Information Management Readiness Checklist

Transcription

1 Information Management Readiness Checklist Introduction When preparing to implement an alternative payment model, it is advisable for an entity to consider whether they have fully addressed all of the relevant administrative infrastructure touch-points within their organization. To assist you with this activity, the HIMSS Alternative Payment Models Infrastructure Task Force has developed a checklist for each of the five structural areas identified within the administrative infrastructure: Governance; Program Administration and Operations; Information Management; Revenue Cycle Management; and Contracting. You will find a checklist specific to each structural area in the HIMSS Administrative Infrastructure Toolkit related to that structural area. Following is the checklist for the Information Management structural area. Over time you will find tools and resources related to each line item on the checklist. For example, for more detailed information about what is meant by There is a process for trading partner management under the Policies and Procedures heading, click on the link and you will be taken to a document with more information about the recommended expertise and skills necessary to operate a highly successful alternative payment model entity. If a line item does not contain a link, content is still in development. If a line item does not contain a link, content is still in development. Should you have questions or comments, please contact Pam Jodock, Senior Director Health Business Solutions, HIMSS at pjodock@himss.org.

2 Instructions: For each of the line items listed below, consider your current state of readiness. Mark the appropriate box, and include any additional comments regarding work to be done to improve your readiness or activities currently underway that will result in the level of readiness you assigned to the line item. Key: H = High state of readiness. You have fully evaluated this item within your organization and have taken all necessary action to ensure the organization is fully prepared to execute this line item on Day 1 of Go Live. M = Medium state of readiness. You have considered this line item, and are in the process of taking the necessary steps to ensure the organization is fully prepared to execute on Day 1 of Go Live. L = Low state of readiness. You have not previously considered this line item and will need to implement an action plan to ensure that the organization is fully prepared to execute on Day 1 of Go Live, N/A = This line item does not apply to your organization. Guiding Principles There is a formal document that clearly articulates the organization s intentions regarding with whom and how information will be shared to ensure achievement of the organization s overarching goals/mission There is a process for sharing this formal document with all affected employees These principles are incorporated into all affected data sharing agreements Systems, platforms and applications System exists to manage claims, payments to providers and encounter submission and receipt Care management capability exists to leverage population health analytics, and support proactive and intensive case management Application exists for identity management A data model that supports integration across application platforms to support data sharing and enterprise workflows Patient engagement tools exist to enable effective communication and self-service Page 1 of 4

3 Data analytics and reporting Information Management leadership has met with all appropriate business units to determine data analytics/reporting needs External data sources have been secured as necessary and appropriate Analytics tools are available to support population health and integrating behavioral and social determinants of health data when available Standard reports have been developed and approved requesting adhoc or new regularly generated reports reviewing and maintaining routine reports to ensure there are no changes to data needs or the relevance of the individual reports attributing patients, providers, practices, health plans and programs (including updating and using attribution) Interoperability Capabilities exist to acquire patient data from external sources and use internally Capabilities exist to push or otherwise make available patient data to external partners using standardized and nonstandardized transaction sets Capabilities exist to move data from internal system to internal system to meet internal needs. Capabilities exist to move data based on business rules fired by data type or content. Page 2 of 4

4 Policies and procedures There is a policy in place to meet the minimum necessary requirement under HIPAA. There is policy and procedure in place to onboard new data connections. A data retention policy and procedure to handle data that should not be retained exists. Templated agreements exist for use in onboarding data exchange partners. A policy outlining role based access to clinical data exists. A policy exists outlining the method of person identification to be used for incoming and outgoing data. There is a process for trading partner management. Page 3 of 4

5 Regulatory oversight There is a process for including Information Management staff in all internal legislative/regulatory work groups and implementation activities each business unit to understand and monitor regulatory requirements regarding information management as they apply to that business unit There is process in place for reporting and addressing concerns regarding noncompliance or potential non-compliance There is a process in place for ensuring changes to report requirements or business processes will not adversely affect regulatory compliance Disaster recovery and business continuity There is a plan to handle backlog of data exchange after disaster recovery. There is a list of mission critical data exchanges that must be kept running during a disaster. Training and education There is a training plan that discusses value and methods of exchanging data (internal and external). Education exists regarding the use of the data being exchanged. Training exists on the tools used to exchange data (internal and external). Test environment exists for use in training Self-service education exists Page 4 of 4