Energizing (or Re-energizing) Your Information Governance Program. NCHICA 23 rd Annual Conference September 11, 2017

Transcription

1 Energizing (or Re-energizing) Your Information Governance Program NCHICA 23 rd Annual Conference September 11, 2017

2 Topics Why Information Governance? The business drivers Case Study: Cone Health Industry Perspectives Data Governance vs. Information Governance Starting or restarting your IG program Discussion THN Quality & Analytics 2

3 Business Drivers: Why Information Governance Financial Incentives Population health, publicly reported outcomes, and risk based contracts make ensuring information integrity and accessibility imperative. Staff and provider satisfaction People are frustrated with conflicting data and with lack of access to actionable information. Enterprise risk Greater organizational complexity and joint risk arrangements with outside entities necessitate in depth understanding of legal and compliance risks. Privacy/security controls are crucial to patient and affiliate provider trust. THN Quality & Analytics 3

4 Business Drivers: Shift to Value-Based Payment Models Current CMS Innovation Models in NC Source: Innovation.CMS.gov/initiatives (2017) 4

5 Business Drivers: Controls vs Democratization of Data Controls Democratization Larger data sets More data sources Diverse formats/types More timely/real-time data 5

6 Business Drivers: Health System ownership of entities like ACOs and insurance plans All IG programs must be structured to comply with statutes such as Sherman Anti-trust, Stark, and others. THN Quality & Analytics 6

7 Case Study: Cone Health Insurance Plan ACO Six Hospitals Multiple Centers of Excellence 100+ Physician practice sites Two Skilled Nursing Facilities 7 Three Ambulatory Care Centers Four Urgent Care Centers Three Outpatient Surgery Centers

8 Case Study: Information Governance at Cone Health Catalysts for re-examination of Cone s Information Governance Program were: EDW 8

9 Case Study: Cone Health s IG Journey Initial efforts included Creation of a Head of Data Governance role embedded in the Analytics dept. Creation of an Information Asset Steering Committee Focus on data governance and EDW stand up Selection of an Information Governance framework (AHIMA s IGAM) THN Quality & Analytics9

10 Cone Health: Adopting an IG framework THN Quality & Analytics 10

11 Case Study: Cone Health s IG Journey Next Steps Cone conducted an enterprise wide self assessment of our IG maturity using AHIMA s tool IGHealthRateTM. 11

12 Case Study: Cone Health s IG Journey New Goals Educate leaders Lessons Learned Quick Wins = Engagement Empower the new IG Council to hold stakeholders accountable. A framework brings focus and understanding Reduce Organizational Risk Top down effort 12

13 Industry Perspectives Data Governance Standard metrics, definitions, terminology Standard master & reference data Metadata/business glossary Data quality monitoring, SLAs Information Governance Data life cycle management policy/procedure External release of information policy/procedure Legal, compliance & risk management Data access & use Security & privacy 13

14 Examples: Value-Based Care Use Cases Use Case Data Governance Needs Info Governance Needs Identify outliers in cost/utilization Clinical taxonomy Normalized charge master Define Key Performance Indicators (KPIs) Define data quality KPIs Role-based access policy Identify gaps in care/preventative services Compare performance across clinicians / clinician performance incentives Referrals analysis/ leakage analysis Enterprise Master Patient Index Provider master Define process KPIs Define data quality KPIs Define standard Clinical Quality Measures (CQM) Define data quality KPIs for CQMs Provider master Provider attribution rules Define KPIs Define data quality KPIs Provider attribution rules KPIs = Key Performance Indicators 14 Security/privacy policy & controls Data sharing agreements Data retention policies Data discovery/legal risk assessment & requirements Data quality SLAs & enforcement Legal/regulatory risk assessment (Stark, Sherman)

15 Challenges for ACOs/CINs Awareness of information governance needs & risks Community provider perceptions of the health system I don t want the health system to be able to access my data Changing the culture People are very territorial Availability of staff with the right knowledge and skills Lack of standards/consistent interpretation of standards Trying to boil the ocean Need for clinical documentation improvement across the network THN Quality & Analytics 15

16 IG: Organization Structure Better Practices Who? Existing executive leadership team Multidisciplinary process & data owners with decision authority Standing & ad hoc teams of subject matter experts, data stewards, & data custodians Executives Steering Committee Workgroups THN Quality & Analytics 16 What? Define strategy Allocate resources Advocate for change Hold people accountable Define tactics/ plans Operational oversight, issue resolution Institute change / change management Approve policies, standards, procedures Hold people accountable Recommend policies, standards, procedures Execute tactics/plans Escalate issues Coach/support front-line during changes

17 Where should we start (re-start)? Top Down Educate executives Conduct gap analysis/risk assessment Align with strategic plans & initiatives Develop a roadmap practical, tactical, value-focused Establish key roles & responsibilities Allocate key resources Bottom Up Identify 1-2 strategic use cases and take them on as a pilot Support a strategic initiative that is already resourced & has attention Do the DG & IG work and educate the project participants Formalize what works into the base for your IG program Educate on/advocate for IG using the outcomes of the initial work THN Quality & Analytics 17

18 In Summary Information Governance is Needed to effectively provide information needed to enable value-based care Crucial to manage and reduce organizational risk Information Governance is NOT a project It needs to become engrained in ongoing, day-to-day work Resource allocation & job descriptions need to account for this Each organization has unique challenges driven by history, culture, and current strategic priorities The right approach will vary Start focused on quick wins and grow from there THN Quality & Analytics 18

19 Questions? Comments? Richard J. Pro, MBA, MS, FAHM Laurie Norton, MPH Paula Edwards, Ph.D. THN Quality & Analytics 19