WashingtonStateHealthInforma3onManagementAssocia3onLynnwoodWashington4/30/2016
AndyTauberMCSE,MCDBADataArchitect
Data Integrity and Governance What should we do and how do we get there?
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Snapshot of The Vancouver Clinic
• Physician-owned and governed, professionally managed • Founded 1936 • 265 providers • 990 employees • 5 sites
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Data Growth
• Byte = 1 Character • Kilobyte = 1,000 Characters • Megabyte = 1,000,000 Characters • Gigabyte = 1,000,000,000 Characters • Terabyte = 1000 Gigabytes (1 Trillion bytes) • Petabyte = 1000 Terabytes (1015) • Exabyte = 1000 Petabytes (1018) • Zetabyte = 1,000,000,000 Terabytes (1021) 3/25/16 WSHIMAAnnualConference2016 3
Data Growth
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Data Growth
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Data Growth in Healthcare
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Cost of Bad Data
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The Legal Climate
EMRs can hurt physicians during lawsuits
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Testimony
• Plaintiff attorney: Doctor, if the emergency renal consult was called in at 11:30, why did you wait until 6 p.m. to see the patient, during which time his kidneys became severely damaged?
• Doctor: I did see the patient within 30 minutes.
• Plaintiff attorney: Where does it show that in the chart?
• Doctor: Uh … it doesn’t, I guess. I saw the patient but wrote the note later.
• Plaintiff attorney: So you claim you saw this critically ill patient for 30 minutes, spent one hour evaluating him, but did not document your findings for another six hours?
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Horror Stories
ThisSSNisalreadyinthesystem. Justadd1toit.
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Our Process
• Data Flow • Data Inventory
• Servers • Databases • PHI
• Report Inventory • Current State Assessment
• MaturityModelAssessment• MaturityModel
• Define Governance Structure
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Our Process
• Training • Management • DG Council Members • Data Stewards
• Define Subject Area Priorities • Begin Implementation • Monitor
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Maturity Model Assessment - Foundational
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Maturity Model Assessment - Project
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Maturity Model Assessment
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Maturity Model
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Structure BoardofDirectors
DataOwners
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Current Structure
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Structural Evolution
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Documents
• Charter• Vision• MissionStatement• Capabili3es• RolesandResponsibili3es
• DataGovernanceChecklist• MajorItemsNeeded
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Documents
• JobDescrip3ons• DataSteward• DataOwner• DataCustodian• DataGovernanceCouncil
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Framework
DataGovernance
Discover
Define
Apply
Measureand
Monitor
Discover • Data Discovery • Data Profiling • Data Inventories • Process Inventories • CRUD Analysis • Capabilities Assessment
Measure and Monitor • Proactive Monitoring • Operational Dashboards
• Reactive Operational DQ Audits • Dashboard Monitoring/Audits
• Data Lineage Analysis • Program Performance • Business Value/ROI
Define • Business Glossary Creation • Data Classifications • Data Relationships • Reference Data • Business Rules • Data Governance Policies • Other Dependent Policies • Key Performance Indicators
Apply • Automated Rules • Manual Rules • End to End Workflows • Business IT Collaboration
