This document discusses establishing an information governance program to optimize an electronic health record (EHR) system. It provides an example of Hawaii Pacific Health, which focused on improving data quality and standardizing definitions to decrease costs and improve clinical quality. The summary discusses that an information governance program sets accountability and priorities for managing health system data and information assets. It also notes that executive support is important to establish a successful long-term information governance program.

1. HealthCare System EHR Governance Information Discussion
HealthCare System EHR Governance Information Discussion ON HealthCare System EHR
Governance Information DiscussionMoving the Needle toward a Data-Driven Health Care
System-Optimizing the EHR through Information GovernanceFor this review, you must also
create a PowerPoint.Your review should include:An initial identification of the article
(author, title of the article, title of the journal, year of publication, and other details that
seem important, e.g., it is originally a French edition), and an indication of the major aspects
of the article you will be discussing.A brief summary of the range, content, and argument of
the article. You may occasionally summarize section by section, but in a short review
(1,000-1,500 words) you usually only pick up the main themes. This section should not
normally take up more than one-third of the total review.A critical discussion of 2-3 key
issues raised in the article. This section is the core of your review (50-60%). You need to
clarify the author’s own argument before you criticize and evaluate it. You must your
criticisms with evidence from the text or from other writings. You may also want to indicate
gaps in the author’s treatment of a topic, but it is seldom useful to criticize a writer for not
doing something they never intended to do.A final evaluation of the overall contribution
that the article has made to your understanding of the topic (and maybe its importance to
the development of knowledge in this particular area or discipline, setting it in the context
of other writings in the field). How can this help small
businesses?moving_the_needle.pdfUnformatted Attachment Preview:i HEALTH
INFORMATION MANAGEMENT SANDRA KERSTEN Moving the Needle toward a ^ j Data-
Driven Health Care Systenri: Optimizing the EHR through Information Governance
Developing a Program that Engages Critical Owners and Has Executive Will Help Ensure
Success T At the time of this writing, Sandra Kersten, MPH,RHIA, was Director of HIM
Practice Excellence at the American Health Information Management Association (AHIMA).
For additional information, email proprac@ ahima.org. he recent 2013 HIMSS National
Meeting provided a glimpse into a more mature electronic health record (EHR)
environment, where quality, performance improvement, patient engagement, and
reimbursement models are under close scrutiny and strategies addressing those topics
center around EHR. Across the board, the message was clear that the EHR has progressed
from implementation to optimization and that provider organizations are beginning to
realize the benefits of EHR technologies in their service delivery models, using them to
better clinicians in utilizing best practices of care as well as a means to capture data that
provides evidence of care quality; they also can be used for decision-making. But how do

2. organizations move from implementation to optimization? In spite of health care reform’s
focus on data-driven care, organizations still face many challenges in getting and using the
right data. The organizations that are doing it best describe multi-phased, multidisciplinary
approaches to getting the right information out of their EHR and, in fact, all their hospital
information systems.Management of information across the enterprise, through
information governance (IC), can help organizations optimize their technology resources to
become data-driven. Hawaii Pacific Health, the 2013 Davies Award Winner from HIMSS, set
a goal of demonstrating a return on investment (ROI) from its EHR to kick start its efforts
Journal of Health Care Compliance — May – June 2013 45 Health Information Management
in maximizing the EHR. The company focused initially on a revenue cycle measure,
improving (decreasing) its “cost to collect” as a means of demonstrating its ROI. Tb address
the problem, the company gathered a multidisciplinary team with representation from
finance, information systems (IS), patient safety, health information management (HIM),
clinical staff, and other frontline users (such as registration and scheduling staff). Tackling
the problem from the perspective of the data, the company first had to agree on which data
was critical to understanding and/or solving the problem. Early on, Hawaii Pacific realized
that a lack of standardized internal definitions was making it difficult to apply consistent
measurement across the organization. The organizational team, in coordination with their
vendor, came to agreement on key data and definitions that were needed (what was the
point of collection; was it coded data or data generated directly from the patient encounter;
if there were multiple collection points, which system or data field was the source of truth).
They were able to identify areas where data was not captured accurately (basic data did not
match across various reports and/or functional areas) and develop a solution to get it
corrected (determining whether it was a people, process, or system issue) to bring
improvements to the patient administrative workflows.Once they achieved success in the
revenue cycle cost of collection indicator, they turned their attention to clinical quality
indicators, making significant improvements in obstetric and pédiatrie care and, ultimately,
using their EHR and other information systems to bring improvements to the population
health of their care constituency, with outreach to patients for screenings and chronic
disease management. To make this happen, the organization made it a priority to get
maximum value from its technology systems and the data. The company recognized the
value of the information as a key resource 46 and asset in achieving quality of care and used
the data and its EHR to achieve improvements in its bottom line and clinical quality of care.
The recognition that the information is a valued asset is a key first step in information
governance (IG), a structured approach to managing the information systems and data of an
organization. An information governance program sets a structure of accountability for the
information assets, sets priorities for the overall management of the organization’s
information systems and data, and ensures policies and procedures are available to guide
the appropriate use of data, from initial capture through retention or disposition. A fully
established IG program must address information quality, the information lifecycle, security
and privacy of information, and data and documentation standards. When Hawaii Pacific
Health focused on improving its bottom line through its information assets, it focused on
the information quality aspect of IG, drilling into the data to determine what it really needed

