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Crowdsourcing Data Governance
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Power to the People:
Internal Crowdsourcing for Data
Governance That Actually Works
Paul Boal, Amitech Solutions
Kamalakar Jasti, SSM Health
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Objectives
Understand the value and challenges of top-down
and bottom-up approaches to data governance
Appreciate the importance of access to information
and process transparency
Identify how a broad range of stakeholders at
different levels can be engaged with data governance
Design a strategy for establishing an impactful data
governance program that fits your organization
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Agenda
• What Drove Data Governance at SSM Health?
• Why Do Data Governance Projects Fail…
– Half-baked Vision and Execution
– High-flying ideas that Crash and Burn
– Programs that Suffer a Long, Slow Decline
• And How to Prevent Failure!
• How SSM Health is Succeeding!
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SSM Health
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• $9+ billion in annual revenue
• Over $500 Million in Community Benefit
• 40,000+ Employees
• 9,900+ Physicians/Providers
• 300+ Physician Office/Outpatient Sites
• 24 Hospitals
• 10 Post-Acute Facilities
• 83 Counties – SSM Health at Home
• 5.4 Million Covered Lives – Navitus
• 410,000 Covered Lives – Dean Health Plan
• 40+ Managed Hospitals/
Affiliate Relationships
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Technology, Process, People, Culture
…the secret to high performance and
satisfaction-at work, at school, and at
home—is the deeply human need to
direct our own lives, to learn and create
new things, and to do better by
ourselves and our world.
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2a: Burnout with No Motivation to Change
Clichés about Change:
• Change is a marathon
• The only thing constant is change
• Need quick wins to build buy-in
• Kotter’s 8 step process for change
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2b: Crash Against Organizational Inertia
• Top-down compliance breeds resentment.
• Resentment leads to
resistance.
• Resistance leads to
disengagement.
• Disengagement leads
to the Dark Side.
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Mythical Hierarchy
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DG Steering
Committee
Manage
Working Group /
Business Steward
Define / Monitor
Technical
Steward
Confirm /
Enforce
Domain Trustee /
Steward Define
DG Executive Council
Plan and Guide
Data Executive
Approve
Information User
Follows Procedures
Strategic
Tactical
Operational
Business Technical
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Top Down and Bottom Up
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Strategic
Tactical
Operational
Business Technical
Operational
Business Technical
Tactical
Strategic
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3a: Slow Decline by …
• “Did you get data
governance approval?”
• “Did you see that there’s a
new process for that?”
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The Work of Health System Leadership
What patients think I do What nurses think I do What doctors think I do
What I want to do someday What I have to do today
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Time to Reset Expectations
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System
Execs
WI
STL
OK
Care Mgmt
Clinic Hospital Operations
Physicians Nursing
The System Executives
will determine which
are the right metrics
and goals.
Subject Matter Experts
from across the system
will work together to
standardize exactly
how the measures
will be calculated
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Tightly Align with Strategic Direction
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• Executives will be
reviewing
performance during
regular joint meetings.
• They’ll also need
access to the detailed
information on how
metrics are calculated
now.
i
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Bottom-Up Involvement in Data Governance
• Information Portfolio
Content provided by
hands-on subject mater
experts
• Content owners are
business leaders, not
data or IT specialists
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System
Execs
WI
STL
SLU
Care Mgmt
Clinic Hospital Operations
Physicians Nursing
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Example: All Cause Readmissions
1. Different regions used different definitions and business rules:
– Which authority is defining readmissions?
– How is the information being used?
– Do we include or exclude observation stays?
– Skilled nursing facility confusion
– What is the right goal?
2. What are the challenges in bringing SMEs to agreement
– We are saying the same words but not meaning the same thing.
– It takes time to drill down into the details.
– Some time has to be spent as a group, some time one-on-one.
3. How the wiki helped facilitate that:
– Writing things down and reviewing them always helps.
– Putting those written works in a “public” place makes you think harder
about how someone else might interpret it.
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Next Steps
• Next use cases:
– Population Health
– Clinical Quality – centralizing / standardizing
– MACRA/MIPS
• Increase adoption:
– Standard process for adding new areas and new information
– Integrate existing information from other systems and build additional
forms and templates
– Mobile capabilities
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Setting the stage:
A year ago, SSM Health hired a new CEO from outside the organization.
There are lots of challenges that come with a new CEO – for the new CEO, for existing leadership, for everyone up and down the organization.
Worked well for Kevin Costner but doesn't usually work out well for IT projects.
EXAMPLE: Fresenius DW Next
Tools built by information management professionals for information professionals, rather than business users.
EXAMPLE: Data Dictionary with cheeseburger definitions
Knowledge repositories that typically contain technical knowledge but lack business context.
“Adoption is a management issue.”
Process that are built around compliance as opposed to value.
Don’t focus closely enough on what the ultimate objective is – cleaner data, better decisions, faster analysis, etc.
Ignoring the fact that people have to be involved in doing the process.
Talk about the Item Add process at BJC
There are a lot of clichés about change and even more books about how to lead and manage change.
Some of the best lessons I learned about change management came at a time where I was trying to introduce my executive team to data governance, lead subject matter experts into a new way of sharing all of their knowledge with the broader organization, and literally training to run a marathon at the same time.
Quick wins...
The counter-example of centralization
Talk about the conversations with Scott about his email inbox
Setting the stage:
A year ago, SSM Health hired a new CEO from outside the organization.
There are lots of challenges that come with a new CEO – for the new CEO, for existing leadership, for everyone up and down the organization.
Came in from a highly mature organization / structured
Hospital KPIs all available
What she saw was lots of astrixes… each hospital does things slightly differently
Expectation
Standardized way of comparing
Reality
Each person has their own binder
Meetings / accountability is show-and-tell
Leads to… Vision
Top down: system determines measures and goals
Bottom up: determining standard definitions, informed by real understanding of operations, workgroups, SMEs, agreement on standard way to defining