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Training
• Executive Team • Whatisit?• GovernanceaspartoftheSystem(manualorcomputer)DevelopmentLifecycle
• Se\ngDataGovernancePriori3es
• Data Governance Council • Whatisit?• RolesandResponsibili3es
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Training
• DataStewards• Responsibili3es• Tools• Empowerment
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Goals
• StandardizeDataDefini3ons• ImproveDataQuality• Enablebeaerdecision-making• Reduceopera3onalfric3on• Protecttheneedsofdatastakeholders• Trainmanagementandstafftoadoptcommonapproachestodataissues• Buildstandard,repeatableprocesses• Reducecostsandincreaseeffec3venessthroughcoordina3onofefforts• Ensuretransparencyofprocesses3/25/16 WSHIMAAnnualConference2016 25
Ini6al Steps
• DataInfrastructureMap• DataInventory• ReportInventory• DataFlow
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Database Infrastructure
COBAS.vanclinic.int
BIORAD_QCDO
E-CLRTY-NPRD-01.vanclinic.int
Metric_info TVCApplications
BusinessObjectsCMS Clarity Clarity_Stage
E-Clrty-PRD-01.vanclinic.int
Reportserver ReportServerTempDB
Metric_info
BusinessObjectsCMS Clarity Clarity_Stage
TVCApplications Reportserver ReportServerTempDB
E-SQL-PRD-01.vanclinic.int
Interconnect_ErrorLogging SystemPulse
Hera.vanclinic.int
CitrixFarm
ContinuumDB
Microtel
MicroTelCall
MicroTelTemp
PFPR
Production Providers SurgSched
MGMT-ANLYST-01.vanclinic.int
ClinicOperations
HL7
JUMP
OnBaseApps
MGMT-HLPS-01.vanclinic.int
HS2000CS Reportserver ReportServerTempDB
MGMT-METASYS-01.vanclinic.int
JCIAuditTrails JCIEvents JCIHistorianDB
JCIItemAnnotation MetasysIII MetasysRAPTranslation
MetasysTree
ReportServer ReportServerTempDB VancouverClinic2
XMS
MGMT-RMM-01.vanclinic.int
CTX_Info Logon_Script_Data Nexpose_export
Server_Data VeeamOne XTrans
MGMT-VBR-02.vanclinic.int
VeeamBackup VeeamBackupReporting
MGMT-WIKI-01.vanclinic.int
Bdc_Service_DB_2764d0b466ad4b64abae3a38c4bfc80f
CBOWiki CBOWikiTest ISWiki
SharePoint_AdminContent_a4c3289c-ccd9-445a-b2e9-63020e4f154e
SharePoint_Config TestWiki TrainingWiki
WSS_Content_ISOpsCentral WSS_Logging WSS_Search_IsOpsCentral
MS-AUD-01.vanclinic.int
eTona NOAHDatabaseCore
MS-CGMS-10.vanclinic.int
ACCUCHEK_1 ACCUCHEK360_SDB
MS-GMED-01.vanclinic.int
gCare2 gCareMuItumDrug gPortal
MS-LYNC-01.vanclinic.int
cpsdynlis
mgc rsconfig
rsdyn rtcab
rtcshared
rtcxds
rtc
rtcdyn
MS-PAPER-01.vanclinic.int
PaperSave
MS-SCM-01.vanclinic.int
sgmaster sgvault
MS-SQL-01.vanclinic.int
CINET CitrixProvisioningServicesTVC CitrixXenAppFarmTVC
CitrixXenAppFarmTVC_ConfigurationLogging sgcredentvault CredentAudit
CredentError CredentScreenDefinition CredentSecurity dvimages
DYNAMICS FCTest ForecasterLLC ForecasterTVC Imc_final2
obdat32
OPS OPS_Backup
ProvisioningServer6FarmTVC ReportServer ReportServerTempDB
SharePoint_AdminContent_c5832508-33e7-4909-9e80-3694e5d9ec37 SharePoint_AdminContent_c5832508-33e7-4909-9e80-3694e5d9ec37
SharePoint_Config
SharePoint_Config_GP
TEST
TVCApplications TVCXenAppFarm
TVCXenAppFarm_ConfigurationLogging
VCB
VCI WSS_Content
WSS_Content_3cf84eafff3d49c387aaaf12e7fc4b42 WSS_Content_935541ee3df149e1a1319237a5fdf070 SharePoint_Config WS_Content_BP
WSS_Content_ebc46f7573624e9e942bc5df0fb3d8ffWSS_Content_ff5e754c8ea94110bf865f6a0c338755
WSS_Epic_Content WSS_HIPPA_Content
WSS_ISProjects_Content
WSS_Mcomp_Content WSS_NSST_Content
WSS_PatientAccounts
WSS_Search
MS-SQL-02.vanclinic.int
BESReporting BFEnterprise HCAudit
HCxaccess MSMDT ReportServer
ReportServerTempDB TEMTRC TPMFOSD
MS-SQLBI-01.vanclinic.int
GPWarehouse AdventureWorks AdventureWorks2008 AdventireWorksDW AdventureWorksDW2008
AdventureWorksLT AdventureWorksLT2008 MisysBLOBExportStaging MisysConversionStaging
ReportServer ReportServerTempDB SharePoint_AdminContent_beeb3b35-8d50-4bf0-acac-8e47d38b345c
SharePoint_Config TVCAdvAccess TVCAnalytics TVCContracting TVCDocuments TVCFinancial
