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Up Close with Master Data Management

Master Data Management at the Veterans Health Administration

Healthy data is critical to high quality patient care and safety

An interview with Beth Franchi, director, data quality at the Veterans Health Administration

At the Veteran's Health Administration, good, clean, accurate data is a business priority. In this interview, we talk with Beth Franchi, director, data quality (which includes master data) at the Veterans Health Administration about how she and her team support the care of 5.5 million active patients across 153 medical centers and 745 community-based outpatient clinics.

“The electronic health record is vital to the care of patients,” Franchi says. “How we manage that electronic health record is critical to providing the highest quality care to our patients and subsequently patient safety.” The VHA's Master Patient Index has become a cornerstone of its ability to not only improving patient searching and matching but providing a better care experience for veterans.

TDWI: Everyone seems to have his or her own definition of master data management. What does that term mean at the VHA?

Beth Franchi: At the VHA, master data management means that the longitudinal electronic health records for our patients are available at any location offering patient care. We have many care sites and a very comprehensive electronic health record. That means that the stakeholder spectrum is very large, and use of the electronic health record at the VHA for patient care and related health care activities is extensive. We feel it’s vitally important to coordinate the definition and use of the key data to ensure that the right record/information is available to the right person at the right time.

Can you describe some of the challenges that led you to implement an MDM initiative at the VHA?

VHA implemented its own master patient index in 1998 and established a unique health identifier for each active patient over the implementation period. At that time, it became very clear how important the availability and accuracy of the complete longitudinal record for each patient was to patient care and patient safety. What started as an effort to improve the data quality of the identity traits we use in VHA has expanded to include formalization of a data stewardship program. It has also led to a clinical data quality program and the formation of a business product management group to ensure that business requirements and all software products support data quality and master data management of the patient’s electronic health record.

Everyone understands that data quality and the patient’s electronic health record are important, but they don’t necessarily understand what it really means to implement a master data management plan to achieve data quality based on national standards for health care. Throughout the formation of the group, we have strived to identify ourselves as the program office with the expertise and support for these functions. We really find that we are a direct complement to the IT side of the effort as we interface with the business lines and provide direct support as specialists to identify and resolve data quality issues that impact patient care.

How quickly (or slowly) did you see results?

Impacts in the identity management area are immediately seen in the patient safety area, where we have implemented safeguards and business processes. Those processes support the immediate identification of a potential problem and resolution activities, as well as proactive solutions including training to help prevent problems in the first place. Our data quality efforts focused on VHA’s patient-identity traits, and has led to creation of a best-of-breed view or concept. We have developed that on our business rules based on the strength or authority of the data. We recently had an analysis done on these identity traits; that analysis indicated that our stewardship efforts were very successful as the quality of the data was strong.

The VHA is a service-oriented institution, rather than, say, a product manufacturer. What particular challenges does that present for master data management?

In health care, it means that there are specific rules for interacting with the patient’s medical record at an enterprise level that applications must follow in order to maintain the record’s integrity. That is a difficult concept to inculcate throughout the organization. Patient safety is a key focus for VHA. The electronic health record is vital to the care of patients; how we manage that electronic health record is critical to providing the highest quality care to our patients and subsequently patient safety.

Can you give a brief overview of what you’ll cover as a speaker at TDWI’s MDM Insights conference in March?

I’ll give a brief history of the journey we’ve been on for master data, the stewardship activities, policies and collaboration, lessons learned, and some high-level information about our future goals

About the Author

Linda L. Briggs writes about technology in corporate, education, and government markets. She is based in San Diego.

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