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What steps would you take as a consultant hired to assess the feasibility and functions for selection and implementation of an electronic document

  What steps would you take as a consultant hired to assess the feasibility and functions for selection and implementation of an electronic document and record management system at a large multi-specialty clinic? 

Enterprise Content and Record Management

Documents, records, and unstructured data of all types continue to proliferate, making it increasingly more difficult to locate and retrieve content. The evolving discipline of enterprise content management (ECM) is an integrative view that brings together concepts like data governance and data stewardship, practices such as document and record management, and work in such fields as thesaurus and ontology development to help tame the content chaos.

            There are a number of practices and technologies that are used to manage content for the primary purposes of searching for, locating, and retrieving information. These systems can be viewed as a continuum from those that are simpler with less functionality, such as document imaging systems, to those that the more complex, such as electronic content management. At its simplest, document imaging is a system consisting of software and hardware that converts source documents to digital format. Systems that have mid-range functionality are electronic document management systems that automate the preparation, organization, tracking, and distribution of electronic documents. Systems and processes with high-end functionality are often referred to as content management systems. These more complex systems are able to move beyond categorization of documents and records to classifying content through the use of taxonomies, thesauri, and ontologies.

            Content management is the entirety of practices and technologies used to manage the lifecycle of content from creation, capture, or receipt through archiving and destruction. The content management roadmap must be aligned with the strategic objectives of the organization, support business process and stakeholder needs, and be framed within a data governance perspective.

Chapter 9

Enterprise Content and Record Management

St. Rita’s EIM Team Questions

What is the nature of content, document, and record management?

What are the functions and technologies for content management?

Are there overlaps between content and metadata management?

What implementation and DG issues exist with content management?

Content and record management concepts

Content and Record Management Terminology


Information created, received, and maintained as evidence and information by an organization or person, in pursuance of legal obligations or in the transaction of business

As a business record, records must not be changed and must be maintained  by the organization  in an unalterable form  

Content and Record Management Terminology

Record characteristics

Content: the data or information within the record that composes its intellectual substance

Structure: the format of the record and its relationship to the record’s content

Context: the circumstances about the record’s creation, receipt, and use (for example, how it was created, when it was created, and by whom it was created), and links to other records

Identifying What Documentation Constitutes a Record

Was it made, sent, or received in the course of business?

Does it document a decision?

Does it document advice given?

Does it document a process of arriving at a decision?

Is it required by legislation?

Content and Record Management Terminology


Recorded information or object which can be treated as a unit

Not considered to be associated with the criteria for a business transaction or a legal requirement

Can be updated and do not have to be maintained   by the organization for  legal compliance

Can become records if they are used in a business transaction or created to document a transaction

Content and Record Management Terminology


The intellectual substance of a record or document

Consists of the data or information, including text, video, sound, and images contained in documents and records, that fulfill the intended purpose of the documents or records

Includes structured and unstructured data

Document, record and content management

Electronic Systems for Document and Record Management

Continuum of systems from simpler with less functionality to complex with greater functionality

Electronic document management system (EDMS)

Electronic record management system (ERMS)

Electronic content Management (ECM)

Electronic Systems for Document and Record Management Continuum

Electronic Document and Record Management Methodology

Content management tools

Electronic Content Management (ECM)

Organizing, categorizing, and structuring data or resources so that they can be stored, published, and reused in multiple ways

Associated with the management of unstructured data

Includes text, image, video, and audio documents and records

Evolutionary successor to EDMS and ERMS

Drivers include increased accessibility to content for business operations and compliance

Collaboration Content Management

Collaboration tools enable people to create, share, and use common content

Tools create virtual workplaces where people can create, share, and edit common document types

Examples include SharePoint and Lotus Quickr

Tools also allow social collaboration

Creation of blogs and wikis, discussion boards

Collaboration Content Management

Collaboration tools create enormous amounts of content

Knowledge associated with this content is lost to the organization if it is not managed

Some content may constitute business records necessary for meeting legal and compliance requirements

Safeguards for availability, access, integrity, security, privacy must be put into place

Digital Asset Management (DAM)

The practices for organizing digital files such as images, video, audio, graphics, web pages, and photographs

Requires a categorization method to catalog the digital assets

Enterprise, mid-market, and light-weight DAMs

Web Content Management

Establishing processes to control the content of a website


Cataloging and indexing web content

Creation and use of content templates 

Tracking media check-out and check-in

Content management classifications

Content Management Classification

Classification of content makes it easier to locate

Classification alternatives







The science or technique of classifying objects to identify them and help search and retrieve them

Types of taxonomies

Flat taxonomy

Facet taxonomy

Hierarchical model

Flat Taxonomy

The simplest type of taxonomy

A controlled set of categories where each object in the set has the same weight


A list of states

Alphabetical listing of people belonging to a specific group

Facet Taxonomy

Multiple characteristics are assigned to one object

No inherent relationship among the characteristics


Attributes of a book

Hierarchical Taxonomy

A tiered order of concepts and their relationships

Presupposes inheritance qualities from the “parent class” to the “child subclass.”

