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Inside AHIMA's Framework for Healthcare Information Governance

Inside AHIMA's Framework for Healthcare Information Governance

Healthcare historically struggles with information governance. The American Health Information Management Association hopes to change that.

"Overall, information governance programs are less prevalent and less mature in healthcare organizations than is warranted, given the importance of information."

That's the first of the conclusions the American Health Information Management Association reached when viewing the results of its survey on information governance in healthcare.

More than 90 percent of the healthcare professionals surveyed indicated that "high-value information" helps improve care quality, contain costs and analyze clinical, business and financial performance. What's more, 65 percent "recognize[d] the need to formalize information governance practices," AHIMA wrote in its white paper on the topic.

[ Commentary: Do You Even Know What Information Governance Is? ]

That said, only 43 percent of respondents had initiated an information governance program, and only about one in four who had reported "substantial benefits." That's compared to the 22 percent of respondents who hadn't initiated a formal information governance program at all.

Healthcare Orgs Should Treat Data as Strategic Asset

To that end, AHIMA made governance a priority this year, releasing an information governance framework at its convention in September and discussing the framework and its accompanying information governance principles at the College of Healthcare Information Management Executives CHIME 14 Fall CIO Forum in October.

The framework represents the "cornerstone component" of AHIMA's information governance efforts, says Gretchen Tegethoff, who sits on the CHIME Board of Trustees, but it's not meant to replace the programs that healthcare organizations may (or, for that matter, may not) already have in place. Think of it, she says, as a plan for treating data as a strategic asset.

Information governance practices must remain consistent and collaborative across an organization, Tegethoff says. Just like data itself, governance is of little value if it remains in a silo.

Deborah Bass, CEO of the Nebraska Health Information Initiative, outlines AHIMA's eight information governance principles thusly.

  • Accountability: Senior leadership must be responsible for the oversight of information governance.
  • Transparency: The policy must be documented, open and consistent with business needs.
  • Integrity: Data must be authentic, reliable and complete.
  • Protection: Data must be safe from breach, corruption and loss, as this is essential to business continuity.
  • Compliance: The policy must adhere to all applicable laws, regulations, standards and organizational policies.
  • Availability: Data retrieval must be timely, accurate and efficient.
  • Retention: The policy must take into account legal, regulatory, fiscal, operational, risk and historical requirements.
  • Disposition: Data that an organization is no longer required to maintain should be properly disposed of -- with the understanding that this process can be suspended for legal or regulatory reasons.

Information Governance Requires 'Collaborative, Interdisciplinary Approach'

Along with the information governance framework and guiding principles, AHIMA is drafting a five-level maturity model to help healthcare organizations determine where they stand.

Mary G. Reeves, associate vice president of health information management and operations and clinical documentation improvement at RegionalCare Hospital Partners, acknowledges that information governance isn't easy. You'd be hard-pressed to find any organizations that have achieved level five, or "transformational," information governance, she says.

[ Related: New Role for CIOs: Governance for Data Analytics ]

Most should aim for level three ("essential"), focusing primarily on the principles of data availability and integrity while also setting a timeline and goals for addressing the remaining principles. Upon reaching level four ("proactive"), organizations may want to consider a dedicated information governance role. It need not be a C-level role, Reeves says, "but someone needs to be in charge of it."

Information governance must continue to mature if healthcare intends to achieve the oft-cited triple aim of improving health, advancing care and reducing costs, AHIMA writes in the conclusion to its white paper. Organizations won't achieve that maturity without taking a "collaborative, interdisciplinary approach," AHIMA says.

That will take time. As noted, AHIMA's information governance maturity model remains in development. So, too, does a set of guidelines for making governance operational. However, simply understanding what information governance means helps healthcare organizations make use of their terabytes of data. That's certainly a good start.

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