By Kristi Fahy, RHIA
The evolution of the healthcare industry continues as we settle into 2018. The doors on 2017 are now firmly closed, giving us opportunity to reflect upon the changes that have occurred and prepare for what is to come. From merger mania to record-breaking cybersecurity attacks, payment reform, and the era of Big Data, we can safely say that we need to rethink our current approaches to ensure we are staying ahead of the curve in the most cost-effective and efficient manner possible.
Many organizations have struggled to keep up with industry demands, leaving them vulnerable and even non-compliant at times. The good news is that there is an answer to help meet these demands: information governance (IG).
In today’s world, we are seeing the benefits of harnessing data and information through major companies like Amazon, Google, and Apple. These organizations are maximizing the true value of their information and using it to advance outcomes and thrive in their respective markets. They are using their vast amounts of information for such purposes as predictive analytics, which can help determine new strategies for promoting and growing their businesses even larger. It’s no secret that these lucrative companies are doing something right. By viewing information as an asset, these companies are investing time and resources to ensure the information they have on hand can be used appropriately, is available when necessary, is accurate, is protected, is leveraged, and is used to meet industry and business demands.
We can see what other industries have done to achieve success, but how can the healthcare industry benefit and achieve success through information governance? What resources are required, and how can we get the program to a stable and consistent state that is accepted enterprise-wide and becomes part of the organization’s culture? Half of the battle is making the case for IG. Why should healthcare organizations use their already precious resources for this thing called “information governance?”
Making the Case for IG to Leadership and Organizational Stakeholders
The first step is to get everyone on the same page about what IG is and why it is necessary for the organization. It is not uncommon for staff to resist change on new initiatives, especially if they don’t understand it. It is important to show “the light at the end of the tunnel” so that colleagues and organizational leaders know what they are working toward.
Healthcare has shifted not only to a more technological industry, but a more consumer-centric industry as well. These shifts are driving healthcare in a new and unchartered direction, and we must improve our processes to be successful. Part of this includes breaking down the siloes that exist in various departments and improving collaboration throughout the organization.
We also must answer a series of questions. Can we trust our data and information? Is it protected, and can it stay protected from internal or external threats? Is accurate information being used to determine patient care paths? Is information being used to innovate and redefine current practices?
Most everything we work with involves information. As a result, a formal IG program can not only enhance our current practices, but also help us to keep up as new industry shifts and trends continue to surface. IG has proven to advance many initiatives that we are already aiming to improve such as:
- Care coordination
- Interoperability (trusted exchange)
- Population health
- Patient safety
- Patient satisfaction
- Physician and employee satisfaction
- Reduction in operating costs (record storage, retention, and destruction; EHR interface and/or user issues)
- Data and information quality
- Payment reform and value-based reimbursement (MACRA)
- Privacy and security, including cybersecurity and the Internet of Things
- Program implementation (telemedicine)
These are just a few of the many initiatives that solid IG practices can help to achieve or improve, and will grab the attention of executives. In addition to more easily meeting industry demands, there is also a significant amount of return on investment (ROI) and cost reductions to be realized. Whether it is tangible (storage cost savings) or intangible (risk mitigation), IG gives organizations a competitive advantage over those who are not treating their information as an asset. Scoping out potential IG projects and estimating their ROI and cost reductions will help strengthen the case for executive support, and the support of stakeholders throughout the organization.
The light at the end of the tunnel is a bright one, and we must do all we can to ensure we get there.
Piecing Together the IG Committee
The case has been made, you have an IG executive sponsor, other stakeholders are on board, and your organization has decided to move forward with IG. Now what?
IG is a collaborative and multi-disciplinary effort. It is critical that the IG program incorporates the input of the various business units as a way to identify gaps and ensure that all perspectives are taken into account before a final decision is made.
The below example is meant to describe why we need to implement or repurpose a multi-disciplinary committee to address IG initiatives. Each business unit’s input is valued and should be considered for IG initiatives.
- Developing an email policy for employees for onboarding and annual training updates (Human Resources)
- How the email exchange will be protected, potentially with encryption (IT)
- How the email will be accessed (IT)
- What the financial investment will be, and if the budget will allow for the best solution to be selected (IT and Finance)
- If there is a legal impact (Legal)
- How it will impact each business unit (All departments)
AHIMA’s Information Governance Adoption Model (IGAM)™ provides a structured approach for IG committees to use as they develop their IG strategic plans. The IGAM is comprised of 10 organizational competency areas that, when working in unison and at the enterprise level, will result in cost avoidance, risk avoidance, and more efficient and streamlined business and clinical processes. The IGAM can be used as a base to determine representatives for each of the competencies and the IG initiatives within those competencies.
Determine the Scope and Required Resources for the IG Program
Your organization has an established IG committee in place, now what?
Now it is time to determine the direction, focus, and scope of the IG program. This can be determined by a few things:
- Organizational strategy: Aligning IG initiatives with the strategies of the organization (population health, patient satisfaction, interoperability)
- Funding: Funding and staff resources available directly impact the scope of the IG program
- High-risk areas: Organizations may choose to focus on high-risk areas
- Return on investment (ROI): Organizations may choose to focus on areas that will give a clear or substantial ROI and/or cost reductions
Every organization is different and may choose specific approaches for different reasons. The IG committee should develop an IG charter to drive the direction of the program. A sample IG Charter template is located online here in AHIMA’s HIM Body of Knowledge.
Execute the IG Projects, Measure Successes, and Keep Going!
The scope and required resources have been identified. Now what?
The next steps are for the IG committee to distribute IG projects to the work groups and task forces for execution. As IG projects are in progress or completed, the work groups and task forces should report back to the IG committee with updates: what is going well, what is not going well, availability of proper resources, whether more time is required, if improvements have been realized, etc.
From here, the IG committee can re-evaluate scope for in-progress projects, measure the successes on completed projects, devise a plan for the maintenance and upkeep of IG-related projects, and determine the next opportunities to address.
IG is an ongoing and continuous program that requires constant support, awareness, and thoughtful execution. Harnessing information assets through the IG program is a strategic way to combat Big Data challenges and cybersecurity threats, improve outcomes and decision-making, improve operational effectiveness, meet regulatory demands, and stay competitive in the shifting consumer-centric healthcare market. We must redefine how we view our information—much like the Amazons, Googles, and Apples of the world—if we plan to succeed in the future.
Kristi Fahy (firstname.lastname@example.org) is an information governance analyst at AHIMA.