Healthcare Information Governance Requires a New Urgency


From safeguarding the privacy of patient medical records to ensuring every staff member can rapidly locate emergency procedures, healthcare organizations have an ethical, legal, and commercial responsibility to protect and manage the information in their care. Inadequate information management processes can result in:

  • A breach of protected health information (PHI) costing millions of dollars and ruined reputations.
  • A situation where accreditation is jeopardized due to a team-member’s inability to demonstrate the location of a critical policy.
  • A premature release of information about a planned merger causing the deal to fail or incurring additional liability.

The benefits of effectively protecting and managing healthcare information are widely recognized but many organizations have struggled to implement effective information governance solutions. Complex technical, organizational, regulatory and cultural challenges have increased implementation risks and costs and have led to relatively high failure rates.  Ultimately, many of these challenges are related to information governance.

In January 2013, The U.S. Department of Health and Human Services published a set of modifications to the HIPAA privacy, security, enforcement and breach notification rules.  These included:

  • Making business associates directly liable for data breaches
  • Clarifying and increasing the breach notification process and penalties
  • Strengthening limitations on data usage for marketing
  • Expanding patient rights to the disclosure of data when they pay cash for care

Effective Healthcare Information Governance steps

Inadvertent or just plain sloppy non-compliance with regulatory requirements can cost your healthcare organization millions of dollars in regulatory fines and legal penalties. For those new to the healthcare information governance topic, below are some suggested steps that will help you move toward reduced risk by implementing more effective information governance processes:

  1. Map out all data and data sources within the enterprise
  2. Develop and/or refresh organization-wide information governance policies and processes
  3. Have your legal counsel review and approve all new and changed policies
  4. Educate all employees and partners, at least annually, on their specific responsibilities
  5. Limit data held exclusively by individual employees
  6. Audit all policies to ensure employee compliance
  7. Enforce penalties for non-compliance

Healthcare information is by nature heterogeneous. While administrative information systems are highly structured, some 80% of healthcare information is unstructured or free form.  Securing and managing large amounts of unstructured patient as well as business data is extremely difficult and costly without an information governance capability that allows you to recognize content immediately, classify content accurately, retain content appropriately and dispose of content defensibly.

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Defensible Disposal means never being accused of spoliation for hosting “Shred Days”


U.S District Judge Ronald Whyte in San Jose reversed his own prior ruling from a 2009 case where he issued a judgment against SK Hynix, awarding Rambus Inc. $397 million in a patent infringement case. In his reversal this month, Judge Whyte ruled that Rambus Inc. had spoliated documents in bad faith when it hosted company wide “shred days” in 1998, 1999, and 2000. Judge Whyte found that Rambus could have reasonably foreseen litigation against Hynix as early as 1998, and that therefore Rambus engaged in willful spoliation during the three “shred days” (a finding of spoliation can be based on inadvertent destruction of evidence). Because of this recent spoliation ruling, the Judge reduced the prior Rambus award from $397 million to $215 million, a cost to Rambus of $182 million.

Two questions come to mind in this case; 1) why did Rambus see the need to hold “shred days”?, and 2) did they have an information governance policy and defensible disposal process? As a matter of definition, defensible disposal is the process (manual or automated) of disposing of unneeded or valueless data in a way that will standup in court as reasonable and consistent.

The obvious answer to the second question is probably not or if yes, it wasn’t being followed, otherwise why the need for the shred days? Assuming that Rambus was not destroying evidence knowingly; the term “shred-days” still has a somewhat negative connotation. I would think corporate attorneys would instruct all custodians within their companies that the term “shred” should be used sparingly or not at all in communications because of the questionable implications.

The term “Shred days” reminds many of the Arthur Andersen partner who so famously sent an email message to employees working on the Enron account, reminding them to “comply with the firm’s documentation and retention policy”. The Andersen partner never ordered the destruction or shredding of evidence but because anticipation of future litigation was potentially obvious, the implication in her email was “get rid of suspect stuff”. The timing of the email message was also suspect in that just 21 minutes separated Ms. Temple’s e-mail message to Andersen employees on the Enron account about the importance of complying with the firm’s document retention policy from an entry in a record of her current projects in which she wrote that she was working on a case involving potential violations of federal securities laws.

The Rambus case highlights the need for a true information governance process including a truly defensible disposal strategy. An information governance process would have been capturing, indexing, applying retention policies, protecting content on litigation hold and disposing of content beyond the retention schedule and not on legal hold… automatically, based on documented and approved legally defensible policies. A documented and approved process which is religiously followed, and with proper safeguards goes a long way with the courts to show good faith intent to manage content and protect that content subject to anticipated litigation.