Infobesity in the Healthcare Industry: A Well-Balanced Diet of Predictive Governance is needed


Fat TwitterWith the rapid advances in healthcare technology, the movement to electronic health records, and the relentless accumulation of regulatory requirements, the shift from records management to information governance is increasingly becoming a necessary reality.

In a 2012 CGOC (Compliance, Governance and Oversight Counsel) Summit survey, it was found that on the average 1% of an organization’s data is subject to legal hold, 5% falls under regulatory retention requirements and 25% has business value. This means that 69% of an organization’s ESI is not needed and could be disposed of without impact to the organization. I would argue that for the healthcare industry, especially for covered entities with medical record stewardship, those retention percentages are somewhat higher, especially the regulatory retention requirements.

According to an April 9, 2013 article on ZDNet.com, by 2015, 80% of new healthcare information will be composed of unstructured information; information that’s much harder to classify and manage because it doesn’t conform to the “rows & columns” format used in the past. Examples of unstructured information include clinical notes, emails & attachments, scanned lab reports, office work documents, radiology images, SMS, and instant messages. Despite a push for more organization and process in managing unstructured data, healthcare organizations continue to binge on unstructured data with little regard to the overall health of their enterprises.

So how does this info-gluttony, (the unrestricted saving of unstructured data because data storage is cheap and saving everything is just easier), affect the health of the organization? Obviously you’ll look terrible in horizontal stripes, but also finding specific information quickly (or at all) is impossible, you’ll spend more on storage, data breaches will could occur more often, litigation/eDiscovery expenses will rise, and you won’t want to go to your 15th high school reunion…

To combat this unstructured info-gain, we need an intelligent information governance solution – STAT!  And that solution must include a defensible process to systematically dispose of information that’s no longer subject to regulatory requirements, litigation hold requirements or because it no longer has business value.

To enable this information governance/defensible disposal Infobesity cure, healthcare information governance solutions must be able to extract meaning from all of this unstructured content, or in other words understand and differentiate content conceptually. The automated classification/categorization of unstructured content based on content meaning cannot accurately or consistently differentiate the meaning in electronic content by simply relying on simple rules or keywords. To accurately automate the categorization and management of unstructured content, a machine learning capability to “train by example” is a precondition. This ability to systematically derive meaning from unstructured content as well as machine learning to accurately automate information governance is something we call “Predictive Governance”.

A side benefit of Predictive Governance is (you’ll actually look taller) previously lost organizational knowledge and business intelligence can be automatically compiled and made available throughout the organization.

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Ask the Magic 8-Ball; “Is Predictive Defensible Disposal Possible?”


The Good Ole Days of Paper Shredding

In my early career, shred days – the scheduled annual activity where the company ordered all employees to wander through all their paper records to determine what should be disposed of, were common place. At the government contractor I worked for, we actually wheeled our boxes out to the parking lot to a very large truck that had huge industrial shredders in the back. Once the boxes of documents were shredded, we were told to walk them over to a second truck, a burn truck, where we, as the records custodian, would actually verify that all of our records were destroyed. These shred days were a way to actually collect, verify and yes physically shred all the paper records that had gone beyond their retention period over the preceding year.

The Magic 8-Ball says Shred Days aren’t Defensible

Nowadays, this type of activity carries some negative connotations with it and is much more risky. Take for example the recent case of Rambus vs SK Hynix. In this case U.S District Judge Ronald Whyte in San Jose reversed his own prior ruling from a 2009 case where he had originally issued a judgment against SK Hynix, awarding Rambus Inc. $397 million in a patent infringement case. In his reversal this year, 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 as well). 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.

Another well know example of sudden retention/disposition policy activity that caused unintended consequences is the Arthur Andersen/Enron example. During the Enron case, Enron’s accounting firm sent out the following email to some of its employees:

 

 

This email was a key reason why Arthur Andersen ceased to exist shortly after the case concluded. Arthur Andersen was charged with and found guilty of obstruction of justice for shredding the thousands of documents and deleting emails and company files that tied the firm to its audit of Enron. Less than 1 year after that email was sent, Arthur Andersen surrendered its CPA license on August 31, 2002, and 85,000 employees lost their jobs.

Learning from the Past – Defensible Disposal

These cases highlight the need for a true information governance process including a truly defensible disposal capability. In these instances, 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 consistently followed and has 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.

To successfully automate the disposal of unneeded information in a consistently defensible manner, auto-categorization applications must have the ability to conceptually understand the meaning in unstructured content so that only content meeting your retention policies, regardless of language, is classified as subject to retention.

Taking Defensible Disposal to the Next Level – Predictive Disposition

A defensible disposal solution which incorporates the ability to conceptually understand content meaning, and which incorporates an iterative training process including “train by example,” in a human supervised workflow provides accurate predictive retention and disposition automation.

Moving away from manual, employee-based information governance to automated information retention and disposition with truly accurate (95 to 99%) and consistent meaning-based predictive information governance will provide the defensibility that organizations require today to keep their information repositories up to date.

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.

Your organization’s social media problem can’t be cured with antibiotics


You can’t control what employees do away from work on their own time and using their own equipment but companies do have a right to control their brand and that includes how they are represented by their employees on social media sites. For that reason, every organization should develop, implement and enforce a corporate-wide social media policy for all employees (because if you don’t enforce it, then do you really have a policy?).

Gary MacFadden was kind enough to pose a great question in response to my last blog posting titled “Did you hear the one about the Attorney who thought social media was a dating website for singles over 40?”. Gary pointed out that it would be helpful if I could give examples of a corporate social media policy (what it involved) and what the employee education process would be to make employees aware of the policy. With that in mind, here are some aspects of a corporate social media policy:

  1. A policy author with contact information in case employees have questions
  2. An effective date
  3. A definition of what social media is
  4. A description as to why this policy is being developed (for legal defense, brand protection etc)
  5. A description of  what social media sites the company officially participates in
  6. A listing of those employees approved to participate on those sites
    1. The fact that any and all approved social media participations will be done only from corporate infrastructure (this is to protect approved employees from discovery of their personal computers)
    2. A description of topics approved to be used
    3. A description of those topics not approved to be used
    4. A description of any approval authority process
    5. A description of what will happen to the employee if they don’t follow the approved process
  7. A direct statement that unapproved employees that make derogatory remarks about the organization, publish identifying information about clients, employees, or organization financials, talk about organization business or strategy etc. in any social media venue will be punished in the following manner…
  8. A description of how these policies will be audited and enforced

Once the policy is developed, it needs to be communicated to all employees and updated by legal representative on an annual basis. This education process could include steps like:

  1. A regularly updated company intranet site explaining the policy.
  2. A description and discussion of the policy in new employee orientation activities.
  3. A printed description of the policy which the employee signs and returns to the organization.
  4. An annual revisiting of the policy in department meetings.
  5. The publishing of an organization “hot line” to your corporate legal department for real-time questions.

On a related topic, for legal reasons you should be archiving all approved social media participations much like many companies now archive their email and instant message content.

This practice will seem rather draconian to many employees but in reality the organization needs to protect the brand and always have a proactive strategy for potential litigation.

A sampling of various organizations social media policies can be found here. I was particularly impressed withDell’s.