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Healthcare IT
governance:
Why is data
governance
in healthcare
necessary?

Author: Heidi Vella

Healthcare is one of the most regulated industries in the United States and across the world. As a result, hospitals, care providers and pharmaceutical professionals experience complex regulatory and compliance challenges on a regular basis. Fortunately, the digitization of data and processes can allow your organization to develop more efficient and transparent regulatory compliance. But to ensure high standards, security and accountability, it must be underpinned by good healthcare IT governance and the ability to answer the question “Why is information governance important in healthcare?”

Healthcare IT governance: Understanding compliance regulations in the healthcare industry

Healthcare has historically operated on a fee-for-service basis, where reimbursement has been driven by services rendered, regardless of sustainable health outcomes. But the burgeoning cost of care and an upwardly trending GDP spend on healthcare have put pressure on that model. The industry is now migrating toward a values-based reimbursement model, where providers are increasingly held accountable for improved care outcomes. Reimbursement rates can now be reduced by poor quality measures indicators and high readmission rates. Measurably improving patient health is the goal, and complying with those requirements means more focus on data.

Ensuring data transparency can be extremely complex and particularly overwhelming for chief compliance officers. Regulatory requirements can include periodic and reactive billing audits, evaluating risk, ensuring due diligence around the handling of patient transaction data, safeguarding data sharing, preparing for new risks and recording every patient encounter. Failure to manage these various requirements can result in fines and loss of reputation.

Such requirements present challenges for leaders. Healthcare organizations need to understand the importance of internal governance and inputting good checks and balances, particularly in regard to healthcare IT governance, to maintain credibility and trust and comply with applicable law. You must also have compliance professionals and entire departments that understand data management and compliance procedures.

Data governance in healthcare: Why is information governance important in healthcare?

Given the current data-driven environment in healthcare and the strict compliance regulations and requirements, digitizing processes and data collection seems like an obvious solution for efficiency, cost and time-saving. In fact, for some time, healthcare providers have been transitioning from paper-based records and processes to digital ones to the point where they're now business-critical. Of course digitizing and storing healthcare records can present its own set of challenges, but this is why information governance is important in healthcare.

Governance is about providing control and oversight into your systems and aligning them with the requirements and outcomes of your organization. Therefore, it's important to clearly set out and govern how to collect and organize data in IT systems to maintain order, trust and transparency, and be able to derive the necessary insights quickly and with confidence.

In addition to benefiting your organization on an operational level, making billing easier, IT governance can also protect you from reputational risks. Data losses and breaches in healthcare can be catastrophic for the reputation of healthcare and medicine providers. Trust is a valuable commodity in the healthcare sector. If there were a data breach, your organization would be under intense scrutiny, and proving you have robust checks and balances in place and that you're regulatory compliant will be extremely important. This is why it's paramount to be proactive in securing a plan for data governance in healthcare.

Identifying the right governance framework

IT plays a critical role in healthcare provision, and this role will only increase over time. Therefore, once you understand the answer to the question, "Why is information governance important in healthcare?" identifying the right healthcare IT governance framework should be next on your to-do list.

Before making the decision, what do you need to consider? At a high level, healthcare IT governance frameworks should likely include penetration testing, security programming, remote working security and cyber security, but some healthcare providers may not provide all of those aspects necessary to implementing a strong framework.

Before getting started, remember that your IT initiatives, processes and investments should align with your organization's strategic plan and goals to benefit staff and patients alike. It's important to strike a balance.

Your frameworks need to be strong and robust, but too much bureaucracy may have a negative effect. Similarly, your processes may need to change and evolve, so your framework should be flexible and allow for evaluation and ongoing adjustments. Agility should be at the heart of your framework. Your leadership team has a critical role to play: Those in charge of the IT governance framework need to understand the process, strategies and desired outcomes but must also be able to work closely with the executive team to implement the framework at all levels.

It can be beneficial to seek outside expert help to collaborate with your leadership team to build a robust, reliable but flexible framework. Governance, risk and compliance experts can help you discover your firm's current risk posture and navigate security and compliance requirements. These experts offer a broad range of objective and data-driven assessments and advisory services to help you identify potential weaknesses and compliance gaps.

It's likely that healthcare compliance will only grow more complex, and the need for robust systems and qualified professionals will increase in tandem. Organizations that can answer the question “Why is information governance important in healthcare?,” and recognize early that a robust healthcare IT governance framework is required will likely be the best placed to manage these evolving demands. Learn how to take action to help secure your organization’s framework today.