AHIMA Leading the Adoption of Information Governance Practices in HealthCare

Transcription

1 INFORMATION GOVERNANCE IN HEALTHCARE AHIMA Leading the Adoption of Information Governance Practices in HealthCare Deborah Green, MBA, RHIA EVP, and Chief Operating Officer AHIMA AOE, July 2014 AHIMA 2014

2 INFORMATION GOVERNANCE IN HEALTHCARE AHIMA Leading the Adoption of Information Governance Practices in HealthCare Deborah Green, MBA, RHIA EVP, and Chief Operating Officer AHIMA AOE, July 2014 Hello Tweeters! #IGNow AHIMA 2014

3 Information Governance for Healthcare For healthcare, like other industries, adopting IG underscores the value of information as an asset essential for advancing the goals and priorities of the organization. Cohasset Associates AHIMA 2014 Information Governance in Healthcare A Call to Adopt Information Governance Practices.

4 First Benchmarking Survey on IG in Healthcare

5 IG in Healthcare AHIMA - First Benchmarking Survey The survey was conducted using a web-based survey tool. Over 1,000 survey responses were received Invitees: healthcare and industry professionals such as clinical and non-clinical leaders, officers, directors and managers in both provider and nonprovider setting AHIMA members Survey open during March and April White paper available now at:

6 IG in Healthcare First Benchmarking Survey White Paper White paper available now: IGwhitepaper Cohasset Associates AHIMA 2014 Information Governance in Healthcare A Call to Adopt Information Governance Practices.

7 Information Governance in Healthcare AHIMA - First Benchmarking Survey the survey results are undeniable. Information governance is a strategic imperative: regulatory compliance, safe quality care, cost control, responding to changing reimbursement systems and evolving delivery models, are top goals for healthcare organizations. All are highly dependent on trustworthy information. These organizational goals are advanced through the adoption of information governance practices; the absence of IG will impede their achievement. Cohasset Associates AHIMA 2014 Information Governance in Healthcare A Call to Adopt Information Governance Practices.

8 IG-Healthcare Benchmarking Survey Highlights 1. Overall, IG programs are less prevalent and less mature in healthcare organizations than is warranted, given the importance of information. 2. Most organizations have not yet established a comprehensive strategy for information governance. 3. The information governance framework and its foundational components call for strengthening and expansion. 4. Information lifecycle management practices related to core functions require improvement. Cohasset Associates AHIMA 2014 Information Governance in Healthcare A Call to Adopt Information Governance Practices.

9 HIGH - HIGHEST IG in Healthcare Benchmarking Survey Drivers for IG Regulatory compliance 80% 18% 2% Improve patient safety/patient care 73% 22% 5% Need to manage and contain costs 61% 32% 7% Need for clinical, quality and/or business analytics 57% 35% 8% Changing payment environment 54% 38% 8% Need for increased standardization 50% 41% 9% Need to integrate and/or improve systems and technologies 46% 45% 9% New care delivery models (population health management) 44% 45% 11% Lack of trust or confidence in data 20% 36% 44% Strongly Agree Mostly Agree Strongly or Mostly Disagree Cohasset Associates AHIMA 2014 Information Governance in Healthcare A Call to Adopt Information Governance Practices.

10 IG in Healthcare Benchmarking Survey Prevalence in Healthcare Don't know 24% No recognized need; have not started a formal program or initiative 11% Recognized need; have not started a formal program or initiative 22% Program initiated; benefits have not yet been realized 13% Program initiated; some benefits are being realized 19% Program initiated; substantial benefits are being realized 11% 100% Cohasset Associates AHIMA 2014 Information Governance in Healthcare A Call to Adopt Information Governance Practices.

11 IG in Healthcare Benchmarking Survey Prevalence in Healthcare Don't know 24% No recognized need; have not started a formal program or initiative 11% Recognized need; have not started a formal program or initiative 22% Program initiated; benefits have not yet been realized 13% Program initiated; some benefits are being realized 19% Program initiated; substantial benefits are being realized 11% 100% Cohasset Associates AHIMA 2014 Information Governance in Healthcare A Call to Adopt Information Governance Practices.

12 IG Prevalence in Healthcare 50% 45% 40% 35% 30% 25% 20% 15% 10% 5% 0% Don t' Know or See No Need See Need-Not Started See Need- Started 30% Have seen Some or Significant Benefit Only 43% Have Started IG, yet Respondents affirmed critical drivers for IG as:» 98% - Comply w/regs» 95% - Improve the quality & safety of care» 93% - Manage and contain costs» 92% - Respond to payment changes & need for clinical, quality and BI analytics Cohasset Associates AHIMA 2014 Information Governance in Healthcare A Call to Adopt Information Governance Practices.

13 IG in Healthcare Benchmarking Survey Comprehensive Strategy for IG in Place Don t know or do not have IG Plans in Place 34% 35% 65% Yes No Don't know 31% Cohasset Associates AHIMA 2014 Information Governance in Healthcare A Call to Adopt Information Governance Practices.

