Data has become increasingly important to hospitals because of the close relationship data has with reimbursement. However, sometimes it seems that hospitals and health systems focus on the quantity of data rather than the quality. Success with health information technology in general is more about quality than quantity. The hospital with the most expansive electronic medical record or the most expensive data servers can falter if it doesn't have the right health IT infrastructure. In order for hospitals to have the best quality data, they need to institute high-quality health information management, which means building data governance into their health IT infrastructure.
"Health information management needs to be threaded throughout an entire organization. Every one of the hospital's source systems is a medical record system," says Rita Bowen, MA, RHIA, CHPS, SSGA, senior vice president of health information management and privacy officer for HealthPort, a provider of release of information services, audit management and tracking technology to healthcare organizations. "Data governance builds in accountability for data integrity and record retention of these systems. It is integral to how updates are received and how they are communicated back to each system. A two-way communication between every one of the hospital's information systems is critical for quality patient care," she says.
If a hospital can't authenticate the data in its EHR system, then the information is unusable. This is the foundational reason that hospitals need strong health information management. However, there are also a few other reasons.
1. If physicians rely on EHRs, the governance needs to be sound. A strong premise of meaningful use is that EHRs can prompt physicians to conduct the appropriate follow-ups for patients. For this reason, hospitals need strong health information management that verifies an EHR directs information appropriately. When physicians rely on EHRs, there is a strong potential for something to go wrong. "Just like with an iPhone that has GPS and navigation, individuals tend to rely on the phone for driving directions. A similar reliance is possible with physicians. If physicians begin to rely on the EHR to steer them in the right direction for patient care, then the data governance for that EHR needs to be strong," says Ms. Bowen.
2. The data warehouse has more integrity. According to Ms. Bowen, if a hospital's health information management is not thorough for all information systems and the EHR, then its data warehouse can easily become a data outhouse. "If you don't know how the data went in to the data warehouse — a path that is defined by data governance — then it is harder to get it out. For instance, does your data warehouse receive data strictly from the revenue cycle data? All of that information has to come together so you can rely on knowing that when you get information, you are getting everything you need," says Ms. Bowen.
3. The data is more manageable. Strong health information management means data governance that includes data retention — how long the data is stored — which makes the data more manageable. "Hospitals do not need to keep all data forever. There are retention requirements for different types of data and that needs to be analyzed. A lack of management over the health information is setting the hospital up for risk. Keep the data as long as necessary for the hospital and the patient, then appropriately move or destroy it," says Ms. Bowen. Each hospital may differ slightly, but the generally accepted requirement for storing adult patient data is a minimum of seven years. After that time, the data may become more of a liability than an asset.
As the healthcare industry increasingly relies on healthcare data to inform clinical decisions, patient safety initiatives and reimbursement, hospitals and health systems need to guarantee the integrity of their data. According to Ms. Bowen, the best method to authenticate data is to implement data governance throughout the hospital, and to continually update the management of the health information. "The saying 'it's not a destination, it is a journey,' applies to data governance. It is a never-ending process. It is a continuation. Hospitals need to work on the continual management and oversight of the data governance plan," says Ms. Bowen.
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"Health information management needs to be threaded throughout an entire organization. Every one of the hospital's source systems is a medical record system," says Rita Bowen, MA, RHIA, CHPS, SSGA, senior vice president of health information management and privacy officer for HealthPort, a provider of release of information services, audit management and tracking technology to healthcare organizations. "Data governance builds in accountability for data integrity and record retention of these systems. It is integral to how updates are received and how they are communicated back to each system. A two-way communication between every one of the hospital's information systems is critical for quality patient care," she says.
Why hospitals need to build data governance into health IT infrastructure
Data governance provides critical data integrity information to an EHR. Most hospitals have multiple information systems that feed into the EHR, and without data governance built into the health IT infrastructure, the ability of an EHR to authenticate and properly move data — knowing where it came from and where it needs to go — is less likely. Data governance helps an EHR identify the source of data and store it, if necessary, in the appropriate place. "The data governance needs to be done from the beginning so an EHR can identify the source of the data, the original author and the rules for the data, such as if a second author can cosign. "Good data governance will cover this — it needs to be all encompassing," says Ms. Bowen.If a hospital can't authenticate the data in its EHR system, then the information is unusable. This is the foundational reason that hospitals need strong health information management. However, there are also a few other reasons.
1. If physicians rely on EHRs, the governance needs to be sound. A strong premise of meaningful use is that EHRs can prompt physicians to conduct the appropriate follow-ups for patients. For this reason, hospitals need strong health information management that verifies an EHR directs information appropriately. When physicians rely on EHRs, there is a strong potential for something to go wrong. "Just like with an iPhone that has GPS and navigation, individuals tend to rely on the phone for driving directions. A similar reliance is possible with physicians. If physicians begin to rely on the EHR to steer them in the right direction for patient care, then the data governance for that EHR needs to be strong," says Ms. Bowen.
2. The data warehouse has more integrity. According to Ms. Bowen, if a hospital's health information management is not thorough for all information systems and the EHR, then its data warehouse can easily become a data outhouse. "If you don't know how the data went in to the data warehouse — a path that is defined by data governance — then it is harder to get it out. For instance, does your data warehouse receive data strictly from the revenue cycle data? All of that information has to come together so you can rely on knowing that when you get information, you are getting everything you need," says Ms. Bowen.
3. The data is more manageable. Strong health information management means data governance that includes data retention — how long the data is stored — which makes the data more manageable. "Hospitals do not need to keep all data forever. There are retention requirements for different types of data and that needs to be analyzed. A lack of management over the health information is setting the hospital up for risk. Keep the data as long as necessary for the hospital and the patient, then appropriately move or destroy it," says Ms. Bowen. Each hospital may differ slightly, but the generally accepted requirement for storing adult patient data is a minimum of seven years. After that time, the data may become more of a liability than an asset.
As the healthcare industry increasingly relies on healthcare data to inform clinical decisions, patient safety initiatives and reimbursement, hospitals and health systems need to guarantee the integrity of their data. According to Ms. Bowen, the best method to authenticate data is to implement data governance throughout the hospital, and to continually update the management of the health information. "The saying 'it's not a destination, it is a journey,' applies to data governance. It is a never-ending process. It is a continuation. Hospitals need to work on the continual management and oversight of the data governance plan," says Ms. Bowen.
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