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Working Smart a professional practice forum
  ARRA on the Job / e-HIM Best Practices / Data Standards / Legal e-Speaking




Easing e-Discovery
The Electronic Discovery Reference Model and the Information Management
Reference Model
By William S. Horn, MBA




T
The elecTronic Discovery reference Model (eDrM)                        vendors were able to map their products and services to steps in
project offers guidelines and standards for e-discovery. it has        the process and to use industry-defined terms to describe their
helped reduce the cost, time, and manual work associated with          offerings for customer comparison.
e-discovery and has proven to be invaluable to those engaged in          The sidebar offers a high-level description of the model.
litigation support since its creation in 2005.                           The eDrM has been enormously successful in defining the e-
   now this model is traveling upstream in order to provide the        discovery process not only for vendors and customers, but also
same benefits to records and information management profes-            for the courts and regulators. The group’s standards have led to
sionals. in particular, a subgroup is dedicated to providing a         additional guidelines by the sedona conference and changes to
healthcare-specific viewpoint in the information Management            the Federal rules of civil Procedure governing the interaction
reference Model.                                                       between parties in federal court proceedings.

EDRM—A Common Framework                                                IMRM—Moving Upstream
in order to understand the growth and impact of electronically         Technology improvements have made it easier to find informa-
stored information, imagine the following scenario. A hospital         tion. however, they have also highlighted some problems:
receives a request from a federal court for all information relat-       xx x atax storagex isx growingx unchecked.x Organizationsx arex
                                                                            D
ed to patients who are potentially part of a class action lawsuit           creatingxmorexdata,xbutxe-discoveryxhasxrevealedxthatxtoox
involving a regulated drug or medical device. The court requests            manyx arex notx managingx itx throughx thex entirex lifecyclex tox
electronic health records, all medical images, e-mail communi-              disposition.x Thisx excessivex volumex increasesx thex riskx ofx
cations, medical bills, and any other type of electronic informa-           findingxdamagingxinformationxandxe-discoveryxcosts.
tion for dozens of patients over several years.                          xx x txisxtooxhardxtoxfindxallxrelevantxdata.xDepartmentsxsome-
                                                                            I
  requests such as these led to an influx of vendors with tech-             timesxoperatexindependently,xandxlegalxteamsxunfamiliarx
nology products and services designed to quickly find and pre-              withx thex businessx operationsx andx informationx manage-
pare relevant information for presentation to a court or regu-              mentx lackx ax comprehensivex viewx ofx wherex thex datax theyx
lator. Unfortunately, customers evaluating different vendors                needxarexstored.
found it challenging to make an “apples to apples” comparison.           xx x Txdepartmentsxdoxnotxhavexcontrolxoverxcopiesxofxdocu-
                                                                            I
vendors too found it frustrating to differentiate themselves from           ments.xItxisxnotxenoughxtoxdestroyxanxoriginalxdocumentxorx
others in the marketplace.                                                  e-mailxatxthexendxofxitsxlifecycle.xCopiesxarexstillxdiscover-
  litigation attorneys George socha and Tom Gelbmann con-                   ablexandxposexthexsamexrisksxandxcosts.xInxfactxitxisxworsex
firmed these issues with an industry survey and subsequently                ifxlegalxcounselxreportsxtoxthexcourtsxorxregulatorsxthatxthex
founded the eDrM project to define the e-discovery process in               dataxdoxnotxexistxonlyxtoxfindxaxcopyxlater.
a simple model with common terminology. Through this model,              xx x rganizationsxlackxaxcomprehensivexrecordsxholdxprocess.x
                                                                            O

44 / Journal of AHIMA January 10
Electronic Discovery Reference Model

  ThE EDRM DEfInES the e-discovery process in a simple model with common terminology, which offers vendors a way to
  map their products and services to steps in the process and use industry-defined terms to describe their offerings for cus-
  tomer comparison. The volume of information handled, represented by the yellow triangle, decreases as the process pro-
  gresses. The green triangle represents the relevance of the information handled, which generally increases in tandem with the
  decreased volume.


                                                                                  Processing


                                                      Preservation


      Information           Identification                                          Review                     Production              Presentation
      Management


                                                       Collection


                                                                                   Analysis




       VOLUME                                                                                                                          RELEVancE
                                             Electronic Discovery Reference Model / © 2009 / v2.0 / edrm.net


  Information management: getting the organization’s                        converting it, if necessary, to forms more suitable for review
  electronic house in order to mitigate risk and expenses                   and analysis
  should electronic discovery become an issue, from initial                 Review: evaluating the information for relevance and
  creation of electronically stored information through its final           privilege
  disposition                                                               Analysis: evaluating information for content and context,
  Identification: locating potential sources of electronically              including key patterns, topics, people, and discussion
  stored information and determining its scope, breadth, and                Production: delivering information to others in appropriate
  depth                                                                     forms and using appropriate delivery mechanisms
  Preservation: ensuring that electronically stored information             Presentation: displaying the information before audiences
  is protected against inappropriate alteration or destruction              (e.g., at depositions, hearings, and trials), especially in native
  Collection: gathering information for further use in the                  and near-native forms, to attempt to persuade or elicit further
  e-discovery process (e.g., processing and review)                         information
  Processing: reducing the volume of information and                        Source: Electronic Discovery Reference Model. www.EDRM.net.



