Deborah Green is playing a lead role in the American Health Information Management Associations effort to highlight the importance of information governance. The executive vice president and chief innovation and global services officer recently had a Q&A with HDM Editor Fred Bazzoli about findings of a recent AHIMA survey.
HDM: What are some of the most significant results from this years survey?
Green: I see important findings, both in the indications of traction with IG adoption and the readiness levels of professionals who are taking on the challenge of advancing IG in healthcare.
While there are significant numbers of organizations not yet formally on the IG path, there is evidence that growing numbers are prioritizing information governance. For me, among the most significant findings is that 36 percent of the respondents indicate that a senior executive has been designated to sponsor IG. Thats a major sign that IG has established a toehold in healthcare. This means more than a third of the organizations represented are sufficiently convinced to take this step because they see the value of information as a strategic asset. I hang a lot of hope on this indicator, because without senior sponsorship, IG will not move within the organization.
The survey also showed that 38 percent indicate that IG objectives are included in their organizations strategic goals, and 32 percent have appointed an IG change management champion. Other significant findings include that 23 percent of the 1,260 respondents either chair or participate in an IG oversight group, and 44 percent report modest or significant IG advancements in the last 12 months.
The survey results on professional readiness and opportunity provide valuable guidance for individual professionals as well as organizations as we all move to shepherd the evolving professional discipline of Information Governance itself. We saw in the findings clear areas of self-reported competencies and confidence as well as areas warranting focus and bolstering.
HDM: The survey found that a large minority of respondents are lagging behind and have no current plans to address information governance. Does that surprise you? Do you expect those results to change?
Green: The numbers do not surprise me. Although adoption levels are not where we want them to be, we are NOT behind other industries. Organizations in healthcare are dealing with multiple and major challenges including macro-economic issues, reimbursement changes that are pushing delivery system changes and demands to prove the value of healthcare purchased. Organizations will understandably insist on being convinced of the return of any change with significant organizational impact. Certainly IG is in that category. An objective of our IG pilot program underway is to demonstration return on investment. We will be publishing case studies, articles and IG learnings based on pilot experience, to share knowledge on IG implementation and IG benefits/returns. We hope this will help to increase adoption.
HDM: What will be some of the key drivers to encourage healthcare organizations to address information governance? Will changes in care reimbursement and healthcare organizations incentives have a straight-line impact on increasing awareness of and activity in information governance?
Green: Results of our first survey on the state of IG in healthcare, published in June 2014, found that there was overwhelming agreement on drivers for IG in healthcare. These included safe and quality care, reimbursement changes, delivery system changes, and the need for reliable data to support clinical categories that mirror the Triple Aim.
Reimbursement changes will absolutely drive the need for IG. Changes such as value-based purchasing, payment bundling and capitation will demand reliable data and information. To prove the value of healthcare purchased requires trust in data and information, but beyond that, trusted data and information are essential to actually delivering that value. Creating value and proving it will require strategic management of information in a business driven and holistic way that is information governance. If organization leaders can be convinced that IG is a key to enabling the value of healthcare purchased, they will move to IG.
HDM: The AHIMA survey also looks at how well respondents are equipped to deal with IG responsibilities. What do you take away from the results of these questions to respondents?
Green: Areas of strength self-reported in the survey should be taken as real positives, as these will continue to support organizational IG competence. These include: data quality management, regulatory compliance, legal processes, risk management, and HIM and IT management. While data governance and analytics were each rated relatively strongly at more than 60 percent, about 40 percent are not confident of their abilities in these important skills. These are gaps that will need to be closed. Strong experiences in lifecycle management were reflected in survey questions on roles and functions today. Also seen as positive was the level of self-reported competence in communication skills.
While responses on competencies in leadership are seen as encouraging, leadership is a competence that requires ongoing self-development regardless of field or focus. Additionally the fact that 41 percent of the respondents do not feel competent to train staff in IG principles and practices represents a need. A high percentage (52 percent) of professionals believe they are not seen internally as credible experts in IG. This points to added need for focused training and development on IG practices and domains.
HDM: AHIMA believes that IG initiatives need support across the organization from a variety of disciplines. Who are key players to have at the table, and what responsibilities must be covered to get the most value from IG efforts?
Green: Multiple disciplines are essential to adopt and achieve maturity in IG. The initiative is too expansive to be advanced by a single or even a handful of disciplines. We see existing disciplines and related roles critical to IG as including: Health Information Management, Information Technology, Privacy, Information Security, Risk Management, Legal and eDiscovery, Compliance, Data Governance, Data and Master Data Management, and Analytics. As IG is an enterprise initiative, organizational supports will be important to success such as Project Management, Training, and Communications. Senior sponsorship, with a designated lead for IG, is critical.
Our survey results provide a really informative view of tasks and roles that are combined into single jobs/roles as well as those that are more often singularly focused. We are in the midst of rapid process and role evolution, because of the disruptive technology of EHRs and broad adoption of all types of electronic solutions. These disruptive technologies, or our inability to plan for and adjust to them, have actually created some of the need for IG. Disruptive technologies have resulted in at least some of our lack of trust in our data and information. This disruption and the rapid process evolution are shining a huge spotlight on trust challenges that we face, and on IG as a way to meet these challenges. We need to recognize that processes and roles will continue to evolve and we must responsibly shepherd this evolution. Being a part of advancing and advocating for IG will help us do that.
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