Information Governance: Capture, Link, & Maintain

I don’t intend to oversimplify the topic of health information governance.  ‘IG’ has many facets and can be an indistinct term even to health care industry leaders that are close to it because of the numerous ways they organize and prioritize people, processes, and technology to achieve their IG goals.  Unfortunately the fuzziness and complexity of the topic can increase the perceived execution risks surrounding proposed investments and foster uncertainty about the value of IG efforts when compared to competing projects.  If decision makers don’t grasp the interconnectedness of different IG projects as well as how they support strategic initiatives or operational imperatives, projects may be deprioritized or defunded because of the perception of diluted value.  In view of this, I propose discussing IG projects in the context of three fundamental activities: capturing, linking, and maintaining data.  Let me explain.

Capturing Data.  Some IG-related activities relate to capturing data from a source.  You might capture data over the phone directly from a patient during a pre-registration process or capture a file of records from a third party for strategic planning or marketing.  EHR platforms may capture data from a practitioner, or an HIM professional may capture patient consent to release information to a third party.  These data sources may need to be captured periodically or only once. 

Despite the nuances in the data sources, the criticality of the captured data will require varying degrees of quality assurance.  Some datasets contain flaws with syntax, format, or content; maybe the data has too many gaps to be useful; or maybe the technique used to capture data opens up opportunities for fraud.  Verifying the integrity of the incoming data and making edits is often tightly coupled with the data capture process, so a few other examples may help further clarify my thought:

• In a patient access workflow, health systems may employ address or identity verification tools to ensure they capture complete and accurate patient information and spot potential fraud.
• In financial assistance decisions, asserted income or occupancy at a residence within a specific geography may be verified.
• For clinical documentation improvement, professional coders review medical records to ensure an accurate representation of healthcare services that were provided.

Linking Data.  Another group of IG activities relates to linking data.  Datasets to be linked could originate within the same application, on different technology platforms, or within different entities altogether.  In a patient matching scenario, data linking can happen with medical records within a single hospital, or the complexity can multiply when exchanging patient data between different entities. For compliance, a credentialing team may capture practitioner license information and link the credentials back to the provider’s master profile.  In other situations, data is linked for the purpose of transparency, such as when updated medical practice information gets linked to a publically available directory on a health system’s website.  Whether individual records, a group of files, or a large-scale data integration, linking data is a core activity within IG.

Maintaining Data.  The third and final group of IG activities I’m proposing involves maintaining data.  The accuracy of data correctly captured today may degrade over time and need to be updated if it is to be dependable.  Data collected many years ago may have a shelf life that regulations and local retention policies govern.  Sometimes data maintenance requires updating the access controls on sensitive datasets with new layers of security along with the latest data segregation strategies and minimization of the data, if the data is considered a high-value target for thieves and fraudsters.  The activities surrounding data maintenance also include migration of data to new platforms, some aspects of prepping it for analytics and informatics purposes, and redesigning the structure of data to make it more assessable to users.  Each of these activities and more are single surfaces in the multi-faceted topic of maintaining data. 

Tying a potential project into an IG framework of capturing, linking, and maintaining data helps clarify how a project supports larger IG efforts as well as strategic and operational aims.  Organizational objectives that include patient safety, clinical integration, and value-based reimbursement come to mind as demonstrations of IG’s crucial role. 

• Can we foster a culture of patient safety without high quality data capture at each interaction with a patient?
• Can we share patient data among care delivery entities if we can’t confidently link datasets together?
• Can we fairly understand provider performance and apportion incentives without first maintaining the underlying data to reflect the varied complexity of patients treated?

At a glance and with all of the other challenges that health system leaders face today, information governance may not intuitively seem like a priority investment, and yet a deeper look reveals that IG is a crucial underpinning for many important and costly initiatives. As you consider how to communicate your next IG initiative, re-framing it in the context of capturing, linking, and maintaining data may help simplify the story and convey the value of IG embedded within other strategic efforts.

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At LexisNexis Health Care, its my pleasure to work with experts in different areas of information governance.  They manage intricate details of nationwide datasets and technology platforms that are foundational to our data management and analytics solutions offered to health care organizations.

E. Todd Bennett, Health Care Market Leader, LexisNexis Risk Solutions.