14 Maturity of Selected IG Components Guidance Mature Improvement underway Priority for next 12 months Not planned Don't Know Business continuity, disaster recovery, crisis management Data map that identifies key information repositories 26% 39% 12% 7% 16% 15% 31% 17% 13% 24% Training for all employees on IG topics 15% 28% 18% 21% 18% Cross-functional IG structure 11% 32% 15% 18% 24% Improvement Opportunities Important findings given the importance of cross-functional scope of information and organization engagement. Cohasset Associates AHIMA 2014 Information Governance in Healthcare A Call to Adopt Information Governance Practices.

15 Survey Summary Findings Cross-Functionality - Maturity Indicator Health Information Management Information Technology Clinical or Health Informatics Quality Management 58% 56% 54% 51% 35% 36% 36% 38% 7% 8% 10% 11% Findings confirm very active engagement by Information Stewards Findings confirm engagement by Compliance & Risk Operations Information Security Compliance Privacy Risk Management 59% 59% 57% 47% 33% 32% 34% 40% 8% 9% 9% 13% Legal 39% 47% 14% Executive Leadership Finance Medical Staff Leadership Nursing Leadership 46% 42% 31% 30% 41% 42% 44% 44% 13% 16% 25% 26% Findings show less engagement by Leadership, with Medical Staff and Nursing Leadership trailing other Leaders Cohasset Associates AHIMA 2014 Information Governance in Healthcare A Call to Adopt Information Governance Practices.

16 Survey Summary Findings IG Framework and Components Information integrity and data quality for electronic health information Mature Improvement underway Priority for next 12 months Not planned Don't Know 26% 41% 15% 8% 10% IG compliance assessments / internal audits 16% 35% 18% 11% 20% Metrics guide IG assessment and improvements 10% 27% 19% 18% 26% Yet, Lack of trust or confidence in data was the lowest rated driver for IG in Healthcare. Strengthening and expansion needed. Implications for Data Quality / Data Governance efforts IG Policies and Practices rated at only 17% mature, though 84% agree that improvements have been seen in last 3 years. Cohasset Associates AHIMA 2014 Information Governance in Healthcare A Call to Adopt Information Governance Practices.

17 Effectiveness of Information Quality improvement Programs Systems and work processes are designed to avoid errors at the source Formalized error reporting and correction processes are in place for electronic health records Quality issues identified through data reporting and analytics are traced back to their source The impact of system upgrades on information quality is formally assessed Desired attributes of information quality are explicit and understood Rates of master person index (MPI) accuracy have improved in the past 3 years Strongly Agree Mostly Agree Mostly Disagree Strongly Disagree Don't Know 22% 54% 10% 3% 11% 30% 43% 12% 3% 12% 26% 47% 11% 3% 13% 24% 44% 14% 5% 13% 20% 46% 18% 4% 12% 27% 33% 11% 3% 26% 68% agree that impact of system upgrades on quality Is assessed Note: Only 66% agree that desired attributes of information quality are explicit & understood Note: the lowest agree rates relate to MPI accuracy, important finding given the patient safety & quality of care aspects w/ patient identity errors. Also note that 26% did not know whether accuracy rates had improved in last 3 yrs. Cohasset Associates AHIMA 2014 Information Governance in Healthcare A Call to Adopt Information Governance Practices.

18 Electronic Health Information Controls Strongly Agree Mostly Agree Mostly Disagree Strongly Disagree Don't Know Documentation requirements are defined through policy and practices 43% 42% 8% 2% 5% Downtime continuity plans have been established 41% 39% 8% 3% 9% Electronic health information policies and practices apply to all operations 38% 42% 11% 2% 7% Data definitions and content management are based on standards 36% 44% 9% 2% 9% Software testing includes data quality 33% 42% 11% 3% 11% Practices for amendments and corrections are uniform 31% 44% 13% 4% 8% Metrics and improvement protocols have been defined for data quality 23% 42% 16% 4% 15% 75% agree that practices for amendments and corrections are uniform Only 65% agree that measures and protocols for improving Data quality have been defined, And 15% Don t Know

19 Survey Summary Findings Effective Preservation with Legal Holds Yes, only relevant information preserved Yes, but we overpreserve Not effectively preserved Don't Know Paper records stored on-site 37% 41% 3% 19% Electronically stored health information 35% 37% 4% 24% Paper records stored off-site 32% 37% 4% 27% Electronically stored business information 30% 33% 4% 33% and other electronic communications Other types of electronically stored information (ESI) 33% 30% 4% 33% 26% 28% 3% 43% Inefficiencies with over preservation And compliance with legal holds, may be improved with use of automated IG and e- discovery tools. Cohasset Associates AHIMA 2014 Information Governance in Healthcare A Call to Adopt Information Governance Practices.

