ERM and Patient Data Communication – Risk Management of Health Information Exchanges (HIE) and Patient Portals

Enterprise Risk Management in Healthcare

ASHRM designates eight domains of risk management to promote an ERM approach in healthcare. ASHRM Website

Technology
This domain covers machines, hardware, equipment, devices and tools, but can also include techniques, systems and methods of organization. Healthcare has seen an explosion in the use of technology for clinical diagnosis and treatment, training and education, information storage and retrieval, and asset preservation. Examples also include
Risk Management Information Systems (RMIS), Electronic Health Records (EHR) and Meaningful Use, social networking and cyber liability.
Source: American Society for Health Care Risk Management

Barriers in Patient Data Communication

Technology risk is one of the eight primary risk domains recognized by the American Society of Health Care Risk Management (ASHRM) see above graphic. Specific barriers regarding health infomation exchanges, patient portals, and their associated vendors contribute to the frequency and severity of the presumed risk.

Specific barriers to effective patient data interoperability include:

Privacy and Data Security Challenges
Standardization of Policy, Governance, Format, & Methods
Adoption and Meaningful Participation
Emerging Technologies
Regulatory Challenges

Why Mitigating Risk for HIEs and Patient Portals is a Growing Issue

Given the pressing need to decrease waste and inefficiency in healthcare spending, mitigating technology risk is of particular importance. Nevertheless, every risk domain is interconnected and patient data communication issues present barriers in each sector of healthcare risk.

Strategic	Clinical	Financial	Human Capital	Legal	Technology	Operational	Hazard
Disruption and M&A activity with HIE vendors	Possibilty of clinical error in data mismatch	Medium revenue cycle risk with non EMR health IT	Burnout risk from downtime and rollout duplication	Pace of regulation is unpredictable and presents exposure	Listed barriers	Patient delays from IT downtime	Future pandemics / crisis overburdens systems
Risk from strategic failures damaging the brand	Medication reconciliation risk from incomplete transmission	Privacy and data security present financial risk from FWA activity	Training challenges present risk of downstream loss	Political shifts cause instability in ACA initiatives	Cyberthreats	Overreliance on automation create risk of gaps in care	Infrastructure risk from outages

ERM and its Importance for Health Information Exchanges and Patient Portals

Enterprise risk management (ERM) provides a more broad approach than traditional risk management. ERM approaches allow for more cooperative, nimble, and high-reliabilty mitigation strategies. As ERM is further embedded into the fabric of the culture, the frequency of loss exposure should decrease and near-miss reporting can help to avoid sentinel events which skew the measurement of risk preparedness.