This means continually strengthening governance and advancing competencies in all disciplines. While every health care professional is responsible for information governance, health information management directors and health care executives can lead the way.
Rita Bowen is former privacy officer at HealthPort in Alpharetta, Ga. Erin Head is director of health information management and quality at Parrish Medical Center in Titusville, Fla.