20 Recommended Actions 1. Overall, information governance programs are less prevalent and less mature in healthcare organizations than is warranted, given the importance of information. Build awareness of the importance of IG and the direct impact of IG on the advancement of organizational goals Educate stakeholders on the importance of establishing an overarching IG program to expand the benefits of interdisciplinary collaboration Illustrate how IG supports top goals for healthcare organizations Designate senior sponsorship for an overarching IG program Identify a champion to enthusiastically lead the change management effort for effective IG Cohasset Associates AHIMA 2014 Information Governance in Healthcare A Call to Adopt Information Governance Practices.

21 Recommended Actions 2. Most organizations have not yet established a comprehensive strategy for information governance. Engage executives in establishing priorities for the IG implementation Define an overarching IG strategy that aligns implementation outcomes to the org goals and priorities, including patient care, org performance and risk mitigation Charter a cross-functional IG steering committee or re-purpose an existing committee to strengthen integration across all IG disciplines, resulting in a comprehensive IG program Model an IG Steering Committee charter on those used by other important committees Include IG topics, on the agendas of other governance committees Cohasset Associates AHIMA 2014 Information Governance in Healthcare A Call to Adopt Information Governance Practices.

22 Recommended Actions 3. The information governance framework and its foundational components call for strengthening and expansion. Prepare a comprehensive, maturity assessment of IG program and create a plan to implement IG strategy Establish/refresh an integrated policy infrastructure that encompasses all IG components and all health and business information in electronic and paper formats Communicate IG goals and achievements, and highlight trends Regularly train all employees on IG components with a strong emphasis on the benefits of IG Collect meaningful metrics on direct actions Adopt a long range change management program to continuously build IG support and improve compliance Cohasset Associates AHIMA 2014 Information Governance in Healthcare A Call to Adopt Information Governance Practices.

23 Recommended Actions 4. Information lifecycle management practices related to core functions require improvement. Strengthen IG practices of managing information throughout lifecycle, from creation or receipt through final disposition Establish interdepartmental teams to develop and apply reasonable, workable IG practices to newer technologies and information types Formalize IG practices to enhance information integrity, quality, trustworthiness Leverage mature aspects of privacy and security to enhance other IG components Employ automated tools to identify and delete information is eligible for disposition Define effective practices to identify and preserve information needed for legal hold, reinstating business-as-usual practices upon conclusion legal matter Establish routine and comprehensive assessments to identify areas of vulnerability and opportunities to refine IG program components Cohasset Associates AHIMA 2014 Information Governance in Healthcare A Call to Adopt Information Governance Practices.

24 AHIMA: Leading IG for Healthcare What DRAFT Definition An organization-wide framework for managing information throughout its lifecycle and for supporting the organization s strategy, operations, regulatory, legal, risk, and environmental requirements.

25 AHIMA: Leading Information Governance for Healthcare Raise awareness of IG for healthcare through references, webinars and events Conduct survey(s) on IG in healthcare Publish white papers on IG Establish and convene experts and leaders to develop, adapt, review and provide input into IG framework Develop principles for IG in healthcare Develop a maturity model for IG in healthcare Develop, provide, and refine ongoing, resources to operationalize IG Solicit organization commitments to use of principles and maturity model (pilots)

26 AHIMA: Leading Information Governance for Healthcare Intelligence gathering Defining Case Studies Awareness Planning Awareness / Education Survey-WP Convene Build Framework: Principles, Maturity, Resources Promote Adoption - Pilots Awareness / Education Survey-WP Convene Refine Framework: Principles, Maturity, Resources Pilots and Impact Measurement

27 Framework IG Framework Development IG Task Force IG Expert Advisory Group IGPHC Maturity Model Resources to Operationalize IG for Healthcare Appointed Review Group(s) Task Forces Framework

28 AHIMA: Leading Information Governance for Healthcare Information Governance Principles for Healthcare (IGPHC)

29 AHIMA: Leading Information Governance for Healthcare Model Principles ARMA International: Accountability Transparency Integrity Protection Compliance Availability Retention Disposition

30 Information Governance Principles for Healthcare The principles are intended to be comprehensive but written broadly, They are not intended to be prescriptive, They do not set forth a legal rule for which strict adherence is required for every organization in every circumstance, They are intended to be interpreted and applied based on an organization s type, size, legal environment and resources.

31 AHIMA: Leading Information Governance for Healthcare Maturity Model Levels with specific indicators of maturity tied to each of the 8 Principles Level 1 Sub-Standard Level 2 In Developmnt Level 3 Essential Level 4 Proactive Level 5 Transformational

32 AHIMA: Leading Information Governance for Healthcare Develop and provide resources to operationalize IG AHIMA Volunteers & Staff Industry and Non-Industry Volunteers

33 AHIMA: Leading Information Governance for Healthcare Solicit organizations to commit to pilot -principles -maturity assessment -tools and resources -report assessments of maturity -review and input on IG tools

34 AHIMA - Information Governance Organizations across industries are recognizing the need to value and control their information. In healthcare we must value, control and assure trust in our information. This requires governance. Governance requires the adoption and ingraining of principles, a framework, rules and managed processes. The time has come for healthcare to govern its information. Trustworthy information depends on it.

35 AHIMA: Leading Information Governance for Healthcare Ahima.org #IGNow

36 Questions