data_governance_cic2019_v1.pptx

Keith F. Woeltje, MD, PhD, FAMIA
BJC HealthCare and
Washington University School of Medicine
St. Louis, MO
Data Governance and the Data and
Information Lifecycle
S11: Presentations - Leveraging Workflow and Data to Promote Efficiency

AMIA 2019 Clinical Informatics Conference
Disclosure
I and my spouse/partner have no relevant financial relationships with
commercial interests to disclose.
2

Learning Objectives
Attendees will learn an approach for describing data as an asset, based on
patient data flow and the data and information lifecycle. Participants will then
learn how to apply specific tools and processes bringing vision into reality within
a healthcare organization.
3

BJC by the Numbers As of year end 2017
15
HOSPITALS
31,811
EMPLOYEES
4,309
PHYSICIANS
3,468
STAFFED BEDS
153,257
HOSPITAL ADMISSIONS
168,828
HOME HEALTH VISITS
563,239
EMERGENCY DEPT. VISITS
$5.0 BILLION
NET REVENUE
$12.9 MILLION
COMMUNITY HEALTH PROGRAMS
(providing more than 529,000 individual services)
$370 MILLION
CHARITY & UNREIMBURSED CARE

5

Washington University School of Medicine
 1,465 full-time faculty physicians (76 sub-specialties)
 3,426,181 total patient encounters in FY17 including:
 1,121,579 outpatient visits
 1,120,962 procedures
 64,488 total hospital admissions on medical campus
 65% of clinical activity on Washington University Medical
Center Campus
 Affiliation agreement with BJC hospitals

BJC, like everyone else, is facing a data tsunami…
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Healthcare data volumes: An
estimated 2,314 exabytes will
be produced in 2020.*
Visits documented in
EHRs: 1 billion patients *

…and the industry is rapidly evolving.
8
New Care Model = data
New Technology = more data

Data as a Strategy
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Organizations must manage “data as a strategic asset” and this starts with “implementing
sound enterprise data management …. “
F. Velasco, (Healthcare HIT News, Feb, 2019)

2013 2014 2015 2016 2017 2018
Data
Strategy
Data Strategy Program –
Office & Community
• Formed and launched
steward community
• DGC and DGTC founded
• Mission/Vision
• Initial role definitions
• Collibra purchase and
resources obtained
Domain Work
• 323 business glossary terms
• 248 terms mapped to table/columns in 1 + systems
• 69 terms mapped to a standard reference data
• 25,617 system code values mapped to 9,315 standard code
values
• Match/merge rules, trust rules provided for MDM
implementation
• Standards developed/implemented in Epic directly or via MDM
• Mappings actively used in MDM with regular upkeep
Data Strategy Development
• Accenture assessment
• Operating model
developed
• Baseline maturity model
Domain Work
• 58 business glossary terms
defined
• 27 reference data sets
standardized
Processes
• Standard registration
• Capture/distribution custom
drug knowledge
• Name style standard
• Change control
Data Strategy/ Management
• Collibra re-messaging and launch of
version 5.2
• DGO work focus - 2018 program plan
• Update role definitions and complete job
mapping
• Data and information lifecycle
management policy
• Alignment with MDM and CCE – review
data domains and organizational need
Data Governance Journey

Secure Secure
Secure Secure
Capture & Collect
The creation, acquisition
or capture of the data or
information needed to
support clinical,
business, operational or
legislative requirements
Storage Access Display & Use
The retention of data or
information, in an
appropriate manner, to
support, clinical,
Ensures only authorized
users have access to
non-public information
in order to achieve
clinical, business,
operational or
The appropriate
utilization and display
of data or information
to achieve clinical,
The appropriate
archiving, removal from
system origin, or
destruction of data or
information that is no
longer required to
meeting statutory
requirements, and/or to
support clinical, business
or operational
requirements
Dispose
Secure
The protection of data or information from the risk of accidental or malicious alteration or destruction, and
from unauthorized access or disclosure. Ensures the appropriate levels of protection from breach, corruption
and loss are provided for information that is private, confidential, secret, classified, essential to business
continuity, or otherwise requires protection.
Data & Information Lifecycle Framework

Patient and Data & Information Lifecycle
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D&ILM served as the framework and terminology for P&P Assessment and Gap
analysis
Once D&ILM assessment and gap analysis was completed it identified BJC had
a some P&P that support the D&ILM, but we also had gaps
Conclusions
Draft a governing policy and align current P&P, forms to each phase – to
assess our current state and ID gaps and next steps
Need a Focus on Data Policies……
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D&ILM Governing Policy
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Capture and collect
• Document standards that include the minimum clinical and business data
elements as well as timeframes for collection.
• Establish training and communication programs that informs employees and
providers of their responsibilities related to minimum data collection
standards.
• Design systems to collect data in the most efficient, accurate, and consistent
way.
Core Policy Example

