The criticality of good data management processes at all levels is becoming apparent as more organisations begin using the HI Service. Data management and cleansing has been a significant effort for all sites to maximise IHI match rates and to ensure provider data are useable. It is evident from the Data Profiling and IHI Match Rate Assessment report5 that there are data quality issues across all sites that will impact use of the HI Service that need to be addressed. A number of common issues were identified in this report but at this point these are not being fed into targeted data quality strategies.
To achieve the level of rigour currently required for a match to be returned there will need to be an ongoing emphasis on data cleansing and quality improvement strategies in all healthcare organisations. It is unclear at this stage how resource intensive the data management obligations will be for organisations, not just in relation to patient data but also for maintenance of organisation structure data and updates to provider information. The maintenance effort for provider data given the number of healthcare providers engaged by public health services will be considerable. The challenge associated with this has been acknowledged and there is currently a two year exemption period from using HPI-Is on discharge summaries.
Poor information management processes and poor data quality in the clinical information system will create risks for the integrity of the IHI database as a failure to retrieve a result will increase the likelihood of unverified IHIs being allocated. The more unverified IHIs there are in the system for the same individual that contain slight variations in demographic data, the higher the risk of the individual’s verified IHI being missed in response to a search and an unverified IHI being created. This will become a compounding error as the individual moves around the system and will be more difficult to resolve.
Obligations to maintain data should be included in communication material to healthcare providers to ensure there is a common level of understanding of the criticality of data quality for the HI Service and the systems with which it integrates. Data quality would be improved if health services had a better level of understanding of DHS data requirements and guidelines and registration processes reflected these, to increase the level of alignment between data held at DHS and health services.
Data quality would also be facilitated if there was more interaction between providers and the HI Service to resolve data quality problems that prevent retrieval of IHIs. The HI Act imposes constraints on the Service that limits the capacity of the HI Service to support providers in this way.
Recommendation 8 – Data governance
It is recommended that:
a. National guidelines on best practice processes for recording of identification data and a national data governance framework for data quality improvement for the purpose of the Healthcare Identifiers and other national systems be developed and implemented.
b. Consideration be given to amendments to the HI Act to provide legislative support for the HI Service to engage in data quality improvement activities.