Data Governance Driving Value in Health
Data Governance Driving Value in Health
Data Governance Driving Value in Health
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Data governance:
Driving value in
healthcare
KPMG International
kpmg.com/healthcare
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© 2018 KPMG LLP, a UK limited liability partnership and a member firm of the KPMG network of independent member firms
affiliated with KPMG International Cooperative (“KPMG International”), a Swiss entity. All rights reserved. Data governance: Driving valueShort
in healthcare
headline | 1
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Table of contents
Maturity model 7
Other considerations 9
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© 2018 KPMG LLP, a UK limited liability partnership and a member firm of the KPMG network of independent member firms
affiliated with KPMG International Cooperative (“KPMG International”), a Swiss entity. All rights reserved. Data governance: Driving value in healthcare | 2
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© 2018 KPMG LLP, a UK limited liability partnership and a member firm of the KPMG network of independent member firms
affiliated with KPMG International Cooperative (“KPMG International”), a Swiss entity. All rights reserved. Data governance: Driving value in healthcare | 3
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2 Data ownership is the responsibility for the creation of the data and the
enforcement of enterprise business rules. It constrains or defines data use in
the organization. KPMG
components of
data governance
3 Data policies are the rules that an enterprise utilizes to manage its data
assets, including enforcing authentication and access rights to data and
compliance with laws and regulations.
4 Data standards are the precise criteria, specifications and rules for the
definition, creation, storage and usage of data within an organization.
The term ‘data governance’ emerged to describe how organizations manage and influence the collection and utilization
of data. It specifies decision rights and accountability, and encourages desirable behaviors towards how data is valued,
created, stored, used, archived and deleted. But how does this definition fit, when so many healthcare systems are
now integrating care? New care models aim to not only improve individual organizations’ operations and performance,
but to also enhance system-wide sustainability and improve patient outcomes. While the concept may sound complex
and opaque, healthcare leaders and executives need to appreciate the value of a robust data governance strategy for
organizations and wider health systems.
Strong data governance ensures that the right information, of the right quality,
is available to the right person, for the right purpose, at the right time.
Evan Rawstron, KPMG Global Healthcare D&A Lead
Enable conformance to data policies, standards, Create accountability and connectivity of roles,
architecture and procedures – have a shared vertically and horizontally – enhancing
taxonomy and ensure compliance organizational/system decision-making
Use a consistent framework to help organizations Promote understanding of the value of data assets
sponsor, track and oversee the delivery of data – maintain momentum in a data-driven digital
management projects and services in an economy
increasingly complex environment
Facilitate increasingly important digital
Manage and resolve data related issues – assure conversations between patients and health
users that the data they use is accurate professionals about care in the face of new
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regulation
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affiliated with KPMG International Cooperative (“KPMG International”), a Swiss entity. All rights reserved. Data governance: Driving value in healthcare | 4
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3. Focused
— Be mindful of legislative requirements and enhanced
data processes and reporting needs. In many countries,
governments require standardized data reporting or data
3
protection measures, and/or offer incentive--based funding
opportunities. Take advantage of data assets, and be on
the right side of data protection and data legislation.
4
4. Strategic We see now that managers are managing data on a
— Align IT governance and data governance. This can daily basis instead of making decisions based on
speed up deployment of an electronic health record. gut reactions
Embedding data governance considerations during the Lynsey Milner McNeal, Director, Data
system design stages can reduce risks at later stages of Governance, Saint Luke’s Health System (US)
the data governance journey.
5. Pervasive
— Shifting the culture towards data governance takes time. We are at the foothills of a massive cultural shift. If we rush
Help senior leaders to talk about data as an asset and it we miss the opportunity to learn as an organization and 5
encourage a culture of change. The hardest part can be pacing properly position data as an enterprise asset
the learning and not rushing the discovery phase. Executives Michael Caesar, Executive Director, Data &
Implementation Science, University Health Network
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Healthcare executives should be aware that technology alone will not create an effective data governance function. To
truly enable, embed and continuously improve on the key components of data governance, organizations should adopt
a capability framework that incorporates people, processes and technology.
The following framework identifies the essential data governance capabilities in these three areas, to achieve a holistic
data governance function.
