Bowtie Confidential 6/7/13

Healthcare Data Governance and Data Stewardship

There is a wealth of articles about data governance, including one that I wrote earlier for HIStalk. It is becoming clear that in today’s complex healthcare environment, data governance and ownership are emerging disciplines with evolving definitions.

As the data-driven healthcare environment provides benefits (e.g., data aggregation enables more efficient care delivery, decision support systems, etc.) and the potential for risk/harm (e.g., incorrect data entry), the industry is realizing the importance of accurate healthcare data, which is dependent on technology.

Through data governance, organizations exercise control over the processes and methods used to input, aggregate, use and re-use data. Data stewardship is an evolving role in this space. The disciplines need to be seen as more than an IT responsibility and as the responsibility of end users as well.

To realize data’s full benefits and minimize potential risk, care providers and others with access to health data must follow sound data stewardship policies and procedures which address the security and privacy of patient data and the quality and integrity of data collected, stored and currently (and prospectively) used.

The data stewardship role is responsible for working with and managing data in terms of integration, consistent definitions, structures, metrics, derivations, etc. – strategic and tactical views of data that will enhance quality, metrics/reporting and efficiencies and effectiveness in delivering care. Both identifiable and de-identifiable data is included within this context. Healthcare environments will need different operations and solutions. However, the presence of data stewardship (an owner or custodian with authority and accountability for the use of health data) is needed.

What is data stewardship?

Healthcare data stewardship’s main objective is the management of the organization’s data assets to improve usability, accessibility, and quality. The data steward works with technology database administrators, data warehouse staff and others to:

• Assist with approval of clinical and business naming standards
• Develop consistent data definitions
• Determine data aliases
• Develop standard calculations and derivations
• Document the business rules of the corporation
• Monitor the data quality in the data warehouse
• Define security requirements

As the demand for data warehouses (with reliable and “quality” data) has grown, so has the need for a data stewardship function. An integrated, enterprise-level view of the data provides the foundation for the shared data that is so critical in the data warehouse.

A typical healthcare organization should consider assigning one data steward to each major clinical/business / operational data subject area. These subject areas include business office, registration (admitting), radiology, laboratory, pharmacy, cardiology, etc. The size of the organization will dictate the number of data stewards needed. A small practice may need just one to oversee all of the data.

The data steward usually works with a select group of employees representing the assigned subject area. This “committee of peers” is responsible for resolving integration issues concerning their subject area. The results of the committee’s work are passed on to the data administrator for implementation into the corporate data models, meta-data repository, and ultimately, the data warehouse construct.

Just as there is a data architect in most data administration functions, there should be a "lead" data steward responsible for the work of the individual data stewards. The lead’s responsibility is to clearly establish each data steward’s domain.

With data stewardship and enhanced governance, an organization can improve data quality, protect sensitive data, promote efficient information sharing, provide trusted business-critical data, and manage information throughout its lifecycle. The data stewardship program enables organizations to develop a strategic approach to utilizing data as an asset to ensure the security and privacy of the data for/of their patients. The program can improve financial performance, increase operational effectiveness and efficiency, and allow full compliance with regulatory requirements.

Of course, it is not about data alone. Data stewards must work with businesses to map collection needs and, where possible, find better or more efficient sources. Then, the steward can create appropriate use policies to limit the collection of unnecessary data and, later on, audit data practices to ensure business compliance.

Data stewardship enables organizations to improve financial performance, increase operational effectiveness and efficiency, and allow full compliance with regulatory requirements.

Rob Drewniak is vice president, strategic and advisory services, for Hayes Management Consulting.