Data Governance Sub-Committee
Purpose
• Develop enterprise strong policies and procedures that describe the ways to manage
data.
• Define the rules of engagement for data.
• Promote an enterprise way of thinking about data (i.e. Data & Information Lifecycle)
and increase communications about data and data activities.
• Identify the resources who manage data and hold them accountable to each other.
• Assure alignment between BJC and WU related to Data Governance.
• Assure that Data Governance sub-committee efforts support BJC clinical and
business objectives/priorities.
16

D
A
T
A
S
T
R
A
T
E
G
Y
S
U
P
P
O
R
T
...OF TECHNICAL
DATA
Identify & Collect
“Data Dictionary”
(System and Database,
Database Table, Table
Column)
...WITH
BUSINESS USE
Develop &
Document
“Business Glossary”
CONNECTING
PEOPLE…
DGO
Steward Community
Data Consumers
DEVELOPMENT, ADVISEMENT,
MAINTENANCE, AND UTILIZATION OF A
BUSINESS GLOSSARY AND
STANDARDIZED METADATA.
BUSINESS
TERMS
TABLE
COLUMNS
(DATA
ELEMENT)
STANDARD
CODE VALUES
SYSTEM
CODE VALUES
MAP
M
AP
MAP
M
AP
Data Domain Goal

Practical Application of this Session
You too can set up a data governance
program for your institution!
18

Questions
The purpose of good data governance is:
Options:
A. to meet regulatory requirements
B. to prevent any use of organizational data without permission
C. to ensure that organizational data can be used effectively for analysis and decision
making
D. to assert control of organizational priorities
19

Answer
A. to meet regulatory requirements
B. to prevent any use of organizational data without permission
C. to ensure that organizational data can be used effectively for analysis and decision making
D. to assert control of organizational priorities
Explanation: The utility of good data governance is to ensure that data generated
in an organization can be used to generate useful information and insights by
allowing comparisons over time, and allowing data from disparate systems to be
combined effectively. Regulatory requirements for data security can be met
without necessarily having good governance. Good governance is not intended to
inhibit users from making good use of the data (although there should be clear
rules of the road and not uninhibited access to all systems). Organizational
priorities should inform data governance, not the other way around.
20

Questions
The purpose of good data governance is:
Options:
A. Capture and Collect; Storage; Access; Display and Use; Dispose
B. Input; ETL; Analysis; Reporting
C. Garbage in, garbage out
D. Design; Transition; Operation
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Answer
A. Capture and Collect; Storage; Access; Display and Use; Dispose
B. Input; ETL; Analysis; Reporting
C. Garbage in, garbage out
D. Design; Transition; Operation
Explanation: There are different formulation for a data and information life cycle,
but a complete formulation should incorporate all steps from data generation to
data disposal (which 'B' doesn't include); while 'C' is an absolute truism, it doesn't
represent a life cycle. 'D' is part of the ITIL service life cycle, but only part of it.
22

References
Hripcsak G, Bloomrosen M, FlatelyBrennan P, Chute CG, Cimino J, Detmer
DE, Edmunds M, Embi PJ, Goldstein MM, Hammond WE, Keenan GM, Labkoff
S, Murphy S, Safran C, Speedie S, Strasberg H, Temple F, Wilcox AB. Health
data use, stewardship, and governance: ongoing gaps and challenges: a report
from AMIA's 2012 Health Policy Meeting. J Am Med Inform Assoc. 2014 Mar-
Apr;21(2):204-11. doi: 10.1136/amiajnl-2013-002117. Epub 2013 Oct 29.
PubMed PMID: 24169275; PubMed Central PMCID: PMC3932468.
Middleton J, Moses JS. HIMSS Practical Steps to Enterprise Data Governance.
Available at: https://www.himss.org/practical-steps-enterprise-data-governance
Bresnick J. The Role of Healthcare Data Governance in Big Data Analytics.
Available at: https://healthitanalytics.com/features/the-role-of-healthcare-data-
governance-in-big-data-analytics
23

@AMIAInformatics
@AMIAinformatics
Official Group of AMIA
@AMIAInformatics
#WhyInformatics
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AMIA is the professional home for more
than 5,400 informatics professionals,
representing frontline clinicians,
researchers, public health experts and
educators who bring meaning to data,
manage information and generate new
knowledge across the research and
healthcare enterprise.
AMIA 2019 Clinical Informatics Conference | amia.org

Thank you!
keith.woeltje@bjc.org

data_governance_cic2019_v1.pptx

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