c07-idc-market-spotlight-3473

Overview of Epic and Data Governance

 

Healthcare provider organizations have made enormous investments in and commitments to the Epic application. In its various combinations of more than 30 modules and applications, it is running vast swaths of many of the largest healthcare provider organizations in the country.

Sometimes it can seem like Epic is the only application in the enterprise and, if you simply do everything “the Epic way,” there is no need for any other solutions or capabilities. But even enterprises that are all-in on Epic have a large number of additional applications, databases, and information systems that are not Epic.

In this white paper we will discuss why holistic data governance is an essential capability to make Epic even more valuable to the enterprise. We will do this in the following sequence:

  • Define holistic data governance

  • Discuss the capabilities required to deploy holistic data governance at enterprise scale

  • Articulate where the Epic application fits into the larger context of holistic data governance

  • Highlight four specific use-cases tied to Epic where holistic data governance delivers value

 

Holistic Enterprise Data Governance

Data governance is a coordinated enterprise effort that protects and optimizes the business value of the organization’s assets—its data assets. The goal of data governance is not just to clarify who “owns” data but also to optimize its value. The data itself is merely the means to the desired end of improved business and clinical performance.

Informatica® defines data governance as “A discipline to create repeatable and scalable data management policies, processes, and standards for the effective use of data.”

As with other business functions, it requires people, policies, and processes with a clear way to measure success, compliance, and organizational effectiveness. We will address each of these throughout this white paper.

 

Essential Data Governance Capabilities

The people, policy and process components focus on the necessary skills, education, sponsorship, behavioral, and even cultural changes and investments required to ensure data governance can effectively achieve real change. In parallel, the technology components are the specific enabling capabilities that are needed as part of a holistic data governance program.

These capabilities include:

Data Profiling

Data profiling helps business analysts and data stewards answer the questions, “What does data look like today?” “How does data in one system relate to data in another system?” and “What rules and policies should we consider defining to improve?” Even within the Epic application itself, there are variance and data quality issues that must be identified and efforts made to correct through staff training, edit rules, and other means. This is even more true once the data has beenexternalized in the Epic analytic environment, where effective governance of the data requires that it be profiled and understood in a comprehensive fashion.

Data Discovery

While data profiling allows in-depth analysis of specified data sets, data discovery allows organizations to identify where any data anomaly or business scenario occurs across all data sources and to create a comprehensive inventory of data across the enterprise. For example, the data privacy organization may require the ability to identify where electronic protected health information (ePHI) or personally identifiable information (PII) is used and how that relates to specific business rules/processes where obfuscation or data masking needs to be used. Since Epic is only one of many potential sources of data available across the enterprise, this ability to discover data wherever it resides is critical to effective use—and protection—of data as an enterprise asset.

Business Glossary

A business glossary allows business and information technology (IT) stewards to capture and share the full business context around critical data. In addition to the expected definitions of core data entities and attributes, context can also include rules, policies, reference data, free-form annotation, links, and data owners. Within Epic, there are multiple locations where terms and their definitions are documented, making it difficult for end-users to know where to look and quickly find the definition they are seeking.

Some organizations simply manage their shared definitions in Word documents or spreadsheets, an approach that typically focuses on the terms and definitions but misses the broader context including workflows, approvals, and collaboration features. A comprehensive business glossary application enables collaboration across the business and IT roles that create, approve, and consume these definitions. This minimizes the risk of redundancy, definition stagnation, and versioning conflicts. A good business glossary should also provide access capabilities that enable sharing of the business vocabulary across the organizations. A common business vocabulary that is not available to everybody all the time has limited value.

Metadata Management and Data Lineage

The ability to reconcile and provide transparency and visibility to the supporting metadata of critical data is a foundational element of a data management reference architecture. Data lineage visualization and auditing capabilities allow data architects and stewards to visualize the flow of data through their environment and effectively assess the impact of potential changes to data definitions, rules, or schemas, as well as root cause analysis capabilities when responding to a data quality or security failure. In many cases this lineage will tie back to an Epic source, which can provide critical understanding and validation of a metric or measure.

We will also see how being able to visualize the downstream impact of a changed or deprecated data field within Epic can have far reaching consequences that must be effectively (and efficiently) mitigated. IT staff ranging from data modelers to enterprise architects, business systems analysts, developers, and DBAs often manage the technical metadata, while business analysts and business stewards are often responsible for the business-oriented metadata. Ideally, the business glossary should be well-integrated with the metadata solution to enable an unambiguous collaboration between business and IT.