The child subclass inherits the parent’s set of characteristics and becomes more specialized


Classification of plants and animals (figure 9.2)

Automatic Categorization

Automatic creation of taxonomies through analyzing documents

Creates taxonomies through conceptual analysis, using mathematical analysis and comparisons

Mathematically analyzes example documents to calculate concepts that are used to develop categories to categorize documents

Provides ability to link content among objects (documents)


Dictionary thesaurus

Listing of alternative terms for a word

Information management thesaurus

A controlled list of terms linked together by semantic, hierarchical (parent-child), associative (related), or equivalence (synonymous) relationships

Categorize concepts and then map associated words to the concept

Information Management Thesaurus

Maps words to each other indicating broader, narrower, associated, or equivalent terms that represent a concept

Usually indicates the preferred term for a concept

In searching, use of a broader term retrieves more general results; searching using a narrower term retrieves more specific results

In searching use of a related term provides similar results

An example of an information management thesaurus is Medical  Subject Headings (MeSH) 

MeSH Thesaurus Example


More complex relationships between terms than a thesaurus

Focus is on a particular domain or subject

Describes terms more richly than a thesaurus

Describes a term by specific attributes in a structured format, such as noting properties, features, characteristics, or parameters of the term

Describes relationships between classes or inter-term relationships


Useful in data exchange

In the naming, meaning, equivalency, and relationships between core business entities, such as patient, provider, and supplier, within organizations and across healthcare systems.

Constructs such as “same as” or “equivalent property” help establish common semantics when the same business entity is called a different name in different processes or by different organizations

Examples: SNOMED CT and LOINC


In content management, metadata are used to classify documents

Considered a faceted taxonomy

Doses not provide the richness of association among classes or objects like an ontology

Content life cycle management

Content Life Cycle Management

A set of activities and content identification methods that:

Defines documents and records

Ensures the assignment of proper ownership

Enables the appropriate use, security, retention, and disposition of content

Promotes efficient search, location, and retrieval strategies

Content Life Cycle Management

Content Life Cycle Management Activities

Identify stakeholder and business needs

What content should be created, captured, and maintained to support business and end user needs?

Identify the creation, receipt, and capture of content

Who creates, receives, or captures content, when do they create it, and by what means?

Content Life Cycle Management Activities

Identify the uses of content (business processes and functions)

How will content be used for business operations and to meet legal and compliance mandates?

Identify the users of content

Who are the users and the classifications of document and record they use?

Content Life Cycle Management Activities

Develop a description of what constitutes a document and a record

What are the criteria for determining what constitutes a document?

What are the policies and practices for handling these?

What are the criteria for determining under what circumstances a document may become a record?

Content Life Cycle Management Activities

Associated criteria include:

Identifying document and record ownership and stewardship

Assigning access rights to documents and records

Developing data and audit controls

Assigning security levels to documents and records

Developing retention, archival and disposal policies for documents and records

Content Life Cycle Management Activities

Identify organization documents and records

Select content management technologies with functionalities to meet business needs

Categorize documents and records

Apply taxonomies or ontologies

If taxonomies are not available, develop these to meet organization needs and in accordance with established standards for classification development

Content Life Cycle Management Activities

Develop policies and practices that ensure quality content

Develop policies, procedures, and standards to ensure the quality of content from inception through final disposition

Applying Data Governance to enterprise content and record management

Applying Data Governance

Develop a strategy and roadmap for ECM  

Create policies and procedures for content management

Establish policies and procedures that meet business, legal and regulatory requirements

Apply taxonomies, thesauri, and ontologies for content identification, location, and retrieval

Applying Data Governance

Implement stewardship processes that ensure content capture, maintenance, quality, and security over the content lifespan

Institute standards and audit procedures for content management

Coordinate content management with other DG functions (metadata management)  

St. rita’s eim team Conclusions and next steps

St. Rita’s EIM Team Conclusions

ECM is essential to manage the growing amount of unstructured data

Policies, processes and criteria must be developed to identify and distinguish between documents and records

Electronic systems for the management of documents, records, and content must be chosen that meet organizational needs

St. Rita’s EIM Team Conclusions

Taxonomies and ontologies play a key role in identifying, searching, and retrieving information

Policies and processes must be in place to management the entire life cycle of content to meet business, regulatory, and legal needs

ECM will play a big role in the success of health information exchange

St. Rita’s EIM Team Next Steps

Develop a roadmap to help chart how SRHS can develop ECM

Investigate appropriate taxonomies and ontologies for document, record, and content management

Evaluate the next EIM domain, data security management


Kajal Patel

Information Governance

Assignment 5: Feasibility and Functions

What steps would you take as a consultant hired to assess the feasibility and functions for selection and implementation of an electronic document and record management system at a large multi-specialty clinic?

1. Build your Electronic Health Record (EHR) Implementation Team.

When one is implementing his/her EHR, one needs a strong team to help the process go as smoothly as possible. The team can include staff members such as physicians, nurses, medical assistants and administrative staff. Team members will assist the process by teaching colleagues EHR skills and serving as messengers to the implementation team to identify challenges along the way.

A lead superuser, lead physician, and project manager are three essential roles to consider while building your team, lead a super user. That is; the lead superuser is the resident in-house EHR expert. Whereby, a few duties may include template creation and developing workflows. This position may also be responsible for creating standard operating procedures to address problems users come across as they use the system.

2). Prepare the Software   

That is, when implementing your EHR, you need to ensure that the security measures are met with an aim of not violating HIPPA. Your organization may need to conduct a HIPPA risk assessment where you can work with your health IT vendor to make sure the software is compliant.

3) Determine Your Hardware Needs

By maintaining this, your hardware choices will have a significant impact on the time and money your practice uses. For instance, having a printer in every room can save physicians up to 30 minutes a day. However, some practices provide each staff member with their own tablet or laptop to save time logging in and out between each patient interaction.

4) Consider The Patient Treatment Room   

Since the EHR program requires an electronic data entry, the room layout can have a substantial impact on patient engagement and satisfaction. If the staff and physician face away from the patient while entering data, patients may feel like they are not being heard. And this is solved through various ways like triangle of trust.


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