Session #31: Data Governance in Healthcare Joseph Pollman Executive Director, Business Knowledge Management, Community Health Network Rich Pollack, MS CHCIO, FHIMSS Vice President and Chief Information Officer, VCU Health System Chris Harper Director of Business Architecture and Analytics, University of Kansas Medical Center Facilitator: Dale Sanders Executive Vice President, Health Catalyst

First, raise your hand… Is there a data governance function currently in operation at your organization? Randle McMurphy

Sanders’ Philosophy You can’t “cause” data governance to happen by implanting a top-down, complex system to execute it. It will be rejected as a foreign body by the immune system of the organization. “Quality is not an act. It is a habit”– Aristotle To a large degree, the economic model of US healthcare still makes data governance and quality optional.

Poll Question #1 Rate your organization’s cultural appreciation for the value of data to the future of healthcare: It’s very low. Our data culture is Neanderthal, and our data amounts to scratch marks on cave walls. It’s low, but the appreciation is growing. We just don’t know what or how to govern it. We are on the fence. We talk about it as if it were important, but our actions speak softly. We’ve made the transition. We get it. We are developing a strategy right now to address data quality, analytics, and the use of that data to improve care quality and lower costs. We rock. We are the intelligentsia of data. In fact, we shouldn’t be seen around ingrates like you. We’ve been data driven for years! Follow up group participation 1Would you like to participate in a follow up group on this topic that would meet 2-3 times next year to share progress, challenges and best practices? (Yes, No)

KUH Overview The University of Kansas Hospital (AMC) 12 U.S. News Best Hospital Specialty Ranking Top 10 Consistent UHC Quality Leadership Award By the Numbers 759 Licensed Beds (Med&Surg) 33,164 Admissions 54,682 Emergency Visits 1,151,536 Outpatient Visits

KUH Data Governance Frame Data Governance Executive Group – Decision making body Data Advisory Group – Recommendation making body Data Governance Support Team – Dedicated resource Working Groups – Investigation and “solutioning” body

KUH Data Governance Objective Information governance – Jointly design and optimize information assets in alignment with the organization’s strategies and goals Quality – Enable decision making that data is complete, timely, and accurate Usability – Approve creation of enterprise analytics applications, as well as creating data standardization, data dictionaries, data education, and metadata repository Availability – Approve implementation of analytical infrastructure for clinical, operational, and administrative needs

KUH Current Focus Approving the next development work for KUH EDW and Analytic Applications Identifying and cleaning Epic provider data quality opportunities (particularly SER) Creating “source of truth” with multiple EMRs through Clinical Integration Supporting LEAN initiatives Education and training the data harvesters and data consumers “Data Governance is a marathon not a sprint.”

Lessons Learned from KUH Partner with the “right” team or teams (data harvesters vs. data consumers) Be patient and take time onboarding the right team leader and members Identify a “burning platform” to start Focus on “continual improvement” and not an IT project Aim for transparency instead of gatekeeping

Community Health Network Fully Integrated Health System Central Indiana Not-for-Profit 200+ sites of care Acute care, urgent care, surgery centers, physician practices, home health, behavioral health, and employer health TPA & MSO Key statistics – Acute Care and Physician Care 7 acute care hospitals & 1 rehab hospital Staffed beds – 1,200 Admissions – 53,400 ER visits – 243,000 2000 physician on staff, 500 employed 700,000 office visits – employed physicians 12,000 employees Grown organically and through M&A/Affiliation

Community Health Network Operating System Environment – Partial List EMR Epic Cerner Meditech CPSI Centricity Analytic Environment – Partial List Health Catalyst Oracle ERP – HR, Supply Chain, GL Epic – Healthy Planet Primaria Health - MSO Clarabridge – Patient Experience McKesson HPM NRC Picker – CAHP Surveys Optum – Impact Pro, Impact Intelligence, and Humedica

Community Health Network Community Knowledge Connect Governance Committee BI Platform Data Governance Data Governance Oversight Committee Data Governance Department Operational Support Work Group A Work Group B Data Owners Data Stewards SMEs

What Are We Working On? Deploying Discovery Applications New Decision Support System Data Bus Initiatives Product Line Reporting Inlier Variance Management Projects Starting Master Date Elements Definitions Data Veracity Issues

Lessons Learned It takes a lot of time! It is a significant Team Effort Data Governance is both a ‘Local’ and ‘Enterprise’ initiative Make sure to connect them A Data Governance Platform is essential Dictionary Technical Non-technical Document Business Policy & Rules Consolidate, map, and validate source data You have to discover ‘Your way’ - it will evolve

Poll Question #2 Do you think your healthcare organization would benefit from having a Chief Data Officer? Definitely not; that’s overkill. We don’t need yet another Chief in the organization. Maybe, but not right now. We have more important issues of leadership to address. Yes, sort of. This should be an additional responsibility of the CIO or other C-level executive. Yes, we could definitely benefit from having a CDO and there is growing cultural awareness that it is a unique skill set, not currently among our executive team. Yes; we already have one and she’s running circles around you ingrates. You’d be wise to get out of her way.