Policy Management

Business policies and standards are critical to capture and communicate for any data governance function. Common policies that must be agreed upon, documented, and complied with include data accountability and ownership, organizational roles and responsibilities, data capture and validation standards, information security and data privacy guidelines, data access and usage, data retention, data masking, and archiving policies. Ensuring that the data created, maintained, and externalized for secondary uses from Epic is tied to enterprise policies is critical to managing compliance with regulatory requirements, ensuring confidential data is protected, and mitigating the risk of electronic protected health information (ePHI) and personally identifiable information (PII) proliferating throughout the enterprise.

 

Where Epic Fits Into Holistic Data Governance

Epic is a critical application to healthcare organizations and, depending on the scope of the implementation, can take on most enterprise functions. But no matter how comprehensive the use of Epic within a hospital or health system, the following things are always true:

  • Epic is never the only application in the enterprise. There are always departmental systems, legacy applications, and new cloud applications for customer relationship management, consumer engagement, etc.

  • There are always sources of valuable data that are outside the Epic application. These sources can include legacy databases, data marts, data warehouses, departmental systems, and countless other newly implemented and legacy data sources that are critical to the operation of the enterprise.

  • Epic data is always consumed outside the Epic application and used by individuals without authorized access to Epic. One of the strengths of Epic is that it externalizes much of the data of interest for analytics and reporting in industry-standard relational databases. This encourages the use of data sourced from the Epic application by a wide variety of analysts and other individuals throughout the enterprise who are creating their own reports and dashboards using Tableau, Power BI, or any number of other self-service tools. These individuals may never interact with the Epic application directly and likely will not have user access either.

As a result, even in the largest accounts with a complete commitment to doing things “the Epic way,” the enterprise need for holistic data governance dictates that Epic participate in a larger program and platform for data governance rather than stand alone.

 

Use Cases for Epic as a Participant in Holistic Data Governance

Epic and your analytic environments are key components of the IT infrastructure at your organization. That’s why it is important for you to support your Epic environment and its entire data lifecycle from the creation and curation of data to the optimizing and improving the data.

The success of a holistic data governance program relies on knowledgeable and engaged data consumers and users. It is imperative that you educate consumers and users at each stage of the data lifecycle and provide them a means to engage and participate in data governance. This is best accomplished by deploying an application to support collaboration and transparency into your data governance program’s policies and definitions; a data catalog to support the discovery and inventory of your most critical data assets; and a data quality solution to ensure that you’re using only the most trusted data.

Informatica offers an Enterprise Data Governance solution as part of its Intelligent Data Platform™ that can effectively govern Epic data and seamlessly include the broader data landscape of any healthcare system. Combining Informatica’s solution, which includes Axon™ Data GovernanceEnterprise Data Catalog and Data Quality, while partnering with Prominence, can ensure you hit the ground running with use and adoption that delivers meaningful value to the enterprise quickly.

The following examples are customer-specific use cases illustrating how Axon Data Governance, Enterprise Data Catalog and Informatica Data Quality can help you manage your Epic data pipeline:

  • Support self-service and deliver a certified, trusted source of truth

  • Connect business context to technical metadata and logic

  • Centralize information and knowledge to increase enterprise data literacy

  • Ensure impact analysis, lineage, and reporting transparency

 

Use Case: Support Self-Service and Deliver a Certified, Trusted Source of Truth

Every organization wants, and needs, clearly defined sources of truth for data that people rely on to make decisions and take action—especially when patient care is on the line.

Releasing certified content to BI and data analytics developers and consumers is a first step, but to truly make an impact and give everyone the confidence needed to act on the data, you need to provide context and transparency.

Direct your self-service users to the right table, providing information about how it was created and where it is being used to enable confidence and trust through Informatica’s Enterprise Data Catalog, Axon Data Governance, and Informatica Data Quality.

These capabilities empower your team to deliver meaningful context and transparency to the myriad of data you release to your end consumers, internal and external. This raises literacy, engenders trust, builds confidence, and ensures your people are maximizing your investment in enterprise intelligence by making the right decision based on the right information. This improves:

  • Patient outcomes

  • Patient satisfaction

  • Employee satisfaction

Use Case in Action

Enterprise Data Catalog can play a crucial role in governing your self-service data. As a user, you know you’re supposed to use the master tables as an organizational source of truth, but you’re not sure where the data is coming from. Enterprise Data Catalog can give you a holistic view of trusted data, relationships, and lineage. It enables trust through:

  • Data lineage: Leverage the data connections to understand how the self-service layer was created and from what data source.

