Information governance doesn’t look the same from organization to organization, or even industry to industry. Even if all healthcare organizations followed AHIMA’s Information Governance Principles for Healthcare™ (IGPHC) to the letter, every organization will interpret the guidelines differently. However, nearly every IG consultant recommends forming a multi-stakeholder task force as a starting point.
Mission Control or Solo Mission?
Mark Diamond, president and CEO of the IG consulting firm Contoural, has been a vocal supporter of IG task forces, likening them to the NASA mission control teams that help guide rockets and shuttles into space. At this year’s National Conference on Managing Electronic Records, Diamond moderated the keynote panel discussion “Making the Moonshot: Launching Your Information Governance Program.”
Diamond likes the space and mission control analogy because “what mission control does, it has many different functions working together as a team and communicating as a team and working together,” rather than having one person run the whole show, he explained to the Journal of AHIMA.
“An executive council group or community within a healthcare organization needs to ensure that it is communicating the value and benefits of an IG initiative at a business level,” Diamond says. “Too often they say ‘we’ve got to do this because this is what the rules say,’ or we’ve gotta do this because some other reason,’ and there’s tremendous business need for doing it. Part of it is for meeting compliance, but a big part of it is it makes the organization more productive.”
Barclay T. Blair, founder and executive director of the Information Governance Initiative, says that an IG council, with many departments within an organization represented, is important because “information flows through the entire facility, and no one group can manage and monetize it because of its ‘horizontal’ nature.’”
Blair, however, has been among the most outspoken IG experts to advocate for the widespread adoption of the role chief information governance officer (CIGO), which would, ideally, put IG in the C-suite of an organization. In a blog post, Blair writes that he’s been encouraged by executive-level roles with IG functions, such as chief data officer.
He admits, however, that it is “simplistic to believe a new C-level title will solve anything on its own. In fact, in the past couple of decades we have seen some of these titles amount to little more than an empty office and a PR bump. Even with this knowledge and caution, I do believe that the idea of a C-level role for IG at least helps to bring attention and focus to the current, vast information leadership gap.”
Who’s On Deck?
NASA’s mission control team is led by a flight director, who helms a team of flight controllers. The team, depending on the type of mission, can include the following critical roles, among other technical specialties:
- The spacecraft communicator, who serves as the communications link between the flight control team and the astronauts
- The data processing system/engineer, who monitors data processing
- The flight dynamics officer, who plans maneuvers and monitors trajectory
- The surgeon, or staff medical doctor, who monitors the health of the astronauts
In many ways, this mimics the makeup of an ideal IG council. One person must serve as a liaison between the council and the rest of a healthcare organization (like the spacecraft communicator). Someone must represent the data processing and monitoring arm of the organization, typically an IT person (like the data processing engineer). A medical officer, or someone representing the medical staff, should be on board to remind the council of how policies affect patients (the surgeon/medical doctor). Someone who can speak about risk, compliance, and legal matters and protection of the organization’s security (the flight dynamics officer) should also be included.
Diamond says one place where healthcare organizations get tripped up with IG is thinking that implementing electronic health records (EHRs) means they’re done. But to measure success the IG team really must be able to answer several questions:
- Do we know what kind and how much data we have?
- Do we know where all that data is?
- How long are we saving it?
- Is it being stored and protected properly?
- Can we discover effectively and ensure our employees have the right information, and keep them productive and collaborative?
AHIMA thanks ARMA International for use of the following in adapting and creating materials for healthcare industry use in IG adoption: Generally Accepted Recordkeeping Principles® and the Information Governance Maturity Model. www.arma.org/principles. ARMA International 2013.
IG in the Mission Control Seat
The space program has come a long way since the United States put a man on the moon, as evidenced by its most recent achievement: sending the New Horizons probe on a flyby of demoted-planet Pluto. These milestones would be impossible without the collective efforts of the NASA mission control team—a group consisting of specialists that are experts in all the facets related to a given space mission. Mission control is not unlike an information governance (IG) council in healthcare, the formation of which is an almost universally recommended strategy for getting IG off the ground and into the atmosphere. Both missions—interplanetary travel and IG—require a team of professionals.
Flight Director/Chief Information Governance Officer
NASA missions typically have a flight director who is responsible for shuttle missions and payload operations, and leads the flight control team. This person weighs the advice of the other flight controllers before making mission-related decisions. The IG world equivalent should be, according to IG experts at the Sedona Conference and the Information Governance Initiative (IGI), an individual serving as chief information governance officer (CIGO). As Barclay Blair, IGI’s founder and executive director, explains, IG “is a new discipline that of course builds on the disciplines it coordinates, but one that also represents a major evolutionary shift in how organizations understand, use, and, well, govern, their information.” Therefore, a CIGO should not “be a rebranding of senior records management roles, but someone who has the requisite breadth of management, technology, and legal expertise.” HIM directors, with their broad understanding of legal, financial, clinical, risk, and compliance, are an ideal fit for this role.
Data Processing System (Engineer)/IT representative
In their mission control capacity, the data processing system engineer (DPS) monitors the data processing system of computers, which makes these individuals indispensable members of NASA’s team. The obvious comparison is that of an IT representative on an IG council. Mark Diamond, president and CEO of the IG consulting firm Contoural, says IT is a key player because IT “owns” many of the systems that need governing and developing. In the HIM world, IT helps design and install electronic health records (EHRs), and manages security systems to protect information stored in databases.
Public Affairs Officer/Legal and Compliance Officer
If a space mission is successful or unsuccessful, the person who has to communicate this to the public, via journalists, is the public affairs officer. When the news is good—the Mars rover landed!—their job is easy. But if a space station resupply shuttle crashes, their job becomes to protect NASA’s reputation in the face of tragedy. Similarly, legal and compliance professionals must be part of the IG team to protect a provider or healthcare organization from litigation. Lawyers are there to help an IG team develop retention and disposition policies, make sure business associate agreements are in order, and to ensure HIPAA compliance. With meaningful use requirements, ICD-10, and HIPAA compliance ever changing, it would be unwise not to have the counsel of a good legal or compliance officer.
Spacecraft Communicator/Director of HIM
Manned space missions have a communications link between flight/mission control and the astronauts aboard the craft. This is the person who communicates the message “Houston, we have a problem” to the relevant members of mission control. They have to be able to translate highly technical instructions to and from astronauts and the people on the ground. HIM directors who sit on IG councils do the same. They’re on the council to provide their much-needed health information and data management perspective to the council, and then communicate the council’s vision back to the departments they oversee. Without them, nobody would see the big picture.
Implementing IG and exploring space are similar because embracing both means embracing the unknown—and being willing to make mistakes along the way. Information governance in healthcare still has a long way to go, compared to IG in other industries. Every small step of the process will feel like a first step (for mankind and for providers), but the benefits can be transcendent. HIM professionals must not be afraid or daunted by the prospect, and like the first man to set foot on the moon, Neil Armstrong, they should not be afraid to plant their flag firmly in this new territory.