Question

For this discussion, you will assume the role of a data steward for a large healthcare facility with multiple departments. In your initial post:

Define/describe health data stewardship.

In an acute hospital or a large provider practice, identify who should practice data stewardship and why.

Describe specific practices suggested for data stewardship.

Include a minimum of three best practices, explained in detail. Explain the importance of health data stewardship.

As the health data steward, describe what will you do to ensure that PHI is put to appropriate uses and misuses are prevented.

Describe how data stewardship has changed as the healthcare industry progresses to the electronic health record.

Answer 1

• Health data stewardship is a responsibility, guided by principles and practices, to ensure the knowledgeable and appropriate use of data derived from individuals' personal health information. These uses include data collection, viewing, storage, exchange, aggregation, and analysis.

• Data stewardship is the responsibility of everyone who collects, views, stores, exchanges, aggregates, analyzes, and uses electronic health data. No single person can know everything about every system, it’s best to have many data stewards — at least one for every major source of data in the organization.the best person to perform this role is the person who knows the most about how and why the data is collected in each of the various source systems. This includes health care organizations, clinicians, payers, information exchanges, vendors, the quality improvement community, health statistics agencies, researchers, and caregivers.
• The specific practices suggested for data stewardship include transparency about use; identification of the purpose for data use; participation of individuals; security safeguards and controls; de-identification (when relevant); data quality, including integrity, accuracy, timeliness, and completeness; limits on use, disclosure, and retention; oversight of data uses; accountability; and enforcement and remedies.

1. Individual rights

• Access for an individual to his/her own health data - An individual has the right to know what is in his or her health records.
• Opportunity to correct one’s own data - Improving the accuracy of the data enhances health care and the utility of the data.
• Transparency for the individual about the uses of his/her data - Making an individual aware of what information exists and how it will be used builds trust. The individual should be notified in advance of policies, procedures,and technology, including what information will be shared under what circumstances.
• Individual participation and consent for the use of the data - Allowing an individual to make decisions about electronic exchange of his or her data also builds trust. The degree of choice may vary with the type of information, the purpose of the exchange, applicable law, population health needs, and other factors.
• Education - In order to participate meaningfully, consumers should be educated about the principles and practices governing appropriate use of their health data and the potential benefits (and risks) of health data use for the public.
• Other rights to privacy of personal health information as set forth in state and federal laws and regulations.

2. Responsibilities of the health data steward

• Adherence to an appropriately determined set of privacy and confidentiality, principles and practices.
• Appropriate use of information from the standpoint of good statistical practices (such as by not implying cause and effect when the data only point to correlation)
• Limits on use, disclosure and retention
• Identification of the purpose for a specific use of the data
• Application of “minimum necessary” principles
• Verification of receipt by the correct recipient, wherever possible
• Data de-identification (HIPAA-defined and beyond)
• Data quality, including integrity, accuracy, timeliness, and completeness.

3. Security safeguards and controls

• To ensure the confidentiality, integrity, and availability of health data, data stewardship requires the implementation of administrative, technical and physical safeguards to protect the information and minimize the risks of unauthorized or inappropriate access, use, or disclosure.

4. Accountability, enforcement, and remedies

• Data stewardship requires policies that specify appropriate use and identify clear accountability. Mechanisms are needed for detection of failure to follow policy. When a failure occurs, consequences to the accountable party must be enforced, along with remediation for the individual whose data are involved.

The purpose of stewardship is to realize the greatest possible benefit from the effective and appropriate use of data while minimizing the risk of harm. Health data stewardship has taken on great practical urgency because of the increase in availability of electronic health data; growing recognition of the value of electronic data in improving health care and population health; the acceleration in the use of information and communication technology; and awareness of the potential risks associated with incorrect or inappropriate uses of health data.