Data Integrity: An Ounce of Prevention

Benjamin Franklin once said that an ounce of prevention is worth a pound of cure. This certainly applies to data integrity in your medical staff database. In the 2017 Annual Report on Medical Staff Credentialing, 90.5% of you indicated that data management is an initiative that is extremely or very important, and 72.9% of you have fully or partially implemented a single, master provider database for your enterprise that is the single source of truth for provider data. Based on these numbers, it is undoubtedly vital to implement processes that will keep your database accurate and complete. For those of you who have been in the medical staff field for many years, this is likely a major shift from the days when your data only affected your department. While it can be an intimidating change, it also opens up new challenges and roles that have the potential to be highly rewarding. I have outlined several strategies below to consider when planning both your preventative measures and your cures.

An Ounce of Prevention

1. Set clear expectations. Everyone involved in the process of either entering or utilizing the data should be clear on the field definition and expected output. This will include your staff, recipients of your data, and owners of any downstream systems that your database feeds.

2. Define and document your business processes. At a minimum, you will need a data dictionary and standard operating procedures (SOPs). Your data dictionary should provide a comprehensive definition and data entry standard for every field used in your database. Your SOPs should walk employees through the required steps for any processes that take place in your database, including (but certainly not limited to) initial credentialing, reappointment, enrollment, and referring providers. If SOPs are new to you, expect this process to take time. Focus on tackling one process at a time, and be prepared to make changes after you roll it out. You will also need to continuously update these documents as processes change or as new fields are used.

3. Engage your staff. If your data entry staff understands the impact the data they are entering has on the entire organization and patient care, they are more likely to be invested in keeping the data clean.

A Pound of Cure

Implementing the ideas above will go far in minimizing the data entry issues that occur within your database. However, because we are all human, you will also need methods in place to catch data errors or gaps when they inevitably materialize.

1. First, determine what is important and/or urgent. These may or may not be the same, and you will need to work with other departments that use your data to make these decisions collectively. For urgent issues, you will need to find ways to catch these as quickly as possible. You might look to in-software alerts or reports that are scheduled to notify you multiple times per day. For issues that are important but not necessarily urgent, you may want to periodically run reports, especially ahead of reports that need to be highly accurate and contain fields that you otherwise do not audit on a regular basis.

2. Determine ownership. Who is responsible for receiving these alerts or running reports? When mistakes are found, should they be resolved by the person who discovered them or the person who made the error? The responses to the 2017 Annual Report on Medical Staff Credentialing indicated that 21% of you have created or are in the process of creating new data roles within your MSO or CVO, and this person will be heavily involved here. If you do not have a dedicated data resource, it is vital to carve out time for you or your staff to take care of this.

3. Provide continuing education and review for staff. The owner(s) of your database’s data integrity may notice patterns of data entry issues. There should be some sort of process, either formal or informal, to note and address these issues. If it’s a widespread issue among multiple staff members, you may need to reevaluate your data dictionary and/or SOPs to provide more clarity.  Spending just a few minutes during your regular staff meeting to review and clarify these problem areas can save valuable time and energy in the long run.

4. Communicate externally. If you are feeding your data to other systems, it can be an ongoing challenge to make sure users of those other systems know to contact you with changes or updates. Collaborate with leaders of other departments who use your data to make sure that everyone knows how to provide updates to data rather than only changing it in the downstream system. If you have regular newsletters that are distributed to your entire organization, consider placing periodic reminders to contact your department with changes to provider data.

Though exposing your data can initially feel painful and frustrating, try to welcome the opportunity to share data with other departments. The more eyes you have on your data, the cleaner it will have to become for everyone.