Survey: Majority of Healthcare Organizations Lack Vital Information Governance Strategy

The first major survey studying the information governance practices of healthcare organizations shows that only 35 percent have a comprehensive strategy guiding information governance efforts.

Two-thirds of the respondents, or 65 percent, said they lack a strategy for information governance, well below what AHIMA experts say is warranted given the rising importance of quality health information in reimbursement, audits, and delivering effective care.

The new survey, conducted by AHIMA and Cohasset Associates and released June 2, is the first of its kind to benchmark information governance practices in healthcare.

These and other results are discussed in the survey’s accompanying white paper “2014 Benchmarking White Paper on Information Governance in Healthcare: A Call to Adopt Information Governance Practices.” The survey and paper evaluate and quantify the state of healthcare information governance maturity and effectiveness, address the information challenges facing the healthcare industry, and offer a roadmap for the next steps an organization can take to effectively govern their health and business information.


IG Still Growing Roots in Healthcare

The low adoption may be due to information governance being a relatively new initiative for healthcare. While most organizations have governance programs for certain healthcare functions, like privacy and security policies, the survey showed that an organization-wide information governance program had not yet been established in the majority of provider organizations. Privacy and security policies had the highest maturity ranking at 50 percent, while information preservation policies were only at 30 percent and information deletion and destruction policies at 26 percent.

“Information governance is a strategic imperative for all organizations within the healthcare ecosystem,” said AHIMA’s Chief Operating Officer and Executive Vice President Deborah Green, MBA, RHIA. “Improved quality and patient safety, cost control, care delivery redesign, and responding to regulatory changes are top goals for healthcare organizations, and all are dependent on trustworthy information.”


Healthcare Sees Need for IG Practices

The majority of the 1,000 healthcare-based survey respondents, 65 percent, stated that they recognize the need to formalize information governance practices and align how information is managed across all functional areas. However of these respondents, only 43 percent have actually initiated an information governance program, while 22 percent have not started an IG program.

While information governance practices currently have a low adoption rate, the need is on healthcare’s radar, and efforts are rising. A total of 84 percent of respondents have seen governance measures improve, and 91 percent anticipate a significant rise in information governance practices in the next three years.

The survey showed healthcare organizations agree that there are compelling drivers for formally launching an information governance program and improving practices, with 95 percent stating the ability to improve quality and safety of patient care as a key driver. Managing and containing costs and responding to a changing payment environment were also noted as key drivers for formalizing information governance practices.


Education and Buy-In Still Needed

Education on the benefits of information governance is necessary, according to the survey. While 65 percent recognize the need for IG programs, 24 percent didn’t know if their organization had a formal plan.

To prepare for information governance, AHIMA recommended programs that are cross-functional and have the support of senior-level staff. An organization’s governance focus should not just be on clinical information, but also on non-clinical, business, and operations information as well.

“I encourage my colleagues in the C-suite to make a comprehensive information governance strategy an organizational priority,” said AHIMA CEO Lynne Thomas Gordon, MBA, RHIA, FACHE, CAE, FAHIMA. “It’s easy to think it can be put on hold or maintained in one department while executives deal with other challenges, but this is a mistake.

“Developing a strategy should be a collaborative effort and is essential to realizing the benefits of governance.”


Even Mature Governance Programs Need Attention

Even mature specialized governance programs need attention, according to the survey. While 97 percent of respondents said essential policies for maintaining private and secure protected personal health information were in place in their organizations, only 81 percent reported that business associate agreements were enforced and routinely audited. Just 80 percent report routine and comprehensive auditing for compliance with privacy and information security practices.

The recent changes to HIPAA law—and increased penalties for data breaches—have made it even more important for healthcare organizations to monitor their privacy and security, as well as their association with third-party businesses.

Also, only 37 percent of healthcare organizations said they had the ability to preserve only relevant information—in either paper or electronic health records—in response to a legal hold.

To achieve the full benefits of information governance initiatives, AHIMA recommends organizations develop the following:

  • An accountability framework and decision rights to ensure the effective use of information across an enterprise
  • Defined processes, skills, and tools to manage information throughout its entire lifecycle
  • Information standards, rules, and guidelines for functioning in an increasingly electronic environment


The survey of AHIMA and non-AHIMA members targeted clinical and non-clinical executives, officers, directors, and managers in provider and non-provider organizations within the healthcare industry. The survey received more than 1,000 responses between March and April 2014.


Survey Just the Start of AHIMA’s IG Efforts

In addition to publishing a white paper on the survey results, this year AHIMA is convening healthcare stakeholders to develop an information governance framework for healthcare, has established an expert advisory group to review and provide input into information governance development efforts, and is developing resources and guidelines to aid in operationalizing IG in healthcare.

A Twitter chat will be held from 12 p.m. to 1 p.m. CT on Thursday, June 5 to discuss the results of the Cohasset/AHIMA survey and allow participants the chance to discuss information governance best practices in healthcare. To join the chat log on to Twitter and follow the hashtag #IGNow.


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