healthcare organizations are slow to budget for an overarching
IG program. Likewise, it’s not easy to determine the overall cost
of an IG program nor is it easy to determine the dollar return on
investment of an overarching IG program, but there are many
IG-related projects and initiatives that are already in process or
may be planned for the near future that can show a return. It’s
critical to note that without having a formalized IG program in
place, these IG-related projects and initiatives will not take hold
for the long term and will require downstream clean up—as well
as result in challenges to confidence in information and the organization as a whole. IG is not only a lifelong program, but it
also needs to become part of the organizational culture.
ROI can be demonstrated most directly through tangible values. These are values with a real impact that are concrete and
can be quantified. Examples include proactive person identity
management that eliminates or minimizes retrospective clean
up activities; a formalized, organization-wide record management plan; increased productivity; and reduced staff turnover.
Person identity management includes the ever-important
patient identity management and elimination of duplicate
medical record numbers. In the “Real World Examples of IG’s
Return on Investment” section of this Practice Brief, Karen Proffitt shares her experience with enterprise master patient index
(EMPI) strategies. Additionally, other “person” identities within
the healthcare organization—such as physician identity and attribution and employee identity—are included and should be
addressed through policies, procedures, and staff education.
How often does a healthcare organization report physician attribution to service types (e.g. attending, admitting, consulting,
surgeon) inaccurately? Not only does this reflect poorly upon
the healthcare organization and the provider in question, but
requires rework on the back end.
Record management programs should be organization-wide
and address all types of information on all types of media.
Critical to a record management program is a record retention
schedule and a record destruction policy. Organizations can
save thousands of dollars by destroying records and other documents that have met federal or state record retention requirements and no longer serve a business or legal purpose for the
organization. Additionally, there is a risk associated with maintaining records and documents longer than is needed. This risk
can result in negative legal outcomes.
Improved productivity and decreased staff turnover are two
additional areas worth exploring for ROI. By making proactive
decisions, developing consistent policies and procedures, and
educating staff on their roles and responsibilities, the organization will reduce retrospective workarounds, fixes, and other
rework, thereby making staff more productive. Likewise, there
is a cost associated with staff turnover—the cost to recruit, hire,
and orient new employees is not inexpensive. When staff knows
what is expected and where to find policies and procedures in
support of roles, and are properly educated and trained, they
are most likely to be successful in their work. Reducing stress
and frustration is one way to retain qualified employees.
There are many other areas that can be delved into across the
healthcare organization that will result in increased efficiencies,
which equate to efficient and effective healthcare.
Real World Examples of IG’s Return on Investment
The following offers real world examples of IG projects in enterprise information management and data governance that garnered return on investment.
Enterprise Information Management (EIM)
Karen Proffitt, MHIIM, RHIA, CHP, is vice president of identity
enterprise solutions for Just Associates, Inc., a consulting firm
focused on identifying and resolving patient data and integrity
issues. She has worked with several healthcare clients to centralize management and control of the EMPI for accurate patient identity. She recommends that the EMPI strategy, policies,
and performance monitoring initiative be a key component of
an enterprise IG program. The return on investment for EMPI
program centralization and management includes increased efficiency, productivity, and reduced costs.
To achieve the ROI, Proffitt recommends HIM be the owner of
the EMPI, as they are uniquely qualified to provide:
One authority for adoption of consistent maintenance
Standardized/simplified error correction processes
Consistent MPI conversion decisions with minimal required resources
Numerous hand-offs minimized to improve turnaround
Cross-trained team members who are interchangeable for
One of Just Associates, Inc.’s clients who implemented cen-
tralized EMPI identified a potential return on investment in the
form of full-time employee (FTE) reductions. Previously, under
the decentralized model, there were 40 FTEs with a cost of $21
per task for duplicate medical record number reconciliation.
Under the centralized model, the total staffing decreased to 21
FTEs, and the duplicate reconciliation cost was reduced to $12
per task. Another example of total EMPI centralization for eight
hospitals in a corporate structure model resulted in an overall
savings of $4.6 million.
A focused strategy to minimize duplicate medical record num-
ber creation can lead to additional reduced costs. The average
cost of a duplicate medical record is $100 due to delayed treat-
ment, duplicate tests, and other administrative issues. Another
Just Associates client had significant FTE reductions—from 24
to nine—by centralizing the EMPI and reducing duplicate cre-
ation rates. These examples provide a compelling rationale to
initiate an enterprise information governance program with
centralized EMPI. This is IG at “ground zero.”
Katherine Lusk, MHSM, RHIA, FAHIMA, chief health infor-
mation management and exchange officer and Michelle Her-
mann, MS, RHIA, HIM director at Children’s Health System of