3. and how to get it accurately captured. Where does your organization fall in the information
governance spectrum? If you are not aware of an established data or information
governance program, you can do a quick pulse-check of your organization’s information
assets with these questions: When you try to get information or data to solve a problem, is
there a clear way or place to get it (dashboards, current reports, et cetera)? Once you do get
it, is the data in good shape, and ready to use, or does it need a lot of re-work? Does it seem
that every data project requires cleanup of the data? Do one or more persons have
responsibility for data quality, ensuring that data is collected appropriately and
consistently? These are all facets that should be addressed in an information governance
program. Where do you begin, if a program is not already established? The place to start is
CONTINUED ON PAGE 62 Journal of Health Care Compliance — HealthCare System EHR
Governance Information DiscussionMay – June 2013 HOSPITAL COMPLIANCE CONTINUED
FROM 38 HEALTH INFORMATION MANAGEMENT CONTINUED FROM 46 policy each year
and requiring each employee to submit a signed acknowledgement that they received the
policy is an effective method of keeping the policy fresh and relevant. CONCLUSION Email
has become an essential and effective communication tool in conducting day-to-day
business; however, there are also some inherent risks associated with the use of email. This
article has attempted to highlight some of these risks and to offer some very common sense
solutions to help reduce that risk. A comprehensive compliance program will have a very
detailed section on the use of email and what the expectations are that the organization will
have of its employees. COMPLIANCE AND QUALITY CONTINUED FROM 44 2. 3. 4. 5. 6. 7. 62
States, www.supremecourt.gov/docket/PPAACA. aspx. Accessed July 24,2012. Department
of Health and Human Services, Office of Inspector General, Compliance Program Guidance
for Nursing Facilities, 65 Fed. Reg. 14289; March 16,2000.
oig.hhs.gov/compliance/complianceguidance/index.asp. (Accessed April 3,2013).
Corporate Integrity Agreement between the Office of Inspector General of the Department
of Health and Human Services and Tenet Healthcare Corporation, September 27,2006.
oig.hhs.gov/fraud/cia/agreements/ TenetCIAFinal.pdf. (Accessed March 30,2013).
Department of Health and Human Services (DHHS), Office of Inspector General (OIG) 2013
Work Plan, oig.hhs.gov/reports-and-publications/archives/ workplan/2013/WPOO-
lntro+Contents.pdf. (Accessed March 2013). Medicare.gov, Hospital Compare,
wv^iw.medicare. gov/HospitalCompare/Data/AboutData/About.aspx. (Accessed March
29,2013). Thomas, F. et al. Clinician Feedback on Using Episode Groupers with Medicare
Claims Data, Health Care Financing Review.www.cms.gov/ Research-Statistics-Data-and-
Systems/Research/ HealthCareFinancingReview/downloads/Thomas_ WE_Sep_2009.pdf.
(Accessed March 20,2013). Jones, D.S. Combining Disciplines: Making the Connection
Between Compliance, Risk & Quality Management. Journo/ of Health Care Compliance, May-
June 2007:5-12. with executive leadership. If you are an enduser of the information, raise
awareness of the need for information governance with your executive leaders. Whether
you are in an executive leadership role yourself or an end-user, here are some ideas for
determining an approach: • HealthCare System EHR Governance Information DiscussionSell
the idea to obtain executive-level champions. • You can start from anj^where. It makes
sense to begin with what you know. Set priorities around the data you know most about or

4. the data that is most visible across the organization. Determine where the data originates
(is there a sole source, or can it come from multiple points and systems) and how you can
improve the quality and reliability of that data. • If you do not have executive-level , work
from the bottom up to make progress on your own. Focus on policy development. Research
external requirements, and develop policies that will them. • Develop strategic
partnerships or alliances (such as information technology (IT), business/operations
owners, legal, and financial disclosures). You will need input and involvement from all these
groups for the long-term success of your IG program. • Expect to take at least 12 to 18
months to establish your program if you are starting from the beginning. An information
governance program is critical for maximizing your EHR and other information systems to
get accurate and actionable data that can help your organization achieve improvements in
care and costs. Developing a program that engages critical owners (clinical, legal,
compliance, HIM, IT, finance, et cetera) and has executive-level champions will help ensure
your success. Journal of Health Care Compliance — May – June 2013 Copyright of Journal of
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