Start Small to Tame Big Information Governance Initiatives

Information governance (IG) can at first seem like an overwhelming project—one that calls on health information management (HIM) professionals to shine a light in the furthest, darkest corners of a healthcare organization’s information repositories and make sense of the sprawling, long untouched amassed data clutter.

But while IG is a huge initiative for a healthcare organization, it can be managed as long as it is tackled in pieces. That was the overarching message of Friday’s “Voices from the Field – Information Governance” presentation at the 2016 CSA Leadership Symposium, an AHIMA event running through Saturday in Chicago, IL.

During the session, Sally Beahan, MHA, RHIA, director of HIM at UW Medicine, and Jaime James, MHA, RHIA, senior director of HIM services at Banner Health, discussed the IG lessons their organizations have learned as pilot sites for AHIMA’s Information Governance Adoption Model (IGAM). Both organizations started small in their efforts, and used that as a launching pad to tackle information issues in their organizations.

After hearing concerns from upper management that an organization-wide IG program could turn into just another layer of bureaucracy for UW Medicine, Beahan and her staff decided to start small and focus IG in the HIM department.  They used AHIMA’s IG Toolkit to assess their level of IG implementation, evaluating their level of engagement in each of the 10 IG competencies included in the IGAM using a simple Excel document. This became their IG project plan.

From that evaluation the team selected areas to work on improving their information governance, looking for projects and activities that were already “in flight” and could translate into quick first wins for the pilot. Looking at the scanning/digitization of medical records at UW Medicine and identifying a need to standardize the process, the team launched an effort to update retention schedules for scanned records, as well as update scan/destroy policies.

Another project launched as part of the IG project plan was distinguishing and defining UW Medicine’s legal health record and its designated record set. HIM staff determined what type of information should be released during standard, formal, and legally binding release of information requests.

All of UW Medicine’s IG projects were centered on operational changes that would have a direct impact on the accuracy of the record and record processes – the need for which was brought to light through their evaluation of their current state using the AHIMA IG Toolkit and later AHIMA’s IG HealthRate, which uses the IGAM to assign rating scores for each of the 10 IG competencies.

Starting small was also the approach taken at Banner Health, James said.

“In one word, IG is big,” James said. “When we became a pilot site, we discussed how we could break this down. Even though we wanted an IG strategy, we also wanted to make this operational.”

Banner’s HIM department decided to start their IG pilot by defining just what IG was for their organization, determining the difference between IG and data governance efforts, what the scope of information governance activities should be at Banner (should it involve just clinical data, or also HR and financial information?), and formally determining why IG was important for Banner in the first place. The last thing HIM wanted was for IG to become “another committee or team,” but instead “actually embed this in work we were already doing,” James said.

From the 10 IGAM competences, Banner started small by focusing on two, creating an IG organizational structure, and building IG awareness and education in the organization. Banner also used the IG Toolkit and IG HealthRate to identify IG strengths and gaps.

“Since IG is so big, we really had to identify our gaps and our sweet spots we were already working on and see where we could get leverage on IG,” James said. “You have to pick where you focus initially.”

Banner’s electronic health record team was tapped as a focal point for IG discussions and restructured into the Enterprise Information Management Team, a natural fit since the team was already comprised of a cross-section of organization stakeholders and specialized in information governance-type initiatives, like regulating the information life cycle and information integrity initiatives.

With an oversight team in place and education on the importance of IG occurring system-wide, Banner will next develop specific IG initiatives to address gaps found during their IGAM analysis. These projects will be passed down to specific teams to implement. For example, while Banner found they were at a Level 4 (out of five) in the privacy and security IGAM competency, they were are a Level 2 in their IG structure.

For those looking to also launch an IG program, Beahan said don’t get overwhelmed before you can even begin IG. “As HIM professionals, we have been doing information governance for a long time, but when starting a formal program it is okay to start small. We have the skills, we got this,” she said.

Chris Dimick (chris.dimick@ahima.org) is editor-in-chief at Journal of AHIMA.

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