Defines Outputs
Roles and responsibilities: Identify subject matter experts to support enterprise and operational initiatives, by outlining clear
02
responsibilities for data stewards, data owners and data consumers, including clarity on decision rights, approval processes and
ownership of quality improvement programs
Culture and communication: Establish transparent governance processes that provide structure for data stewards and other
03 personnel to create organizational norms, through a functional community of practice, easily accessible documentation, and robust
internal customer service function
Data asset management: Prepare a data asset maintenance plan to articulate how to manage exponential growth in data volumes
04 and complexity, including developing a data asset catalog, which explains data quality expectations, metadata definitions, source
system environments, and dataset archives
Enabling processes: Embed data governance processes into project pipelines, resource allocation, and budget management
05 within the organization to clarify how new data assets, multi-level access to management, and response times for data requests
will be managed and maintained
Definition and standards: Establish collaborative processes to support the ongoing management and oversight of data
06 dictionaries, taxonomies and business rules, as well as appropriate usage guidelines for data sources – using industry standards
where possible
Data quality management: Ensure adequate data governance representation on Change Advisory Boards, to inform changes in
07
source systems that may result in corrupt or inconsistent data. Use documentation to inform others, including measuring data
quality and executing corrective actions
Metrics and monitoring: Automate data quality monitoring and detection capabilities, by aligning with statistically-driven detection
08
methods and implementing standardized reporting and real-time dashboards, which help measure data quality and improve real-
time clinical decision support systems
Tools and technology: Develop robust data governance policies, to help develop data architecture and cloud-based technologies,
09
and to enable accessible feedback systems to record breaches and improvement opportunities.
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affiliated with KPMG International Cooperative (“KPMG International”), a Swiss entity. All rights reserved. Data governance: Driving value in healthcare | 6
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Maturity model
Organizations should understand the current state of their data governance functions before they can envision their
future shape. Building on data governance capabilities, the following maturity model is a useful tool for achieving this
goal and can be applied at both organizational and business area level.
Using this model makes it easier for leadership teams to plan the roadmap to across nine key capability areas:
— Defining the ‘current state’ can uncover critical success factors and gather lessons learnt
— Once this is complete, leaders can identify the work required for each capability area, clarify priorities and
responsibilities, and develop a program of work to develop a ‘target state’
— The maturity model can also be used for monitoring, by periodically assessing progress and realized benefits.
Aware Tactical
DG vision, investment, and Some siloed DG initiatives;
Capability areas commitment yet to be no true sponsor
identified
Level1 Level 2
Organization structure Informal Awareness of the purpose and Limited to separate, internal
importance of data governance business units
Individual responsibility to
Culture & communication Closed/opaque maintain commitment to DG Disconnected communities of
vision practice across business units
Inconsistent identification of
Metrics & Impromptu/ quality metrics within or across Monitoring of key metrics at the
monitoring as-needed business units business unit level
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7 | Data governance: Driving value in healthcare affiliated with KPMG International Cooperative (“KPMG International”), a Swiss entity. All rights reserved.
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Formalized data governance Chief Data Officer function or Formalized and integrated
team structure and model C-level presence and support equivalent
Appropriate usage guidelines for Openly accessible metadata Collaborative process in place to
data sources aligned to resources, data standards, and manage data assets and Well-defined/accessible
standards policies common taxonomies
Support growth of real-time Standard reporting and real-time Automated data quality
systems, especially clinical dashboard of data quality monitoring and detection Planned/disciplined
decision support measures capability
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Other considerations
Cloud
— Any move to the cloud should not negate or weaken existing data
governance principles that protect patient and staff privacy, information
security and data integrity.
— Not all cloud providers are the same, and not all offerings have the same
service level agreements. When moving to a cloud based provider,
organizations should assess the provider’s maturity, capability, and
existing accreditation in the local market.
— Cloud based clinical software offers multiple accessibility options. To
make the most of this exciting technology, re-assess existing use cases
and future scenarios to ensure controls are in place and auditability is
preserved.
— Ensure an open channel of communication with providers. Ensure
there’s visibility over any future activities that may result in the flow of
data offshore.
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9 | Data governance: Driving value in healthcare affiliated with KPMG International Cooperative (“KPMG International”), a Swiss entity. All rights reserved.
