Information Governance: The Key to Advancing Laboratory Workflow and Outcomes

In this era of ever-changing technology, we are tasked with managing the nonstop influx of data and information that drives that technology. We strive to improve patient care outcomes and patient satisfaction scores, eliminate workflow inefficiencies and work-arounds, manage our increased workloads, and utilize our analytic capabilities to determine ways to reduce lab errors and refine current processes. The answers to all of these challenges are at our fingertips, but we often don’t have the right infrastructure in place to extract the value from our abundant information resources. Unstructured data swarm our systems, leaving us data rich but information poor. It is time to take an approach that allows organizations to look at information more holistically and treat it as a valued asset.

Information governance (IG) is an enterprise-wide framework that helps ensure we maximize the value of trusted information, while simultaneously reducing the consequences associated with using flawed data and information, as we continue to make important business and clinical decisions.

We often see an organization’s staff working in individual and departmentalized silos. Clinical, laboratory, health information management, and other business units all use clinical records in their workflows to complete daily tasks. However, do we ever question the coordination of the disparate systems or information sources that we are working with? Are there processes in place that ensure each system contains the most up-to-date, accurate, and complete record? Can we trust that our patient records are not duplicative and that they capture the full story as we determine the best care plan or diagnosis for each patient?

These are questions that we must be able to confidently answer to ensure that we can rely on our information resources. We can no longer follow the faith-based approach and assume that the information is correct. We have to implement controls, technologies, policies, and procedures that will give us the confidence we need to successfully perform our duties and positively influence patient care and other clinical outcomes.

The American Health Information Management Association (AHIMA) defines IG as “an organization-wide framework for managing information throughout its lifecycle and supporting the organization’s strategy, operations, regulatory, legal, risk, and environmental requirements.”

As a way to apply this definition, AHIMA developed the Information Governance Adoption Model (IGAM) to provide a structured approach for organizations to assess their current state of IG, prioritize IG initiatives, develop an IG strategic plan, measure successes, and determine next steps. Within the IGAM are ten IG competencies. In this article, we will discuss three of these competencies, which support lab functions: enterprise information management (EIM), IT governance (ITG), and analytics.

Enterprise Information Management
In the lab, we aim to standardize processes and validate the outcomes of our findings. It is important that we collaborate with providers and records managers to identify the gaps in our current processes and to create new ways of determining, interpreting, and sharing lab results. Coordinating these efforts requires increased communication across the organization and the governance of information in all stages of its lifecycle. This is where EIM comes into play.

Governance must be in place when information is created, used, maintained, stored, shared, and removed. To be sure that governance is met in all aspects of the information lifecycle and its visibility is increased among the lab, providers, and records managers, our policies and procedures need to reflect how this can be accomplished.

For example, a patient’s electronic health record (EHR) is often first created during the registration process. To ensure accurate data entry and avoid creating duplicative records, staff must adhere to the policies and procedures. Next, the provider adds clinical information to the EHR that can be used to determine next steps for patient care. Then the EHR, along with lab specimens, is sent to the lab for testing and diagnosis. The lab then sends test results and other information back to the provider for interpretation and next steps.

As you can see here, the quality of the information being shared across the continuum of care is critical for accurate results, decision making in patient care, and the general outcomes of our daily job functions. If at any point this information is compromised and cannot be trusted, the decisions we make based on this information are also compromised. It is essential that we effectively manage information so that as we share and exchange it, we can interoperate both internally and externally.

IT Governance
IT investments impact all end-users. Our technology must not only aid in improving efficiency in our daily work functions, but also safely house our data and information assets. When making IT investment decisions, senior leadership should also consult with the business unit leaders outside of IT to ensure everyone’s needs are met and that the IT investments will improve current processes, help resolve usability and interface issues, as well as avoid/reduce unnecessary costs.

Interoperability between business units is a goal we all aim for, but at times does not work as we would hope. Real-time communication among the lab, providers, records managers, and any other essential parties is key to effectively meeting patient care goals. To add to that, we also must make sure that the data and information communicated across the systems are correct, accurate, and not susceptible to breach, corruption, or loss.

Most healthcare organizations have good privacy and security practices around personal health information due to HIPAA regulations. However, IG takes this a step further and requires that all information have the appropriate privacy and security controls around it. Often we have to rely on our IT investments to keep sensitive data and information protected. This is a direct connection to the IGAM competencies IT governance, enterprise information management, and privacy and security, and how they work together under the “IG umbrella,” to manage information assets.

Aligning IT governance initiatives with the organization’s strategy will help mitigate potential risks, reduce costs, and improve the communication of data and information across the entire organization.

Analytics
IG also directly impacts analytic capabilities. We have so much data and information available that, in order to extract business and clinical value from that data and information, we must have the proper technologies, tools, and resources. In addition, the information we use for analytics must be reliable, which supports the value of care that we provide and identifies areas where improvements can be made to patient outcomes by using our data and information more proactively.

In the lab, analytics are imperative for measuring and assessing lab errors, outcomes, and variables. We then implement changes deemed necessary based on the analytic findings. The accuracy of the information, its source, and the IT capabilities of our analytics tools will determine what we improve. Lack of these resources can be detrimental to clinical outcomes, so we must ensure we have what we need in order to properly analyze our information.

Policies and procedures are important too. Multiple sources of information, conflicting data definitions, and a lack of standards need to be addressed. Simple policies and procedures can contribute to successfully implementing necessary changes.

Information Governance Is the Answer
Despite the large amounts of structured and unstructured data and information coming from every which way, we don’t have to lose control. We must be proactive in our current practices and treat information as an asset. Implementing IG may seem cumbersome, but addressing key areas one by one can help make the process more manageable. Leaders in the lab can begin implementing IG by addressing the IGAM competencies referred to above: enterprise information management, IT governance, and analytics. The benefits of streamlining and standardizing the functions among these areas will not go unnoticed. Increased patient safety, risk reduction, cost avoidance, and improved workflows are just a few of the countless benefits of a successful IG program.