Healthcare Data Governance and Stewardship
What the exam tests
This domain tests whether you can distinguish governance from management and stewardship from ownership, and can apply decision rights, policy, metadata, and lifecycle controls to healthcare data. Expect scenarios about data dictionaries, business glossaries, stewardship councils, access approvals, and lineage across EHR, claims, and research systems. DAMA-DMBOK concepts are useful: governance sets decision rights and accountability; stewardship executes domain-level quality and policy duties.
Core rules
- A data owner is accountable for a domain; a steward performs operational duties such as definition maintenance, quality monitoring, and issue escalation.
- Governance is not a committee alone: it needs charters, escalation paths, metrics, and enforcement.
- Definitions belong in a controlled business glossary; technical mappings belong in metadata and lineage.
- Stewardship covers the lifecycle: capture, storage, use, sharing, retention, and disposal.
- Access is role-based and purpose-bound; approvals must be auditable.
Worked example
A quality dashboard and a research cohort report different 'active patient' counts. The steward should not silently pick one. First, trace each definition to source fields and filters. Then convene the domain owner and stakeholders to define one glossary term with inclusion and exclusion rules, effective date, and version. Map it to EHR and claims sources, publish lineage, and require dashboards and cohorts to cite the term version. If research needs a different definition, register it as a variant with a distinct name. Reconcile counts and document the variance.
Traps
- Treating IT as the data owner; IT usually custodies systems, not business definitions.
- Creating a glossary with no approval workflow or version control.
- Confusing data quality remediation with governance decision rights.
- Letting one-off extracts bypass access and retention policy.