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affiliated with KPMG International Cooperative (“KPMG International”), a Swiss entity. All rights reserved. Data governance: Driving value in healthcare | 10
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Case studies
1
Alberta Health and Alberta secondary use of data. This committee,
Health Services, Canada: Data along with its sub-committees, provides
the forum for data stewards and owners
governance for health systems to set information policies and standards
management for the Alberta health system; address
risks and opportunities around the
Alberta Health (a Department of the
exchange of health data in the provision
Government of Alberta) and Alberta
of care; and guides the use of health
Health Services (Alberta’s single
data for health system management,
regional health authority) have evolved a
quality improvement, evaluation, and
joint information and data governance
research.
structure to better enable health
systems management in the province. The Data Governance Committee
interfaces with the joint Provincial
— Alberta Health (AH) is accountable
Health Information Executive
for setting the policy and direction
Committee (HIEC) where AH and AHS
to lead, achieve and sustain a
work collaboratively with
responsive, integrated and
representatives from professional
accountable health system.
colleges and associations and the
— Alberta Health Services (AHS) is the public, to oversee the development and
largest provincial, fully-integrated implementation of information
health system in Canada, management and technology strategies
responsible for delivering health and initiatives. Joint initiatives have
services across multiple domains to included the creation of secure technical
over 4.3 million people. capabilities to share data sets (reducing
Their shared vision is to ensure duplication and increasing quality), and
Albertans receive the right health the implementation of data de
services, in the right place, at the right identification technology to anonymize
time, by the right health providers and and pseudonymize data sets for
teams, with the right health information. secondary use. Building on the existing
Both organizations produce valuable joint governance structure, AH and AHS
data that, collectively, provide insight are creating a number of new ‘pillars’ to
into the health status of Alberta’s drive data governance and improve
population; the efficacy of health analytics, including ‘Consumer’ and
promotion and illness prevention ‘Provider’ pillars. The former will be
strategies; the effectiveness of practice focused on engaging Albertans in their
guidelines and clinical pathways; own health care through generation and
optimized models of team-based care; use of their own health data; while the
and the cost of the system in relation to latter will focus on driving appropriate
health outcomes. Integrated data and information sharing and advanced
information management is a core analytics across multi-disciplinary
capability for both entities, enabling the provider teams. The ultimate goal is to
development of sophisticated business create a set of effective, balanced rules
intelligence and analytics programs. that enables ‘analysts’ from front-line
AH and AHS are represented on the professionals to health system
Provincial Health Information and Data administrators to generate actionable
Governance Committee which provides insights, and create a continuous
advice on health information policy evidence-base for improved patient care
requirements for the primary and and health systems management.
11 | Data governance: Driving © 2018 KPMG LLP, a UK limited liability partnership and a member firm of the KPMG network of independent member firms
affiliated with KPMG International Cooperative (“KPMG International”), a Swiss entity. All rights reserved.
value in healthcare
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2 3 4
Greater Manchester Large eastern US University Large state agency for
Combined Authority Medical System: Health Care Finance and
(GMCA), UK: enabling data standardization & data Administration; data
sharing partnerships governance validation governance assessment, US
As health systems embrace As this large academic medical center This client manages multiple system
integrated care and new care models was about to embark on the with large amounts of sensitive data
involving numerous stakeholders, replacement of its EMR system with (including HIPAA protected PHI/PII
data sharing is set to rise significantly. EPIC, it realized that transformational and IRS Safeguard data). From
Facing a £7 billion (US$10 billion) improvement in healthcare could not eligibility to claims system, their data
funding gap, Greater Manchester happen with a software is subject to many requirements and
Combined Authority (GMCA) – which implementation alone. What changes standards from federal and state
covers five percent of the UK’s EPIC might bring would not be agencies (e.g. CMS, IRS, etc.) which,
population – received the country’s sustainable without data governance. if violated could result in lawsuits and
first city-level devolution of powers They sought to understand where the penalties which could severely
and funding from central government. opportunities were within the hamper the ability for it to operate. It
GMCA quickly identified the need for enterprise to standardize and apply recognized the need to establish a
change, both in the way information is data governance principles. centralized structure with supporting
shared and how it is used to facilitate KPMG conducted an assessment of processes to govern, protect, and
service integration. the medical center’s Care Delivery maintain its data assets. They sought
A major part of the program involved Process and compared it to leading a real-world experience in data
designing a new whole system practices to validate and show governance assessment, design, and
information and data governance impacts of standardization and data implementation to assist in
model, to increase collaboration, governance on their clinical and developing an actionable and practical
problem-solving, and pace for business processes. Opportunities by data governance roadmap. They
proportional information sharing process were identified and a future selected KPMG.