    Oncexlegalxorxregulatoryxactionxisxreasonablyxanticipated,x               The information Management reference Model (iMrM) proj-
    allxrelevantxdataxmustxbexpreserved.xTheyxdoxnotxhavextox               ect was formed to “provide a common, practical, flexible frame-
    bex collectedx immediately,x butx theyx cannotx bex destroyed.x         work to help organizations develop and implement effective
    Destructionxofxdataxsubjectxtoxaxholdxisxspoliation.xRegu-              and actionable information management programs.”1 The proj-
    latorsx havex imposedx substantialx finesx forx spoliation,x andx       ect seeks to engage legal, iT, records management, and business
    judgesxhaveximposedxadversexinferencexinstructionsxtoxju-               stakeholders and provide a common reference for discussion
    ries,xtellingxthemxtoxassumexthatxthexdataxdestroyedxwerex              and decision making based on an organization’s needs.
    incriminating.x
                                                                            A Healthcare-Specific IM Model
  For these reasons, the eDrM team decided this year to attack              The project kicked off with a meeting in May 2009 attended by
the first box of the eDrM diagram, information management.                  30 or so volunteers representing consulting firms, software com-

                                                                                                                            Journal of AHIMA January 10 /45
Working Smart a professional practice forum
  ARRA on the Job / e-HIM Best Practices / Data Standards / Legal e-Speaking

panies, service providers, and corporations in several industries         The iMrM will be published in draft form for comment in ear-
who came to the table with business, legal, and iT backgrounds.        ly 2010 at www.eDrM.net. it will include a high-level diagram
  The healthcare industry stood out as unique as participants          and glossary describing the types of information systems, roles
discussed their experiences in information management. ev-             of key stakeholders, and the relationships between them. it will
eryone had heard the healthcare reform discussions stressing           also include a detailed maturity model for benchmarking.
the need for a migration to electronic health records manage-             The model will describe four levels of information manage-
ment. Most had worked in industries that had been automated            ment maturity with regard to the distinct stages of the infor-
and electronically integrated with business partners for years, if     mation lifecycle, the recognition of roles and responsibilities
not decades.                                                           stated in policies and procedures, the rate of adoption among
  Members were aware of digital automation in pharmaceutical           the workforce, the level of integration between stakeholders’
and insurance companies and knew that larger hospitals gener-          systems, the governance structure of the information program,
ally had system applications, but the degree of penetration in         and the monitoring capabilities for continuous improvement.
the provider community and the integration between business               it will also have a risk assessment component so that organi-
partners seemed to be lacking. it struck the group that if it could    zations can measure gaps based on current state and desired
build an iMrM specifically for healthcare, the industry may be         levels of maturity and weight those gaps according to impact of
able to avoid some of the mistakes made by other industries as         noncompliance, likelihood of occurrence, alignment with stra-
they automated.                                                        tegic priorities, cultural fit, and ease of implementation.
                                                                          A better understanding of the e-discovery process and re-
                                                                       cords and information management fundamentals will help
                                                                       healthcare organizations reduce legal and regulatory risk as
                                                                       well as reduce e-discovery review costs. A more comprehensive
                                                                       understanding of the information flow will lead to operational
                                                                       efficiencies through end-to-end business process improve-
                                                                       ments. A common understanding of departmental information
                                                                       requirements and a common terminology to describe them can
                                                                       improve purchasing decisions, reducing costs through shared
                                                                       iT applications and better systems integration. These are just a
                                                                       few of the potential benefits of the healthcare iMrM, but clearly
                                                                       it will be an asset as the industry moves to electronic health re-
                                                                       cords.
                                                                          The iMrM will change over time just as the eDrM matured
                                                                       over a few years and continues to evolve. Developing and im-
                                                                       plementing the iMrM will not be trivial. however, information
                                                                       management professionals in the healthcare industry are well
                                                                       suited to the challenge.
                                                                          The iMrM project welcomes participants. More information
                                                                       may be found at www.eDrM.net. ¢

                                                                       Note
                                                                         1. “information Management reference Model.” Available
                                                                            online at http://edrm.net/activities/projects/information-
                                                                            management-reference-model.

