The healthcare system business and technology environment is pushing organizations to move beyond traditional, reactive and silo-based data management approaches to a managed – even predictive – approach that treats their clinical, operational and financial data as a strategic asset and uses it to create business value and advantage.
Traditionally, healthcare understood all too well what it took to manage assets such as treatment facilities, clinical staff, and patient relationships. However, when it comes to data, healthcare often fails to implement the responsibilities and accountabilities needed to manage it effectively. The result is deficiencies in data availability, accuracy, timeliness, protection and accessibility. Additionally, when employees aren’t certain who is responsible or where to go for data management, they begin to churn and become misdirected as to what is process related versus what is a technical deficit.
Data Governance is the key. To truly manage the myriad data stores and assets at a health system’s disposal, it needs to establish a cross-functional data governance committee and designate stewards within its business and clinical units to oversee their data’s use. Working together, the governing body should promote the importance of managing data as an asset, establish usage policies and procedures, define storage and security measures, and enforce compliance.
Healthcare however, poses a unique challenge. Given the intricacies of healthcare data, it is difficult, if not impossible, to identify data stewards with the appropriate skill set of clinical/business/technical expertise to support the ever changing needs of the health system. This challenge can be resolved by separating the responsibilities into data stewards and data custodians. Stewards are responsible for the “content” of the data and custodians are responsible for the “buckets” that store the data, and systems that process it.
The involvement of both business users (data stewards) and IT (data custodians) is critical in defining, standardizing and organizing the data and crucial to describe and track activities within any health system. Both roles are needed equally to explain deviations or variability where it occurs and governance cannot be successful without the input of both voices. While on the surface they may appear to be interchangeable, the two roles are very different.
The Data Steward is the “go-to” person within a business group or clinical domain that has:
- Domain Knowledge – they understand the direction, processes, rules, requirements and deficiencies of the data within their domain.
- Domain-area Respect – they can influence business and operational decisions and the ability to obtain stakeholder commitments.
- Analysis – they are capable of juggling several options and examine situations from many angles, serving variable agendas.
- Facilitation and Mitigation – They have the skills to facilitate the data discussions and mitigate conflicts between business/clinical groups and the technology that serves them.
- Communications – Stewards need to be the liaison and cheerleader for governance process, effectively convey the business rules and definitions and promote them across the organization.
Data Stewards must retain responsibility for the data content, quality and integrity. They are an integral part of defining system requirement for data use and have a responsibility to protect the data from misuse or mismanagement. The most valued skill of the data steward is having a solid understanding of who their data users are, how that data is used and the rules and processes that impact that data and its use.
The data custodian is the technical partner for the data steward. The two must work as two sides of the same coin. Data custodians are responsible for:
- Reference Data – They need to have the ability to create and maintain consistent reference data and be the holder of the master data definitions.
- Publishing – They need to maintain control over the publishing and appropriate use of relevant data across the organization, tracking usage/relevance/quality of data sources.
- Metadata Manager – They should create and manage the metadata for published data sources to ensure its usability and scalability across the enterprise.
- Reconciliation – Custodian are the last line of defense for data integrity and quality issues across multiple stakeholders and business units.
Continuous communication and collaboration with the data stewards is essential for the custodian to keep informed about business changes that impact systems and the data. Once changes have been verified, the custodian can then ensure the data asset can be scaled across the organization and leveraged appropriately.
In large organizations or those with well-defined master data management programs these roles may be a formal job title. However, in most organizations, the steward and custodian tasks are secondary responsibilities for those performing other jobs. Whether formal or informal, your users need to know who to approach when they need to know what data to use, validate the accuracy or completeness of the data and who to talk to when questions or issues arise. Data is also cross-functional in nature so several departments might claim responsibility for certain data points and functions or use the same data in different manners. It is important to ensure all voices are heard and a cross-functional governance body is available to divide responsibilities and to resolve conflicts.
Serving as a data steward or data custodian is not an easy job. In addition to possessing all the needed qualifications, the person performing this role has to recognize and be recognized for its importance to the organization. They must be willing to tackle difficult issues and resolve often long standing conflicts among seasoned business and IT professionals to arrive at a solution that correctly utilizes the data under their care. Ultimately, when stewards and custodians truly function as a team, the management of the health systems data becomes a powerful strategic information asset that can produce far reaching financial, operational and clinical results that are scalable across any project, initiative or mission within their organization.
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