across 37 major health and social care state framework and timeline was KPMG identified what components of
partners. delivered. This included a high level data governance were in place, the
KPMG’s team designed a data conceptual data governance model current gaps from leading practices,
governance strategy, to give GMCA that describes organization and and opportunities in the near term and
leadership a better understanding of process recommendations within a long term to bridge the gaps
its maturity level and capabilities. We timeline that blended with their identified. Several key initiatives were
also helped the client manage the upcoming EPIC rollout. KPMG tools described in detail providing overview
technical and cultural challenges of were available to help accelerate the and value to the client; from a
setting up what was the first sharing design of a governance framework. governance council and defining the
body of its kind in the UK. Our core The tools enabled more effective role of a CDO, to development of a
principle was that data should be decision making, early identification of master data strategy, metadata
shared unless there is a legal, program risks, and a streamlined, strategy, and critical data element
statutory or privacy policy reason not standardized program for identification. A roadmap with three
to do so, whilst allowing residents the implementation that provides clear levels of intensity over a three year
right to opt out. And, to help the accountability. period was provided for the client to
various partners gain greater insight choose from as their way forward.
and value from their data, we also
developed a new, balanced, end-to
end operating model.
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affiliated with KPMG International Cooperative (“KPMG International”), a Swiss entity. All rights reserved. Data governance: Driving value in healthcare | 12
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Summing up
What does data governance mean to healthcare organizations and systems? And why is it so crucial to master data
governance to help improve performance? As a key pillar of D&A strategy, data governance defines how an
organization manages its data assets – yet many leaders still don’t fully appreciate its value and are unclear where they
should be investing. To summarize, this document discusses three key themes:
In this document, we have discussed the core data governance capabilities required, and
2 outlined a data governance maturity model. Together, these provide the frameworks and
initial key steps that can enable healthcare organizations and systems to begin building
capacity, as a foundation for advanced analytics.
There are many strategic considerations that will shape healthcare organizations’ approach to
data governance. National or jurisdctional privacy legislation, data sharing practices and certain
3 technologies can enable and challenge healthcare leaders charged with managing data assets.
Moreover, these issues are evolving rapidly and are likely to test the limits of analytics
leader’s ability to adapt.
In our work with healthcare providers, payors, and The purpose of this paper has been to help demystify
regulators in 45 countries around the world, we the role of data governance in helping healthcare
regularly hear from leaders that while they recognise organisations and systems use data to achieve its full
the latent power of data, they are struggling to unlock potential. It is an essential tool for any organisation
its full potential. As leaders work to use information to seeking to make better use of its data assets today and
develop and execute upon strategy, they increasingly will be a critical enabler of those organizations that have
report that often examination of their growing and an aspiration to remain or become a leading healthcare
increasingly complex data sets generates greater provider tomorrow.
uncertainty.
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13 | Data governance: Driving value in healthcare affiliated with KPMG International Cooperative (“KPMG International”), a Swiss entity. All rights reserved.
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© 2018 KPMG LLP, a UK limited liability partnership and a member firm of the KPMG network of independent member firms
affiliated with KPMG International Cooperative (“KPMG International”), a Swiss entity. All rights reserved. Datta gover
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Driving va
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Contact
To discuss this piece in more detail, feel free to contact the authors.
Paul Henderson
Healthcare D&A Lead KPMG in the UK
T: +44 (0)7900 053439
E: [email protected]
Jeff Bailey
Director, Healthcare Data & Analytics, PMP
KPMG US
T: +1 (615) 248-5697
E: [email protected]
Christopher Foster-McBride
Global Executive for Healthcare D&A
T: +44 (0) 7552260911
E: [email protected]
kpmg.com/uk
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KPMG International Cooperative (“KPMG International”), a Swiss entity. All rights reserved.
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