The healthcare sector is focused on improving and demonstrating value with value defined as the outcomes achieved per dollar spent. Healthcare organizations are pursuing value-enhancing goals on a number of fronts but four are fundamental for healthcare reform.
- Population health focuses on outcomes for cohorts of patients over time. It advances care coordination based on enhanced understanding of the factors that put patients at risk and what works best to mitigate risk and improve results. Its focus goes beyond the healthcare entity to a range of health determinants including those in the community.
- Value is also the focus for a range of payment models that factor risks and rewards into result-based payment. Whereas fee-for-service payment was an accumulating process, value-based payment is an analytic process. Along with payment reform, value is advanced as costs become more transparent.
- Achieving and demonstrating high quality and safe practices is also a value-enhancing goal for the enterprise. While a key goal for healthcare organizations for decades, the quality and safety priorities are now driven by the value imperative, in addition to external reporting requirements.
- Finally, value is enhanced as consumers shed their passivity and actively engage with providers and health plans to achieve the best results at the right costs.
Information inter dependencies
Each goal is challenging in its own right at the same time they are highly interrelated. Population health can’t advance without competency in performance and quality improvement. Succeeding under value-based payment requires understanding of populations, risks, and quality control. Patient and family engagement is the linchpin for value improvement because when individuals are able to exercise greater responsibility for their health and wellness, they are more likely to be compliant, make good choices and help to control costs.
Advancing each of these goals requires trusted information and a purposeful strategy for managing and governing that information. Healthcare organizations will determine the scale, pace, and sequence for advancing these four goals based on market forces, resources, and their ability to execute. Ability to execute has a great deal to do with how well the organization has evolved its enterprise information governance and management capabilities.
Information governance as a prerequisite for success
Too often information governance seems like a “nice to do” but optional undertaking, not tied to solving a particular problem. But it is foundational for a value-based health system. Governance of information can be better understood when explained in terms of how it supports the advancement of organizational priorities. Value-transformation relies on successful enterprise-wise information governance and management, but information is the way that value improvements are measured and demonstrated.
Information governance is nothing more than establishing a multidisciplinary governance authority charged with deliberating and determining the “rules of the road” for how the organization intends to manage its information assets across the enterprise. Effective information governance has the effect of unifying the policies and practices for how information privacy, data quality control, access, use, processing and storage will be handled by the hospitals, health plans, physician practices, home health, and other services integral to today’s health systems.
No longer can each service element set its own rules for how it will define and capture information, safeguard and manage it across the information life cycle. Siloed information policies and practices are more costly to administer, make poor use of technology, delay decision-making, and create compliance risk. To improve and demonstrate value in healthcare, we need to ensure that information outcomes are the best they can be for each dollar spent.
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