Information Governance: Efficiencies Gained In HIM Leaking Out Of The Lab?

Topics: Health Information Governance | Pathology Storage Management | Healthcare IT Management

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Today’s Healthcare landscape is constantly changing and evolving. Trends are showing that the industry is undergoing a fundamental shift from fee-for-service to value-based care, delivery, and payment. Reimbursements are on the decline. Medicare claims are increasingly subject to audits for proper coding and documentation. At the same time, government initiatives are driving laboratories to look for new ways to reduce and eliminate duplicate tests, which will ultimately drive down test volume and costs. So what does this mean for you?

Given these trends, laboratories are feeling increasing pressure to drive down costs, maximize efficiencies, and create additional revenue streams and opportunities. The problem is budgets have been worn thin, resources have already been rationalized, and reimbursements are dwindling. Given this scenario, you can’t simply trim your way to new revenue or add clients fast enough to fully compensate for the looming reimbursement rate reductions.

To offset these developments, you need to integrate your laboratory into an enterprise-wide information governance strategy, extending centrally governed policies and processes beyond the file room into the various laboratory departments and information systems across the organization. You must be prepared to get to the root of the problem and re-evaluate even the most fundamental roles and processes, shifting your focus from hard line costs to identifying hidden opportunity tradeoffs that can be leveraged to drive value back into the organization.

The Benefits

To fully connect the patient record and gain optimal visibility, efficiency, and inter-connectivity across the organization, your governance policy framework must address all forms of patient information, including laboratory specimens. The storage and management of laboratory specimens, such as glass slides and paraffin wax blocks, is riddled with complexity and risk, and often overlooked in enterprise-wide governance planning. Establishing clear standards for the handling and storage of specimen archives, as well as a strategic plan for the integration of laboratory test results into the unified patient record can:

  • PROMOTE the consistent and secure handling of all information and assets across your enterprise.
  • ALLEVIATE FTE bandwidth constraints and enable more strategic allocation of onsite resources.
  • LEVERAGE the dedicated budget and facilities of an expert storage vendor to administer, enforce, and maintain an up-to-date best practice approach to storage that improves efficiency and reduces risk.
  • FREE UP premium onsite space for grant-securing research or revenue generating activities.
  • ENSURE providers have all the information required to minimize test duplication and make informed patient care decisions.

How Do I Get There?

You now understand the challenge and the importance of information governance. Here’s a four-step plan to improve your strategy:

1.Break Down Silos

Implement a plan that centralizes the storage and management of physical records, specimens, and other critical documentation offsite to gain economies of scale and establish a framework that enables the consistent application and enforcement of policies and processes.

2.Free Up Limited Bandwidth

Offload transactional work and production functions to an experienced vendor to free up bandwidth and enable more strategic allocation of limited onsite resources.

3.Develop A Business Case

Work with a cross-functional team to develop a broader case for enterprise-wide information governance. This team should be comprised of critical stakeholders across the enterprise and include representation of individuals who possess an in-depth understanding of current data types, record retention policies, and specimen storage processes such as Health Information, Laboratory, and IT managers. For example:

  • How and where records, specimens, and data are being stored across your network and in your facility?
  • What are the various processes and inventory management systems being utilized to track and manage information and specimens across the organization?
  • What are the retention and destruction policies for the various information and specimen types – and how are these policies currently enforced?

4.Establish And Monitor Metrics

Measure results including cost savings, operational improvements, and risk reductions — throughout each phase of the journey. This will enable you to refine and optimize as you go.

Overcoming Internal Resistance

There are many common misconceptions driven by “the way things have always been done.” The key is to educate your critical stakeholders on these misconceptions and guide them through an evaluation of the bottom line costs and opportunity tradeoffs associated with a fragmented, onsite approach to records and specimen management.

Misconception 1: Onsite Storage Is Free

Onsite storage:

  • Strains the limited bandwidth of your full-time employees and hinders the ability to focus on mission-critical initiatives.
  • Requires the routine allocation of additional resources and budget to update space, workflows, and systems to accommodate growing volumes of records and specimens.
  • Forces providers to forego incremental revenue that could be realized by reallocating existing storage space to research, accelerating patient throughput, or supporting new tests.

Misconception 2: The Way We’ve Always Done It Works Just Fine

The success of a value-based system requires rapid access to reliable information across the care continuum. The decentralized management of paper records, electronic records, and laboratory records and specimens:

  • Hinders the integration of information and systems across the continuum of care.
  • Creates pockets of inefficiencies and risk across departments within the organization.
  • Limits your organization’s ability to view a unified patient record in today’s increasingly electronic environment.

Misconception 3: Onsite Equates To Better Access And Efficiency

Increasing pressure to do more with less:

  • Makes it difficult to apply the full scope of resources required to effectively and continually scale space to meet demand, maintain inventory integrity, and sustain compliance.
  • Leaves in-house storage programs bogged down by outdated tracking systems, and plagued by long queues of projects to be completed when bandwidth of existing resources frees up.


In order to survive in these competitive, cost-conscious times, you must be willing to proactively peel away the layers and logic surrounding legacy processes and, where necessary, restructure and reallocate resources within your organization. If you do this successfully and comprehensively it will increase operational efficiencies, accelerate the integration of information and systems across the organization, and continue to advance your competitive position in today’s increasingly difficult healthcare environment.

About Iron Mountain

Iron Mountain Incorporated (NYSE: IRM) provides information management services that help organizations lower the costs, risks, and inefficiencies of managing their physical and digital data. Founded in 1951, Iron Mountain manages billions of information assets, including backup and archival data, electronic records, document imaging, business records, secure shredding, and more, for organizations around the world. Visit the company website at for more information.