It happens more often than you might think. A migration project is completed. Clinical legacy data is securely available in a new location. People begin to access the data for use, and bam, something doesn’t look right. Workflows are immediately interrupted, questions ensue, and relationship tensions heighten between users and IT.
Tens of billions have been spent on new EMR and Pop Health software in the last two years. Billions more will be spent in the years ahead. Tens of millions in fines have been levied for PHI breaches. Millions more will be levied in the years ahead. Billions more have been spent on maintaining legacy systems. What’s at the center of it all? Data. How do providers, collect it, protect it, archive it and make it useful for providing care?
Data stewardship. What is it exactly? And why does it matter in healthcare? Before answering those questions, I wanted to better understand what other industry people think. So I Googled it. While I have more than 2 decades in the healthcare data space, the one thing I've learned is that change is the only constant. As a result, I am always learning...learning from my customers, learning from my team, learning from other subject matter experts.
So back to the aforementioned Google search on this concept of data stewardship and how others in the industry view it. In short, most industry people view data stewardship as the tactical execution within the strategic umbrella of data governance. One perspective noted that governance is not about the data, rather the people and process for managing an asset. In this case, the asset is the data. Each person is entitled to their own perspective.
Experience, however, has taught me a different perspective. Data stewardship is both strategic and tactical. More importantly, it's a purposeful perspective of data as something of value entrusted to your care for responsible management and use. In healthcare, providers don't actually own the data. Most of the data belongs to patients and the communities they serve. Those data owners entrust providers with information that will hopefully contribute to helping them receive the best care possible. Need proof about who owns the data? Look no further than the regulatory requirements for maintaining and protecting PHI.
With that alternative perspective about data stewardship, let’s now explore where it all begins. It begins with understanding the attributes of the environment. That includes stakeholders and roles, regulatory requirements, tools, and available resources. Unfortunately, stewardship often takes a back seat to a race to retire aging legacy systems. While there is a reasonable sense of urgency to do so, based on things outside one’s control (like a flickering green screen, or a looming maintenance renewal), leaders must think strategically. Tactically mitigate risk in the short term while investing time and resources in thoroughly understanding the whole of the current environment. Use a SWOT to model a complete picture. If you are thin on resources and/or expertise, consider using a third party. Sometimes we are too close to a situation to be objective. A qualified third party can go a long way to ensuring objective perspective.
From there, a provider organization needs to create a data stewardship governance framework identifying owners, policies, process and priorities. Ahhhh, priorities. That’s a tough one. The best practice for identifying priorities is to keep things simple. Follow the stellar advice of Jim Collins, Author of Good to Great… “If you have more than three priorities, you have no priorities.” Whether a goal or major pain point, focus on the priorities that directly support the board-approved organizational strategic priorities. It’s the best practice for maximizing the probability of buy-in from stakeholders. One additional note: over-communicate with the entire organization. While it’s not prudent to communicate every detail, dangers, and the like, people still need to know that change is afoot and WHY.
Thirdly, invest time to build a roadmap for creating and preserving the ideal environment of data stewardship. It’s best for the governance team to guide the effort and involve input from multiple stakeholders across the organization. This is far more than an IT initiative. This is an organizational imperative. Still a smaller team must own it, socialize it for feedback, and ensure the objectives are properly managed to completion. In most communities, data has a minimum shelf life of 7-10 years due to regulatory retention requirements. In some communities, data must be kept in excess of 20 years. A cornerstone of retaining and securing data over time means retiring vulnerable and/or costly legacy systems. Creating the right path for this extensive work is critical to optimizing resources, maintaining compliance, and reducing costs…all results that support achieving an ideal environment of data stewardship.
Tune in next time as we cover why and how active archiving serves as a best practice in support of true data stewardship.
Tony Paparella, President