Class: Health Data Management Assignment: Future of HIM, Information Governance Presentation Note: This is a Power Point not a paper. For this assignment, you assume the role of manager of Electronic

The Webinar focused on three key points: 1) how future health care costs are often overlooked in retirement planning; 2) ways that employers can help employees understand how their lifestyle today may affect health care costs when they are retired; and 3) how the Optum Health Savings Checkup tool (healthsavingscheckup.com) can illuminate health costs in retirement.

This article recaps the Webinar discussion and offers additional At Presstime Nearly 20 Percent of Teen Births Are Repeat Births Although teen births have fallen over the past 20 years, nearly one in fi ve teen births is a repeat birth, according to a Vital Signs report from the Centers for Disease Control and Prevention. More than 365,000 teens, ages 15 to 19 years, gave birth in 2010, and almost 67,000 (18.3 percent) of those were repeat births. A repeat birth is a second (or more) pregnancy resulting in a live birth before the age of 20.

Almost any pregnancy during the teen years can change the lives and futures of the mother, child, and family.

Infants born as a result of a repeat pregnancy are also more likely to be born too soon (premature) and born too small (at low birth weight).

Data from CDC’s National Vital Statistics System show that repeat teen births in the United States decreased by more than 6 percent between 2007 and 2010, but the number of repeat births remains high. Repeat teen births were highest among American Indian/ Alaska Natives (21.6 percent), Hispanics (20.9 percent), and non- Hispanic blacks (20.4 percent) and lowest among non-Hispanic whites (14.8 percent). ■ Moving the Needle toward a Data-Driven Health Care System: Optimizing the EHR through Information Governance Sandra Kersten The recent 2013 HIMSS National Meeting provided a glimpse into a more mature electronic health record (EHR) environment, where quality, performance improvement, patient engagement, and reimbursement models are under close scrutiny and strate- gies addressing those topics center around EHR. Across the board, the message was clear that the EHR has progressed from implementation to optimization and that provider organizations are beginning to realize the benefi ts of EHR technologies in their service delivery models, using them to better support clinicians in utilizing best practices of care as well as a means to capture data that provides evidence of care quality; they also can be used for decision-making. Volume 26, Number 9 • May 1, 2013 (See Moving the Needle… page 3) (See Adequately Planning… page 6) May 1, 2013 ■ Managed Care Outlook ■ Page 3 But how do organizations move from imple- mentation to optimization? In spite of health care reform’s focus on data-driven care, organizations still face many challenges in getting and using the right data. The organizations that are doing it best describe multi-phased, multi- disciplinary approaches to getting the right information out of their EHR and, in fact, all their hospital information systems. Management of information across the enterprise, through information governance (IG), can help organi- zations optimize their technology resources to become data-driven.

Hawaii Pacifi c Health, the 2013 Davies Award Winner from HIMSS, set a goal of demonstrating a return on investment (ROI) from its EHR to kick start its efforts in maximizing the EHR.

The company focused initially on a revenue cycle measure, improving (decreasing) its “cost to collect” as a means of demonstrating its ROI.

To address the problem, the company gathered a multidisciplinary team with representation from fi nance, information systems (IS), patient safety, health information management (HIM), clinical staff, and other frontline users (such as registration and scheduling staff ).

Tackling the problem from the perspective of the data, the company fi rst had to agree on which data was critical to understanding and/or solving the problem. Early on, Hawaii Pacifi c realized that a lack of standardized internal defi nitions was making it diffi cult to apply con- sistent measurement across the organization.

The organizational team, in coordination with their vendor, came to agreement on key data and defi nitions that were needed (what was the point of collection; was it coded data or data generated directly from the patient encounter; if there were multiple collection points, which system or data fi eld was the source of truth).

They were able to identify areas where data was not captured accurately (basic data did not match across various reports and/or functional areas) and develop a solution to get it corrected (determining whether it was a people, process, or system issue) to bring improvements to the patient administrative workfl ows.