                                                                       William S. Horn (william.s.horn@comcast.net) is a management consultant
                                                                       with Cohasset Associates, Inc. and a current member of the EDRM project.




                                                                                    Read More in the Body of Knowledge
                                                                            Read more about e-discovery in the AHIMA Body of Knowledge at
                                                                           www.ahima.org. Search on “e-discovery.” In addition, three years of
                                                                            “Legal e-Speaking” columns offer guidance on HIM practices that
                                                                           support legally sound business records and describe the emerging
                                                                                practice of enterprise content and records management.

46 / Journal of AHIMA January 10

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Jahima Edrm Imrm

  • 1. Working Smart a professional practice forum ARRA on the Job / e-HIM Best Practices / Data Standards / Legal e-Speaking Easing e-Discovery The Electronic Discovery Reference Model and the Information Management Reference Model By William S. Horn, MBA T The elecTronic Discovery reference Model (eDrM) vendors were able to map their products and services to steps in project offers guidelines and standards for e-discovery. it has the process and to use industry-defined terms to describe their helped reduce the cost, time, and manual work associated with offerings for customer comparison. e-discovery and has proven to be invaluable to those engaged in The sidebar offers a high-level description of the model. litigation support since its creation in 2005. The eDrM has been enormously successful in defining the e- now this model is traveling upstream in order to provide the discovery process not only for vendors and customers, but also same benefits to records and information management profes- for the courts and regulators. The group’s standards have led to sionals. in particular, a subgroup is dedicated to providing a additional guidelines by the sedona conference and changes to healthcare-specific viewpoint in the information Management the Federal rules of civil Procedure governing the interaction reference Model. between parties in federal court proceedings. EDRM—A Common Framework IMRM—Moving Upstream in order to understand the growth and impact of electronically Technology improvements have made it easier to find informa- stored information, imagine the following scenario. A hospital tion. however, they have also highlighted some problems: receives a request from a federal court for all information relat- xx x atax storagex isx growingx unchecked.x Organizationsx arex D ed to patients who are potentially part of a class action lawsuit creatingxmorexdata,xbutxe-discoveryxhasxrevealedxthatxtoox involving a regulated drug or medical device. The court requests manyx arex notx managingx itx throughx thex entirex lifecyclex tox electronic health records, all medical images, e-mail communi- disposition.x Thisx excessivex volumex increasesx thex riskx ofx cations, medical bills, and any other type of electronic informa- findingxdamagingxinformationxandxe-discoveryxcosts. tion for dozens of patients over several years. xx x txisxtooxhardxtoxfindxallxrelevantxdata.xDepartmentsxsome- I requests such as these led to an influx of vendors with tech- timesxoperatexindependently,xandxlegalxteamsxunfamiliarx nology products and services designed to quickly find and pre- withx thex businessx operationsx andx informationx manage- pare relevant information for presentation to a court or regu- mentx lackx ax comprehensivex viewx ofx wherex thex datax theyx lator. Unfortunately, customers evaluating different vendors needxarexstored. found it challenging to make an “apples to apples” comparison. xx x Txdepartmentsxdoxnotxhavexcontrolxoverxcopiesxofxdocu- I vendors too found it frustrating to differentiate themselves from ments.xItxisxnotxenoughxtoxdestroyxanxoriginalxdocumentxorx others in the marketplace. e-mailxatxthexendxofxitsxlifecycle.xCopiesxarexstillxdiscover- litigation attorneys George socha and Tom Gelbmann con- ablexandxposexthexsamexrisksxandxcosts.xInxfactxitxisxworsex firmed these issues with an industry survey and subsequently ifxlegalxcounselxreportsxtoxthexcourtsxorxregulatorsxthatxthex founded the eDrM project to define the e-discovery process in dataxdoxnotxexistxonlyxtoxfindxaxcopyxlater. a simple model with common terminology. Through this model, xx x rganizationsxlackxaxcomprehensivexrecordsxholdxprocess.x O 44 / Journal of AHIMA January 10
  • 2. Electronic Discovery Reference Model ThE EDRM DEfInES the e-discovery process in a simple model with common terminology, which offers vendors a way to map their products and services to steps in the process and use industry-defined terms to describe their offerings for cus- tomer comparison. The volume of information handled, represented by the yellow triangle, decreases as the process pro- gresses. The green triangle represents the relevance of the information handled, which generally increases in tandem with the decreased volume. Processing Preservation Information Identification Review Production Presentation Management Collection Analysis VOLUME RELEVancE Electronic Discovery Reference Model / © 2009 / v2.0 / edrm.net Information management: getting the organization’s converting it, if necessary, to forms more suitable for review electronic house in order to mitigate risk and expenses and analysis should electronic discovery become an issue, from initial Review: evaluating the information for relevance and creation of electronically stored information