Speak Up and Stand Out for Information Governance

By Cindy Zak, MS, RHIA, PMP, FAHIMA

The health information management (HIM) profession has changed dramatically with the implementation of the electronic health record. Processes have changed, and many tasks can now be accomplished electronically. The days of physicians dropping by the HIM department to complete medical records, and while in HIM, stopping by to chat with the HIM director no longer occurs. In many cases, HIM is no longer residing at the hospital but is now offsite and many staff are working remotely. The networking that once was, does not occur as often and has left many HIM departments to do what they do best in a more secluded environment. It is time to allow HIM to resurface in the organization and make a difference through strong internal networking that will help lead change and allow HIM to “earn a seat at the table.”

In today’s world, HIM staff typically pick up the paper documents on the nursing units that are not electronic for scanning, they query physicians for documentation integrity, release medical record information onsite to requestors, and assist the regulatory folks when the DPH or JCAHO makes a visit to the hospital. Because HIM staff are often dispersed throughout campus, or are remote, HIM may not have the same opportunities to form influential relationships with many of the senior leaders at the hospital. As a result, the HIM directors may not have the same opportunities as in the past to participate in clinical meetings or have the proximity to interact on a daily basis with the hospital management or other key staff. Often, the exposure that we get to physicians and the healthcare team is typically limited to meeting once a month through the HIM Medical Staff Committees… if they are still in existence at an organization.

Information governance (IG) is a great fit for HIM professionals’ skill sets. However, implementing IG requires a strong influence across the organization. Relationships and leveraging current resources will go a long way when implementing change. For these reasons, it has been a struggle for many HIM professionals to make the case for IG internally and to influence the change at the enterprise level. We stay in our “cocoons” offsite and sit back and do our job—and do it well. However, it’s a mistake to think that doing your job well will get you noticed. You have to be responsible for creating the space for change!

Granted, HIM professionals’ exposure and familiarity with senior leadership and directors at the hospital setting is usually limited. Therefore, to implement an IG program, HIM professionals must get out of their comfort zone and introduce themselves and “IG” to others through one-on-one meetings and by having yourself invited to committee meetings to present IG.

1. Get out of your comfort zone: Begin by getting out of your comfort zone and schedule a meeting with the CIO or other chief officer to discuss implementing an IG program. Make the case for IG and obtain their support. Be sure to have your “elevator speech” ready for unexpected time spent with leaders whether that be in the elevator, cafeteria, lobby etc.
2. Obtain stakeholder support: Identify a group in which you participate that has information stakeholders who understand the need for collaboration and working together to maximize information and reduce risk. Determine the pain points of individuals and make a compelling case for how IG can support and improve that initiative. The more support, the more likely the program will take off and succeed.
3. Obtain senior leadership support: Introduce yourself to other senior leaders by scheduling a meeting and request their support for IG. Create a PowerPoint with a few slides to explain IG and start the conversation. Discuss the pain points of those leaders and explain how IG can help. Market the successes that you have achieved in HIM through IG and discuss other areas for opportunity. For example, consider your volume of duplicate medical record numbers and overlays in the Master Patient Index (MPI). A high duplication or error rate in the MPI is a huge patient safety issue that can be addressed with more defined and standardized practices brought by an IG framework. Also, don’t forget to recruit members from these leaders’ areas of responsibility to participate in the sub-committees that are formed under the IG program. The more members you have across the healthcare spectrum the more folks are aware of IG and the silos will begin to break down.
4. Identity IG Potential Committee: Ask for senior leadership’s input on what senior level Committee can oversee IG based on the organization’s strategy. Often, organizations have an existing committee in place with the appropriate stakeholders that can be repurposed into the IG committee. Once you have senior leadership’s input, reach out to the Chair of that committee, market the importance and value of IG, and develop an initial strategy for governing information.

Always remember, IG is about information and HIM professionals are the healthcare “information experts.”

Cindy Zak is the executive director, corporate health information management at Yale New Haven Health and serves as the IG leader who has influenced significant change enterprise-wide. Yale New Haven Health earned AHIMA’s highest honor, the Grace Award, which recognizes excellence in health information management, in 2018.