Data Flow: Connecting The Dots For Trusted Sources

This monthly blog highlights and discuss emerging trends and challenges related to healthcare data and its ever changing life cycle.

By Julie A. Dooling, MSHI, RHIA, CHDA, FAHIMA, and Karen Proffitt, MHIIM, RHIA, CHP


Searching for the quickest path to establish and access data “sources of truth” in your healthcare organization?

In the past, health information management (HIM) professionals were taught to maintain a patient’s health information in a central repository. The paper health record was the singular source of truth. We operated within processes that were relatively “simple” when fulfilling such tasks as continuity of care requests, release of information requests and when the patient requested a copy of their “chart.”

Enter: Advanced technology and electronic health records (EHRs).

Today, the idea of a centralized repository storing all components of a patient’s health record is quite elusive. In fact, there can be many “sources of truth” where a user has to access all components of the patient’s legal health record. “Master data management” is the buzz term that holds much promise, but today’s organizations are slow to adopt the technology due to cost, a vast network of many health information systems, and many downstream systems with a variety of interfaces and integrations.

Without a breakthrough technology landing on our doorstep tomorrow, we must consistently think about how we are connecting the dots today.

Consider the following questions. At first glance, they may seem very foundational in nature, but even the simple questions may be overlooked due to limited resources and the existence of a multidisciplinary team dedicated to lead such a project:

  • Where do you begin identifying, defining, and auditing sources of truth?
    • When was the last time you were able to inventory all your systems with details outlining the purpose of each system, the kind of information contained with associated dates, and what information should be considered as the source of truth?
    • Do your data governance and information governance teams work collaboratively, relying on one another to consistently update this resource and make it available to key stakeholders in your organization?
    • Does your team have representation from HIM and IT with senior level support?
  • Are data capture redundancies consistently monitored to improve data integrity?
    • Are demographic updates being properly applied throughout your systems?
    • Do you routinely monitor downstream systems for the appropriateness of HL7 messaging and those that might not be up-to-date with data merging activities?
    • Is your data flow optimal and efficient? Do you have a current, high-level integration graphical representation to help key stakeholders understand how the data flows?
    • Is the data collected in a standardized manner with policies and procedures outlining the process?
  • Are quality controls in place to ensure the “source of truth?
    • Are you periodically auditing the integrity of key data fields to ensure their accuracy, reliability and completeness?
    • Is your collected data up-to-date and trusted? Is your critical benchmark report output consistent between core systems?
    • Are your data definitions (attributes) consistent and understood throughout your healthcare organization?

Today, you can begin connecting the “source of truth” dots one step at a time. It’s a journey well worth the effort to support quality patient care, research, and overall operations.


Julie Dooling is senior consultant at Just Associates, Inc. Karen Proffitt is vice president, identity enterprise solutions, at Just Associates, Inc.

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