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审视医疗保健组织中有效信息治理的框架、政策和策略。

Examine frameworks policies and strategies for effective information governance in healthcare organizations.

作者信息

Okyere Boadu Richard, Wireko Adu Victor, Okyere Boadu Kwame Adu, Ibrahim Baishatu, Akey Prince, Amishadas Mensah Amponsah, Adzakpah Godwin, Kumasenu Mensah Nathan

机构信息

Department of Health Information Management School of Allied Health Sciences, College of Health and Allied Health Sciences, University of Cape Coast, Cape Coast, Ghana.

Sunyani Teaching Hospital, Sunyani, Ghana.

出版信息

PLoS One. 2025 Jul 11;20(7):e0327496. doi: 10.1371/journal.pone.0327496. eCollection 2025.

Abstract

BACKGROUND STUDY

Health information, over the years, has been regarded as one of the crucial assets in the landscape of health on the grounds of the myriads of benefits derived from it. It plays a major role in policy planning and implementation, quality improvement, clinical decision-making, care continuity, disease surveillance, etc., making it an integral part of healthcare delivery. This substantiates the pressing need for an appropriate information governance (IG) system, ensuring proper data stewardship, measures to ensure data quality and that preserving the privacy and confidentiality of patient data are in place. As part of conscious efforts to improve health information governance, this study examines the entire information governance structure of healthcare facilities used as study areas, taking into account the effectiveness of data stewardship, data quality management and compliance with regulatory requirements.

METHODOLOGY

Employing a cross-sectional study design, data was collected from 432 healthcare professionals emanating from Cape Coast Teaching Hospital (CCTH), Eastern Regional Hospital Koforidua (ERHK) and Ledzokuku-Krowor Municipal Assembly (LEKMA) Hospital, all in Ghana. A semi-structured questionnaire, demarcated into five (5) parts, was used to collect the data. Closed-ended questions were analyzed with Stata 15.0 involving frequencies, percentages, means, standard deviation, standard errors and confident intervals. A chi-square test of independence was deployed to ascertain relationships between variables. Open-ended questions were coded and analyzed with Qualitative Data Analysis Miner 6.0, deploying inductive thematic analysis.

RESULTS

The level of understanding of data stewardship (2.87/4.0), familiarity with concepts of data quality (2.73/5.0) and ethical considerations and privacy (3.13/5.0) when dealing with patient health data were found to be varied among the professionals, overall rated as moderate and affirming the need for improvement. The level of knowledge and understanding on these pertinent areas were highly influenced by type of profession (p < 0.001; p = 0.031 and, p < 0.001) respectively and been indicative that some type of health workers is much concerned about data stewardship and health information governance than others. Various methods and efforts were in place to ensure the quality of data; however, hampering these attempts included factors such as poor data collection methods, lack of resources, inadequate competency and some behavioral factors. In addition to these factors is the low level of training on data stewardship (1.86/4.0), which heavily leads to skewness in knowledge. The majority of healthcare professionals were familiar with and advocated for adherence to regulatory requirements such as HIPAA (33.7%), GDPR (21.3%) and HITECH Act (14.4%), in making data governance much robust. Efforts were also identified in ensuring privacy and confidentiality during the storage, processing and transmission of patient data mostly by deploying methods such as authentication (58.9%), use of secured computers and software (71.2%) and using secure electronic platforms (66.0%) respectively indicating a keen attention for data stewardship and governance. About 70% of healthcare professionals attested to the regular conduct of monthly compliance audits, however, the rate of training on data stewardship was discovered to be very low (1.86/4.0).

CONCLUSION

There is an existence of clear policies and procedures to guide data stewardship to enhance overall information governance, however, healthcare professionals' level of knowledge on subjects of information governance ought to be enhanced. There is a need to intensify training sessions on data quality, and regulatory requirements for health information governance to mitigate the gaps in knowledge among professionals.

摘要

背景研究

多年来,健康信息因其带来的诸多益处,被视为健康领域的关键资产之一。它在政策规划与实施、质量改进、临床决策、护理连续性、疾病监测等方面发挥着重要作用,使其成为医疗服务不可或缺的一部分。这凸显了建立适当信息治理(IG)系统的迫切需求,以确保数据的妥善管理、保证数据质量的措施到位,并保护患者数据的隐私和保密性。作为改善健康信息治理的自觉努力的一部分,本研究考察了用作研究区域的医疗机构的整个信息治理结构,同时考虑了数据管理的有效性、数据质量管理以及对监管要求的遵守情况。

方法

采用横断面研究设计,从加纳的海岸角教学医院(CCTH)、东部地区科福里杜瓦医院(ERHK)和莱佐库库 - 克罗沃尔市议会(LEKMA)医院的432名医疗专业人员中收集数据。使用一份分为五部分的半结构化问卷来收集数据。对封闭式问题使用Stata 15.0进行分析,涉及频率、百分比、均值、标准差、标准误差和置信区间。采用卡方独立性检验来确定变量之间的关系。对开放式问题进行编码,并使用定性数据分析挖掘器6.0进行分析,采用归纳主题分析。

结果

发现专业人员在处理患者健康数据时,对数据管理的理解水平(满分4分,得2.87分)、对数据质量概念的熟悉程度(满分5分,得2.73分)以及伦理考量和隐私方面(满分5分,得3.13分)各不相同,总体评级为中等,表明有改进的必要。在这些相关领域的知识和理解水平分别受到职业类型的高度影响(p < 0.001;p = 0.031和p < 0.001),这表明某些类型的卫生工作者比其他人员更关注数据管理和健康信息治理。为确保数据质量采取了各种方法和措施;然而,阻碍这些努力的因素包括数据收集方法不当、资源匮乏、能力不足以及一些行为因素。除了这些因素外,数据管理培训水平较低(满分4分,得1.86分),这严重导致了知识的偏差。大多数医疗专业人员熟悉并主张遵守诸如《健康保险流通与责任法案》(HIPAA,占33.7%)、《通用数据保护条例》(GDPR,占21.3%)和《健康信息技术经济与临床健康法案》(HITECH Act,占14.4%)等监管要求,以使数据治理更加稳健。在确保患者数据存储、处理和传输过程中的隐私和保密性方面也做出了努力,主要分别采用了身份验证(占58.9%)、使用安全计算机和软件(占71.2%)以及使用安全电子平台(占66.0%)等方法,这表明对数据管理和治理给予了密切关注。约70%的医疗专业人员证明每月定期进行合规审计,然而,发现数据管理培训率非常低(满分4分,得1.86分)。

结论

存在明确的政策和程序来指导数据管理以加强整体信息治理,然而,医疗专业人员在信息治理主题方面的知识水平有待提高。有必要加强关于数据质量以及健康信息治理监管要求的培训课程,以弥合专业人员之间的知识差距。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3e98/12250644/e0df73363bef/pone.0327496.g001.jpg

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