  • Collaboration: You can leave a review of five stars if you know data is trusted and can identify the source of many reports. Tables that have reviews with a higher number of stars will automatically be pushed up in the search results for future users.

  • Data stewardship: You can see stakeholders assigned under people, and you can see your data owner. A green ribbon next to the Master at the top indicates it has been certified by the data governance team.

 

Figure 1: Informatica's Enterprise Data Catalog UI displaying search results
Figure 1: Informatica's Enterprise Data Catalog UI displaying search results

Use Case: Connecting Business Context to Technical Metadata and Logic

Improving your governance program does not require reinventing the wheel. Vendors today— with Epic at the forefront—provide more and more analytics and benchmarking capabilities. To effectively leverage these insights, you need to ensure everyone has transparency into their definitions—both from a business (context) and technical (lineage) perspective.

Stand on the shoulders of Epic, and their collective customer base, and reuse business definitions and calculations to enable comparison to your peers.

Axon Data Governance (Axon), Enterprise Data Catalog (EDC), Informatica Data Quality (IDQ), and Prominence enable you to provide 100% transparency into the business and technical definitions provided by Epic and other vendors. Provide transparency by linking business terms, such as Epic-released benchmarking definitions, to the technical lineage and storage of the data by using Axon and EDC. Automate your data quality rules and standards with IDQ. Validate the standard

KPIs work for your organization. Leverage workflow and stewardship functionality to take the work of adoption out of email and Excel to drive tasks, accountability, and collaboration.

Use Case in Action

Start your glossary and governance efforts with Epic-released benchmarking terms, which can be bulk uploaded with hundreds of other standards into Axon. When you onboard these terms, you can take the time to make the important connections showing where the source data lives and how users can access it. In Axon, you can see business-friendly descriptions and lineage. Links to Enterprise Data Catalog enable you to see technical details showing where the information is stored, accessed, and currently used.

Figure 2: Informatica's Axon Data Governance UI displaying business definitions tied to the technical lineage representing the business concept
Figure 2: Informatica's Axon Data Governance UI displaying business definitions tied to the technical lineage representing the business concept

 

In addition to viewing business and technical context, you can leverage Axon’s workflow and stewardship functionality to take the work of adoption out of email and Excel to drive tasks, accountability, and collaboration. In Figure 3, the workflow moves from the steward to the SMEs and then to the sponsor for final approval. You can see who holds the baton and what the next step is. You can also easily access the history of these interactions.

Figure 3: Example of Informatica's Axon Data Governance displaying a workflow for data stewards to follow
Figure 3: Example of Informatica's Axon Data Governance displaying a workflow for data stewards to follow

Use Case: Centralize Information and Knowledge to Increase Enterprise Data Literacy

How can you be certain everyone is using the right data for the right purpose? Epic is endlessly configurable. This means there are multiple places to document the same information, depending on the workflow (e.g., diagnosis can be recorded in problem list, principle diagnosis, coded diagnosis, and more).

How can you be certain everyone is using the right data given the numerous workflows they’d have to understand and potential places they’d have to examine?

Informatica EDC and Prominence’s experts resolve this challenge by creating a central place for information, including lineage, connections back to your curated business terms, Epic’sreporting table and field definitions, and links to additional detail in Epic documentation. Increase the data literacy of report writers, system analysts, data consumers, and anyone else needingto better understand their data through transparency and a shared language, all available in a single platform.

Use Case in Action

Leverage Epic-curated information as well as your organizational expertise by including the following:

  • Epic-curated definitions for Clarity and Caboodle tables and columns

  • Links out to additional information in the Epic Data Dictionary

  • Epic glossary terms defined in Axon and associated in EDC

  • Information for Epic-based assets like INI and item references

Figure 4: Example of how additional context can be added to support Epic based assets
Figure 4: Example of how additional context can be added to support Epic based assets

Use Case: Ensure Impact Analysis, Lineage and Reporting Transparency

Epic is moving all customers to a quarterly or bi-annual upgrade schedule. This, for most organizations, dramatically increases the frequency with which you need to evaluate the impact of net new and deprecated fields.