Once they achieved success in the revenue cycle cost of collection indicator, they turned their attention to clinical quality indicators, making signifi cant improvements in obstetric and pediatric care and, ultimately, using their EHR and other information systems to bring improvements to the population health of their care constituency, with outreach to patients for screenings and chronic disease management.

To make this happen, the organization made it a priority to get maximum value from its technology systems and the data. The company recognized the value of the information as a key resource and asset in achieving quality of care and used the data and its EHR to achieve improvements in its bottom line and clinical quality of care.

The recognition that the information is a valued asset is a key fi rst step in information governance (IG), a structured approach to managing the information systems and data of an organization. An information governance program sets a structure of accountability for the information assets, sets priorities for the overall management of the organization’s information systems and data, and ensures policies and procedures are available to guide the appropriate use of data, from initial capture through retention or disposition.

A fully established IG program must address information quality, the information lifecycle, security and privacy of information, and data and documentation standards. When Hawaii Pacifi c Health focused on improving its bottom line through its information assets, it focused on the information quality aspect of IG, drilling into the data to determine what it really needed and how to get it accurately captured.

Where does your organization fall in the information governance spectrum? If you are not aware of an established data or informa- tion governance program, you can do a quick Moving the Needle...

(from p. 1) ( See Moving the Needle… page 5) May 1, 2013 ■ Managed Care Outlook ■ Page 5 Cities for Workforce Health Launched to Improve Health of California’s Municipal Workers: With the goal of improving the health and wellness of municipal workers across the state, the League of California Cities and partners announced the launch of Cities for Workforce Health. Together, the League of California Cities, Kaiser Permanente, the Healthy Eating Active Living Cities Campaign, and Keenan & Associates will provide wellness tools and resources to all 482 California cities.

Cities for Workforce Health provides evidence- based wellness programs developed by Kaiser Permanente to help control overall health care costs for cities and supports the League of California Cities’ ongoing efforts to build healthy and sustainable communities. Cities for Workforce Health is designed specifi cally for cities to affordably phase-in employee engage- ment and build stronger wellness cultures over time. The fi rst phase of the program connects all League cities to Kaiser Permanente’s free online health and wellness tools and resources to help develop communication and imple- mentation plans, develop senior management support, and prepare them to achieve successful results from employee wellness. Later phases will be introduced throughout 2013. ■ West pulse-check of your organization’s information assets with these questions: When you try to get information or data to solve a problem, is there a clear way or place to get it (dashboards, current reports, et cetera)? Once you do get it, is the data in good shape, and ready to use, or does it need a lot of re-work? Does it seem that every data project requires cleanup of the data?

Do one or more persons have responsibility for data quality, ensuring that data is collected appropriately and consistently? These are all facets that should be addressed in an informa- tion governance program.

Where do you begin, if a program is not already established? The place to start is with executive leadership. If you are an end-user of the information, raise awareness of the need for information governance with your executive leaders. Whether you are in an executive leader- ship role yourself or an end-user, here are some ideas for determining an approach:

• Sell the idea to obtain executive-level champions.

• You can start from anywhere. It makes sense to begin with what you know. Set priorities around the data you know most about or the data that is most visible across the organization.

Determine where the data originates (is there a sole source, or can it come from multiple points and systems) and how you can improve the quality and reliability of that data.

• If you do not have executive-level support, work from the bottom up to make progress on your own. Focus on policy development.

Research external requirements, and develop policies that will support them.

• Develop strategic partnerships or alli- ances (such as information technology (IT), business/operations owners, legal, fi nan- cial disclosures). You will need input and involvement from all these groups for the long-term success of your IG program.

• Expect to take at least 12 to 18 months to establish your program if you are starting from the beginning.

An information governance program is criti- cal for maximizing your EHR and other infor- mation systems to get accurate and actionable data that can help your organization achieve improvements in care and costs. Developing a program that engages critical owners (clinical, legal, compliance, HIM, IT, fi nance, et cetera) and has executive-level champions will help ensure your success. ■ At the time of this writing, Sandra Kersten, MPH, RHIA, was Director of HIM Practice Excellence at the American Health Information Management Association (AHIMA). For additional information, email [email protected]. Moving the Needle...

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