TVCMarketing TVCMisysArch TVCNew TVCPaperCharts TVCPlanning
TVCPopulation TVCProviderProduction TVCStaging TVCStorageMan
agementTVCVision
WSS_Content_SSRSTest WSS_Content_TVC_BI_Process WSS_Content_TVC_BI_SSRSWSS_Search_MS_SQLBI_01
MS-SQL-CLST1-N1.vanclinic.int
ACCESSCONTROL CitrixTVCXenDesktopPVS CitrixXMM HCXAAuditnprd
HCXAAuditprd HCXAnprd HCXAPCardnprd HCXACardprd
HCXAPrd HPDevMgr NuanceMC NuancePODB
ReportServer ReportServerTempDB sem5
MS-SQL-CLST1-N2.vanclinic.int
ACCESSCONTROL CitrixTVCXenDesktopPVS CitrixXMM HCXAAuditnprd
ReportServer ReportServerTempDB sem5
HCXAAuditprd HCXAnprd HCXAPCardnprd HCXACardprd
HCXAPrd HPDevMgr NuanceMC NuancePODB
SUSDB TVC_AppvManagement_PRD TVC_AppvReporting_PRD
TVC_INFRASTRUCTURE_vCenter55 TVC_INFRASTRUCTURE-vCenter55UpdateMgr
TVC_MDM
TVC_Nexpose
TVC_PVS_TST
TVC_PVS_XA
TVC_PVS_XD
TVC_VDI_vCenter55
TVC_XenDesktopMonitoring
MS-SYNTRAC-01.vanclinic.int
SYNtrac
MS-TELCOR-01.vanclinic.int
NWS POC QMLReports
MS-WDS-01.vanclinic.int
Northwind TVCInv
MS-WIKI-01.vanclinic.int
Confluence TVCApplications
MS-WIKI-NPRD-01.vanclinic.int
Confluence
ON-SQL-NPRD-03.vanclinic.int
OnBaseTST TVCOnBaseTSTQueries
ON-SQL-NPRD-N1
OnBasePRD TVCOnBasePRDQueries
ON-SQL-PRD-N2.vanclinic.int
OnBasePRD TVCOnBasePRDQueries
TLCM-LIC-01.vanclinic.int
MA4000
TLCM-QWRX-01.vanclinic.int
QueWorx
TVCDatabaseInventory
Credent
E-cog-nprd-01
Cogito
DG-SQL-01
PHI II Confidential
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Flow of Informa6on
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What We Did
• Don’tBoiltheOcean(Bitesizedchunks)• Priori3zeSubjectAreas
• Pa3entDemographics• ProviderData• InsuranceandPa3entAccounts
• Iden3fyDataOwners• Iden3fyDataStewards
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Organiza6onal Changes
• Ini3ally• PSRsreportedtodepartmenttheyworkedin.• Loyaltywastodepartment.• Operatedasindependentislands.
• Now• AtleastonePSRSupervisorineachloca3on• PSRSupervisorreporttoDataOwner• PSRSupervisorsheldaccountablefordataquality
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Empowerment
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Process
• WeeklyMee3ng• Aaendees
• DataStewards• DataArchitect• Trainer• EPICAnalystsasneeded• SecurityandComplianceasneeded
• Training• Nowwemeetmonthly
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Process
• Iden3fydataissues• Inconsistentprocedures• Excep3onshandling• EPICissues
• HardStops• ScreenDesign• Reports
• TimeConsumingIssues
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Mee6ng Process
• Priori3ze• Discussion• Research• Nego3a3on• Outcome
• Policy• Procedure• SohwareChange
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Accomplishments • NolongercollectSocialSecurityNumbers• Pa3entIden3tyPolicyandProcedure• Don’tmakeupdatapolicy• Employeeupdatetomedicalrecordpolicy
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Next Steps
• Definemeasurementstomonitorsuccess• Automatemanualprocesses• Iden3fyaddi3onalsubjectareas• Con3nuetransi3ontoadatacentricculture
• Ini3alandongoingtraining• Communica3on• Measure
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Tools
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Tools
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Tools
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Tools
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Tools
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Tools
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Tools
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Tools
• Thetoolisnotimportant• COMMUNICATIONIS
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What It Takes To Get This Done
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COMMITMENT Defined
Involved Commiaed
ThinkoftheSuccessofthisBreakfast
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Ques3ons
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