Additionally, once these new and deprecated fields are understood, you need to ensure all references to those fields are updated accordingly. With thousands of Epic standard reports and dashboards, this exercise can quickly become overwhelming and never-ending (because once you’re done, the next upgrade begins).

Using data lineage and impact between Epic’s reporting database, Epic’s data warehouse, and your analytics tools, you can decrease the amount of manual effort and time required and increase the accuracy of your results. It took one Epic customer more than 30 days and more than 17 emails to resolve a single deprecated field issue. Multiply that by how many field changes occur with each upgrade, and you have a strong business case for implementing technology to ease your quarterly headaches.

Use Case in Action

Let’s follow an example of how to look up the impact of a deprecated field. We know you can find the deprecated fields from Epic tools like DCMA, Nova notes, or an upgrade spreadsheet. From that search, you would get a field that has been deprecated. You would then search for that field in Enterprise Data Catalog and quickly visualize the impact of the change on transformations, reports, and downstream applications. Figure 5 shows that four SQL models and two Tableau applications are impacted. You can further drill down to see the Tableau field and visualizations that need to be updated. Tasks that used to take 30 days now take just minutes.

Figure 5: Graphic explaining how lineage enables users to see the impact of an upstream Epic reporting database change
Figure 5: Graphic explaining how lineage enables users to see the impact of an upstream Epic reporting database change

Summary

Holistic data governance is an essential enterprise competency for healthcare organizations to become data driven and mature along their digital transformation journey. Experience has shown the path to success for establishing data governance as an enterprise competency is to “think big but start small.”

Thinking big is required since the scope and reach of holistic data governance is the entire enterprise, and the thousands of data sources and data consumers and the millions of different fields and data elements they represent. The software capabilities described for data profiling, data discovery, metadata management, data lineage, and policy management are essential enablers of realizing the big vision for holistic data governance. Planning for success and the rapid growth and expansion of your data governance program means these capabilities must be implemented early in your initiative so that you can build the “muscle memory” and change the behaviors and culture of people in the organization to rely on these new systems as an integral part of doing their jobs.

But while thinking big and planning for success is critical, equally important is starting small with “Just Enough Data Governance” focused use cases that deliver immediate value to the organization. This approach allows you to gain enthusiasm, support, and momentum for your governance program by delivering meaningful value to the business or clinical users, teaching people what all the parts of data governance look like cooperating and functioning holistically, and starting to build the culture of collaboration required to manage data as a reliable, trustworthy asset.

For hospitals and health systems using Epic, it is impossible to “think big” without incorporating Epic as a full participant in the holistic data governance program. We have made the case that no matter the scope of your Epic deployment, your holistic data governance program is bigger. We have also shown that Epic must be a full participant in a holistic data governance program—both for the enterprise to get full value from the data in the Epic application, and for the data within the Epic application to be adequately governed and in compliance with your organization’s policies. And lastly, we have identified and described four compelling “start small” use cases for data governance that have been shown in real-life Epic accounts to be of high value and great places to start your holistic data governance journey.

Epic and holistic data governance are unquestionably better together.

 

About Prominence Advisors

Prominence works with the nation’s leading healthcare organizations to make Healthcare Smarter by leveraging the data at their fingertips. In the ever-changing landscape of healthcare IT, overcoming challenges you are facing may seem like summiting Everest. Prominence is the experienced guide and trusted partner that will help you create efficient, creative, and sustainable solutions to overcome each of those challenges. Prominence was founded by former Epic managers, is staffed with the best and brightest in the industry, builds award-winning solutions, and has experience with over 30 EHRs and other software systems.

About Informatica

Digital transformation changes expectations: better service, faster delivery, with less cost. Businesses must transform to stay relevant and data holds the answers.

As the world’s leader in Enterprise Cloud Data Management, we’re prepared to help you intelligently lead—in any sector, category or niche. Informatica provides you with the foresight to become more agile, realize new growth opportunities or create new inventions. With 100% focus on everything data, we offer the versatility needed to succeed.

We invite you to explore all that Informatica has to offer—and unleash the power of data to drive your next intelligent disruption.

 

Contact Us

Contact Informatica or Prominence to learn more about how you can use Informatica Data Quality, Axon Data Governance, and Enterprise Data Catalog to manage your Epic data pipeline.