Understanding Your Information is Key to Governing it by Linda L. Klo, MA, RHIA, FAHIMA

Celebrating #HIPWeek and the Role of HIM

As with so much in business and life, the 80/20 rule is a useful guide for delivering on the promise of health information governance. Simply stated, 80% of your impact will come from bringing 20% of the information under tighter governance and lifecycle management. For example, health care systems rely on accurate patient identification for many mission critical applications to ensure that the right information is available when and where it is needed for safe and effective patient care. Patient identity information management is a fundamental requirement for health record integrity while reducing the cost of labor-intensive error correction when records are inadvertently merged or duplicate records created. It also mitigates the risk of identity theft a growing burden for patients and the health system.

Patient identifiers are Master Data because they are vital to many of the mission critical applications across the health system. Master Data are the 20%, the vital few, requiring the greatest early governance and management vigilance because other information is always added to master data. Nothing derails a quality improvement discussion faster than the discovery that the cases are attributed to the wrong physician. Other types of master health data include provider identification, facility, employee, and service identification, demographic markers, vendors, insurers, and charge schedules.

Reference terminologies such as SNOMED and classification systems such as ICD are also Master Data as are drug, supply, device, charge, and other reference codes. The transition from ICD-9 to ICD-10-CM and ICD-10-PCS is so challenging because these Master codes support so many applications, transactions and processes within an organization and across the health system (many, many more than in 1979 when the current version was implemented quietly, largely within the HIM department). There are a lot of lessons to be learned from the ICD-10 experience. Among them, the importance of having enterprise level governance and management of health care's vital Master Data assets.

The other 80% of information must also be well governed and managed, but the 80/20 rule can again be useful. Clinical data elements in the health record or in registries, for example, are not all of equal value. Employee records contain non-critical information that need not be preserved beyond their short-term use. Like other assets, it's important to inventory your organization's current information assets. The Information Governance body can then determine priorities for Master Data and other critical data that will get the greatest resource focus to improve their value across a range of attributes including quality, security, trust, access, uses and storage.

Yes, the 80/20 rule has utility in making information policy decisions regarding lifecycle information management. It should guide decisions about what information is archived for long-term preservation, how tiered storage strategies are designed and what information is preserved for litigation holds. It even has bearing in determining what information constitutes minimum necessary with respect to uses and disclosures of information under HIPAA. There are a lot of dicey policy decisions to be made across the board, but governance entities, HIM and IT are well advised to begin with getting their Master data under control.

Health information management (HIM) has long played a key role in master patient index, terminologies and classifications, service and provider assignment, chargemaster and other master data management (MDM). MDM has been an important part of HIM's professional role, but this will expand under information governance as healthcare's vital Master and other data are managed to higher standards. AHIMA is celebrating Health Information Management Professionals (#HIPWeek) this week of March 22-28. The profession should resolve going forward to provide even stronger collaborative leadership in governing and managing Master Data and other vital information assets to the standards required by patients, the health system, and the public.

LINK:	http://blogs.ironmountain.com/2015/industry/healthcare-information-man...
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