Healthcare's Value Transformation: The Enterprise Information Management and Governance Imperative

Topics: Healthcare IT Management | Health Information Governance

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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 reporting requirements.
  • 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.

Information-EnabledTransformation

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 of information.
  • 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 systems.

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 system.

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 key capabilities.

Information Priorities

Specific information priorities required to advance population and community health include:

  • A longitudinal health record combining care encounters over time.
  • Approaches for protecting the identity of individuals and groups.
  • Security, access and disclosure management of individual records and databases.
  • Access to and analysis of clinical, financial and health determinants data.
  • 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 databases.

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