Healthcare needs to address information governance

By Rosie Lombardi

Andrea BacqueMany emerging trends, from the Internet of Things to consumer demand for healthcare information, are creating new risks because healthcare information is spilling out of its previously protected domains. “We don’t have or apply standards in consistent ways for managing information across the healthcare ecosystem. Provinces are being driven to develop these themselves but each province has their own view of that. That might not be the best scenario for a Canada-wide e-health objective,” says Andrea Bacqué (pictured), director of Canadian Solutions at Iron Mountain, a global security company.

Bacqué is co-chair of the recently-formed Information Governance (IG) Summit’s Steering Committee, along with Kathleen Addison, board chair of the Canadian Health Information Management Association (CHIMA) and Senior Provincial Director, Health Information Management at Alberta Health Services (AHS).

“Many pockets within organizations manage their healthcare assets properly, but there’s very little formalized rigor and consistency in the way these assets are treated across organizations,” says Addison.

“Information Governance is broader than Health Information Management. We wanted to assemble a Think Tank of Thought Leaders around IG together so we could collaborate and identify whether Information Governance is an emerging discipline in the Canadian healthcare context.”

The first-ever IG Summit was held in Edmonton, Alberta. Several healthcare information experts and leaders from a number of Canadian organizations attended the IG Summit, as well as members from the American Health Information Management Association (AHIMA), which has made IG top of mind in recent years.

IG needs to get more attention in Canada, says Bacqué. “CHIMA, with the support of Iron Mountain, created a Steering Committee and held the Summit because we felt that this topic needed to be elevated across Canada.”

Proper IG is important as systems and devices grow more interconnected, and the ways information is used expands, she says. Agreed-upon rules and standards are needed to ensure trust across the healthcare industry as information flows in and out of disparate systems and organizations.

The current state of neglect is creating problems that will be difficult to address in the future, she adds. For example, one issue that Summit participants discussed was the application of data-mapping standards when moving to the e-health record state.

“What are the data fields and related data mapping standards that we want to consistently apply to the e-health record so that when we’re searching for information on a patient across a province or region, we can expect to find similar patient information? At present, nobody is leading in developing Canada-wide data mapping standards. And each eHealth system vendor will have their own approach. This makes it a challenge when you’re trying to create one record with multiple systems in play.”

Some domains of IG are more mature than others, adds Addison. For example, an incorrect patient name in a hospital database holds risks – it can prevent searches for the right patient’s records, which in turn can compromise patient safety and have other adverse effects.

“There’s a lot of emphasis on the privacy and security domain, but if you look at data quality, there’s a huge amount of work there. Common data standards, with the appropriate metadata, are ultimately needed to enable systems to interoperate.”

Three central questions were discussed by participants of the IG Summit:

Why is healthcare IG important in Canada and why do we need it now?

What should be included in the Canadian IG definition and framework?

What recommendations can be made to the CHIMA board to help them champion and examine this domain of practice?

The participants provided a great deal of valuable input, claims Bacqué. “What we plan to do next is to create a positioning paper on the insights gathered at the Summit that can be delivered to various healthcare governing bodies. The IG Steering Committee, CHIMA and Iron Mountain plan to further develop recommendations brought forward at the Summit, specific to championing an IG definition and framework.”

Various parties need to collectively come together at the federal, provincial, regional and local levels to help develop IG, she adds.

“Ideally, there would be national support on the creation and/or adoption of the standards that should be adhered to on how to govern and manage information across Canada. This isn’t anything we need to create from scratch, as there are already international models we could use as starting points.”

Canada lags the U.S. in sorting out its IG rulebook, and Canadian leaders need take action.

“The lack of standards is impacting our uses of information today and will impact our expanded uses in the future. There are a growing number of systems and devices that we’re accumulating. It’s affecting interoperability and escalating healthcare costs. If there were better standards and rules of the road, we get some of this under control.”

Most healthcare leaders are well aware of the problems lack of IG causes, adds Bacqué. “I think the issues of information quality, ownership and access are probably top of mind for all of them. I would say that Health Information Management (HIM) owners are the ones that have been most conditioned to focus here. But the problem is greater than HIM. It goes beyond this domain to affect the overall healthcare ecosystem. We need their help in championing IG standards and policies, and enable various healthcare governing bodies to act.”