Introduction to VCUHS Mission The Virginia Commonwealth University Health System is an urban, comprehensive academic medical center in central Virginia established to preserve and restore health for all people, to seek the cause and cure of diseases through innovative research, and to educate those who serve humanity Top Recognitions In July 2015, U.S. News & World Report ranked VCU Medical Center as the best hospital in Virginia and the Richmond Metro area 2014 McKesson-AHA Quest for Quality Prize Recipient Numbers for FY 2015 865 beds (including children’s and community hospitals) 700 physician practice plan 10,000 employees Adjusted Discharges- 62,045 Emergency Department Visits- 89,549 Outpatient Clinic Visits- 631,874 Virginia Premier Health Plan Member Months- 2,276,423

Data Governance - Structure Data Governance Executive Committee Chief Operation Officer (Chair) Data Management Committee Data Architect(Co-Chair) , Director of Analytics(Co-Chair) Data Steward Workgroup Patient Access Systems Manager (Chair) EDW Steering: CIO (Co-Chair) CRIO (Co-Chair) Major IT Systems, e.g., Cerner, Lawson, IDX, etc.

Data Governance - Structure Broad Strategy Executive/ Executive Steering Committee Provides Leadership, Direction, Funding, & Resources for Data Governance Program EDW Steering Committee Established to Implement a Robust, Extensible Platform for Analytics Strategic & Tactical Data Management Committee Executes Data Governance program Reviews and approves new data standards Communicates Data Governance initiatives to health system Operational & Technical Data Stewardship & Working Committee Identifies need to establish data standards Documents and implements standards across the health system Reviews data quality reports Maintains the metadata dictionary

Current List of Initiatives for Data Governance Develop and Publish a Data Dictionary Publish a System Data Source Map Assign Data Stewards to Key Organizational Data Element Create a Tracking Mechanism for Data Integrity Issues Manage RFP Process for Selecting a New EDW Vendor 4/7/2019

Lessons Learned from VCUHS Try to find quick wins with tangible goal setting. Keep members engaged and interested by distributing responsibilities and deliverables. Develop a top to bottom communication plan. The pace of early stage Data Governance implementation is directly related to the resources assigned who have time to dedicate to the process. If possible, enlist a skilled Project Manager to keep the groups on task. Like quality or safety, Data Governance is not something that can be “completed” but rather an enterprise wide mentality shift which needs dedicated resources to promote and educate.

Don’t Let This Happen To Your Data Governance Strategy 

Analytic Insights Questions & Answers A

Choose one thing… Write down one thing will you do differently after hearing this presentation Follow up group participation 1Would you like to participate in a follow up group on this topic that would meet 2-3 times next year to share progress, challenges and best practices? (Yes, No)

Thank You Follow up group participation 1Would you like to participate in a follow up group on this topic that would meet 2-3 times next year to share progress, challenges and best practices? (Yes, No)

Session Feedback Survey On a scale of 1-5, how satisfied were you overall with this session? Not at all satisfied Somewhat satisfied Moderately satisfied Very satisfied Extremely satisfied Follow up group participation 1Would you like to participate in a follow up group on this topic that would meet 2-3 times next year to share progress, challenges and best practices? (Yes, No) What feedback or suggestions do you have?

Upcoming Speakers 3:20 PM – 4:10 PM Building Creative and Innovative Organizations Ed Catmull, Co-Founder of Pixar, President of Pixar and Walt Disney Animation Studios 4:10 PM – 4:30 PM Final Polls and Summit Winners 4:30 PM – 5:00 PM Closing Remarks Dan Burton, Chief Executive Officer, Health Catalyst Location Grand Ballroom Grand Ballroom Follow up group participation 1Would you like to participate in a follow up group on this topic that would meet 2-3 times next year to share progress, challenges and best practices? (Yes, No) Grand Ballroom