Demand action, not assumption
By Mary G. Reeves and Rita Bowen M
any of us are familiar with the old adage “garbage in, garbage out,” or “GIGO.” If your organization is one that does not have an active, authorized and responsible data gov- ernance program, you run the risk of achieving GIGO. Even with a fully implemented electronic health record (EHR) and achievement of meaningful use, the value of your information is compromised without data governance.
Clinicians must have a high level of trust in the integrity of EHR information. Achieving that level of trust is accom- plished through data governance. Data governance is the who, what, where, when, which, how and why of content management in the electronic record. And, like Vanderbilt University Medical Center, many of the nation’s leading healthcare providers are actively implementing programs, creating policies and assigning executive teams to ensure it is in place. Data governance of patient information enables organizations to support patient safety by providing complete and accurate information.
A real-world example Vanderbilt University Medical Center has had a self- developed EHR for more than 20 years. The organization now has 100 percent of its inpatient population’s information available electronically. When Vanderbilt created its EHR, it started with comput- erized physician order entry (CPOE). This initial step suc- cessfully introduced providers to an electronic environment and encouraged them to use the EHR as an important part of patient care. As many have learned, EHR implementa- tion must be a top-down project with clinician acceptance and support.
The organization quickly found that stronger data policies were needed. Vanderbilt needed policies to answer these specifi c questions:
10 June 2012
Mary G. Reeves
A data governance model at Vanderbilt University Medical Center supports patient safety by providing complete and accurate information.
• What happens to the data? • Who manages the data?
• What data is authorized for inclusion in the EHR? • What defi nes draft, edited and fi nal versions of the data?
Vanderbilt began addressing data governance through its traditional medical records committee. This silo method was a long and diffi cult approach. Ultimately, the organization enlisted a top consulting group to develop a data governance committee and structure with a new health record executive committee at the top.
Easier and faster if done upfront
It is easier and faster to establish policies and procedures for data governance when done upfront, versus trying to correct “the way we’ve always done it” mentality. Secondly, there will be many groups and departments within an or- ganization doing their own thing, from both a technology and data governance perspective. It is important to corral these groups and feed them through central governance. This is where policies are established, implemented and enforced. Vanderbilt’s health record executive committee began in September 2009. The charter states the following purpose: “Sets strategy and guiding principles for creation and use of the health record and is responsible for the continued migration and evolution of the health record.” The primary focus of the health record executive committee and the two subcommittees – policy and migration/deployment – is to develop strategies for enhancing standardization of practice, while reducing risk and enhancing compliance. Members of the executive committee include represen- tation from medical staff, clinical staff, hospital executive leadership, CMIOs, CIOs, director of patient care informat- ics, director of VUMC medical information services, risk
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