Healthcare's Value Transformation: The Enterprise Information Management and Governance Imperative
Healthcare’s Value-Transforming Goals
The healthcare sector is focused on improving and demonstrating value, with value defined as the outcomes achieved per dollar spent. The key levers for transforming healthcare are reflected in the goals of most healthcare organizations and include:
- Population health focuses on outcomes for cohorts of patients over time. It advances
care coordination based on enhanced understanding of the factors that put patients at
risk and what works best to mitigate risk and improve results. Its focus goes beyond the
healthcare entity to a range of health determinants including those in the community.
- Value is also the focus for a range of payment models that factor risks and rewards into
result-based payment. Whereas fee-for-service payment was an accumulating process,
value-based payment is an analytic process. Along with payment reform, value is
advanced as costs become more transparent.
- Achieving and demonstrating high quality and safe practices is also a value-enhancing
goal for the enterprise. While a key goal for healthcare organizations for decades, the
quality and safety priorities are now driven by the value imperative, in addition to external
- Finally, value is enhanced as consumers shed their passivity and actively engage with
providers and health plans to achieve the best outcomes at the right costs.
Each of these value-transforming goals becomes more urgent as revenues are declining,
margins are shrinking and patient and societal need is growing. Each lever is a gamechanger,
but transformation requires that all be advanced with thoughtful and determined
purpose. Leadership and vision is a prerequisite, but so is the need for accurate information
that is properly managed throughout its lifecycle.
Advancing each of these transformative goals requires trusted information
and a purposeful strategy for managing and governing that information.
Information is an asset, and like other organizational assets, its stewardship
and management can’t be left to chance. And if it is to be up to the task
of enabling transformation, this irreplaceable asset must be governed and
managed across the enterprise and throughout its lifecycle.
Information Governance defines the organization’s intentions, principles
and policies – the rules of the road - for how information can be managed
and used. It also ensures that all practices are in compliance with legal
and regulatory requirements. However, Information Governance depends
on effective information management. So, to advance transformative
change, healthcare organizations need sound information governance and
information management practices across the enterprise..
Each of healthcare’s transformation challenges has unique information
governance and management requirements that are described in this White
Paper; they all share three essential requirements:
- Information is managed as an asset to realize full return on investment.
- Information governance is formalized across the organization for all types
- Information management executes on governance policies and brings
forward new issues that require governance
Improving Population And Community Health
Population health refers to achieving
the best potential health outcomes
for a group of individuals. Though
long the focus of public health,
population health is now a goal for
healthcare providers and payers.
Taking greater responsibility for
health and wellness doesn’t stop at
the hospital door; it extends to life
in the communities served by health
Improving the health of populations
requires assessing and managing
information across a range of
determinants of health including:
medical problems and conditions, and
care received; personal behaviors
and lifestyle; genomics; and a
broad range of social, geographical,
environmental and economic factors.
Expanding the focus of providers and
payers from the individual to groups
of individuals and their families and
even the communities where they
live is a game-changer for the health
Advancing population health and
improving health in the community
requires expanded capabilities to
collect, aggregate, use and manage
information across its lifecycle.
Investments in electronic health
records have paved the way for
a population focus, but analytic
systems must be added to the
transaction systems, and enterprise
information governance and
management must replace siloed
approaches. Most organizations are
still relatively early on this transition.
However, having population and
community health improvement as
a clear goal does focus attention on
Specific information priorities
required to advance population and
community health include:
- A longitudinal health record
combining care encounters over
- Approaches for protecting the
identity of individuals and groups.
- Security, access and disclosure
management of individual records
- Access to and analysis of clinical,
financial and health determinants
- Application of a range of statistical
and algorithmic mechanisms to
assess and predict risk.
- Lifecycle management of
information in all forms from
individual records to large-scale