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Data Governance – The Healthcare Gap

Public Healthcare is spoiled for Data Governance at a Federal level.

Whether or not the industry realises it, there are 25 committees in Australian Institute of Health & Welfare (AIHW) alone to develop and work through data set specifications and information needs for our federal health statisticians. There’s a plethora of organisations that meet and discuss information agendas, policies, goals, standards, and metadata at the national level. We have a National Health Data Dictionary, standardised code sets and terminology, and National eHealth Transition Authority (NEHTA)’s Unique Health Identifiers (UHIs) amongst other initiatives.

But how does that translate to the state level? How does that trickle down to the individual institutions and in to the private sector?

How does the ward clerk or administration assistant know how you have defined an Occasion of Service by Mode of Telephone?

Therein lies the problem.

With such a top-heavy array of committees and healthcare reform programs how are the states, or even institutions, managing to keep up with it all?

So let’s focus on one big factor here – the Individual Health Identifier (IHI) brought in by NEHTA. The IHI is intended to be the one identifier that follows someone their whole life and is used by healthcare institutions to resolve identities. This provides the capacity to link health records across systems, institutions, or jurisdictions. In the event you have a patient presenting with a common name such as John Smith it will aid in ensuring you have the right ‘John Smith’ when prescribing a medication that does not trigger his allergic reaction.

NEHTA recommends  your organisation meets a minimum data quality maturity rating of 3 against their framework and maturity model, not to mention have also tackled managing the single view of patient across your systems through the use of a Patient Master Index (PMI) or similar. NEHTA has already had some pilot sites operating with the IHI but this has proven to expose the actual reality of underlying data quality issues – not a pretty sight!

So how are healthcare organisations handling this?  The answer is they’re still struggling to cope and have not yet tackled the real issue – effective Data Governance and Stewardship programs. The technology may be present, where are the people and process dimensions to accompany it? Some of the initial questions arising are:

  • What data elements are necessary for your master data records?
  • How has the organisation defined the Stewardship for each data element?
  • Who has determined the correct classifications and what will be standardised?
  • Who is accountable for the data at the source or once its hit their MDM solution?
  • Who has the expertise to act as a Steward for such critical data?
  • How will the organisation proactively manage upcoming initiatives or react to reform in relation to their data?

Is your organisation equipped with the people and processesto manage the technology across systems, business units, and facilities? Orwill you be balancing patient outcomes on the great unknowns? Healthcare reform initiatives bring an exciting road ahead for the industry, but it is a long and windy road.