through its final privilege disposition Analysis: evaluating information for content and context, Identification: locating potential sources of electronically including key patterns, topics, people, and discussion stored information and determining its scope, breadth, and Production: delivering information to others in appropriate depth forms and using appropriate delivery mechanisms Preservation: ensuring that electronically stored information Presentation: displaying the information before audiences is protected against inappropriate alteration or destruction (e.g., at depositions, hearings, and trials), especially in native Collection: gathering information for further use in the and near-native forms, to attempt to persuade or elicit further e-discovery process (e.g., processing and review) information Processing: reducing the volume of information and Source: Electronic Discovery Reference Model. www.EDRM.net. Oncexlegalxorxregulatoryxactionxisxreasonablyxanticipated,x The information Management reference Model (iMrM) proj- allxrelevantxdataxmustxbexpreserved.xTheyxdoxnotxhavextox ect was formed to “provide a common, practical, flexible frame- bex collectedx immediately,x butx theyx cannotx bex destroyed.x work to help organizations develop and implement effective Destructionxofxdataxsubjectxtoxaxholdxisxspoliation.xRegu- and actionable information management programs.”1 The proj- latorsx havex imposedx substantialx finesx forx spoliation,x andx ect seeks to engage legal, iT, records management, and business judgesxhaveximposedxadversexinferencexinstructionsxtoxju- stakeholders and provide a common reference for discussion ries,xtellingxthemxtoxassumexthatxthexdataxdestroyedxwerex and decision making based on an organization’s needs. incriminating.x A Healthcare-Specific IM Model For these reasons, the eDrM team decided this year to attack The project kicked off with a meeting in May 2009 attended by the first box of the eDrM diagram, information management. 30 or so volunteers representing consulting firms, software com- Journal of AHIMA January 10 /45
  • 3. Working Smart a professional practice forum ARRA on the Job / e-HIM Best Practices / Data Standards / Legal e-Speaking panies, service providers, and corporations in several industries The iMrM will be published in draft form for comment in ear- who came to the table with business, legal, and iT backgrounds. ly 2010 at www.eDrM.net. it will include a high-level diagram The healthcare industry stood out as unique as participants and glossary describing the types of information systems, roles discussed their experiences in information management. ev- of key stakeholders, and the relationships between them. it will eryone had heard the healthcare reform discussions stressing also include a detailed maturity model for benchmarking. the need for a migration to electronic health records manage- The model will describe four levels of information manage- ment. Most had worked in industries that had been automated ment maturity with regard to the distinct stages of the infor- and electronically integrated with business partners for years, if mation lifecycle, the recognition of roles and responsibilities not decades. stated in policies and procedures, the rate of adoption among Members were aware of digital automation in pharmaceutical the workforce, the level of integration between stakeholders’ and insurance companies and knew that larger hospitals gener- systems, the governance structure of the information program, ally had system applications, but the degree of penetration in and the monitoring capabilities for continuous improvement. the provider community and the integration between business it will also have a risk assessment component so that organi- partners seemed to be lacking. it struck the group that if it could zations can measure gaps based on current state and desired build an iMrM specifically for healthcare, the industry may be levels of maturity and weight those gaps according to impact of able to avoid some of the mistakes made by other industries as noncompliance, likelihood of occurrence, alignment with stra- they automated. tegic priorities, cultural fit, and ease of implementation. A better understanding of the e-discovery process and re- cords and information management fundamentals will help healthcare organizations reduce legal and regulatory risk as well as reduce e-discovery review costs. A more comprehensive understanding of the information flow will lead to operational efficiencies through end-to-end business process improve- ments. A common understanding of departmental information requirements and a common terminology to describe them can improve purchasing decisions, reducing costs through shared iT applications and better systems integration. These are just a few of the potential benefits of the healthcare iMrM, but clearly it will be an asset as the industry moves to electronic health re- cords. The iMrM will change over time just as the eDrM matured over a few years and continues to evolve. Developing and im- plementing the iMrM will not be trivial. however, information management professionals in the healthcare industry are well suited to the challenge. The iMrM project welcomes participants. More information may be found at www.eDrM.net. ¢ Note 1. “information Management reference Model.” Available online at http://edrm.net/activities/projects/information- management-reference-model. William S. Horn (william.s.horn@comcast.net) is a management consultant with Cohasset Associates, Inc. and a current member of the EDRM project. Read More in the Body of Knowledge Read more about e-discovery in the AHIMA Body of Knowledge at www.ahima.org. Search on “e-discovery.” In addition, three years of “Legal e-Speaking” columns offer guidance on HIM practices that support legally sound business records and describe the emerging practice of enterprise content and records management. 46 / Journal of AHIMA January 10