Information Management and Knowledge Generation
From data to decisions
This domain covers how data become usable information and how information becomes evidence for practice. It overlaps heavily with privacy and security items, which are among the most commonly missed.
Data quality. Analytics depend on data that are accurate, complete, timely, consistent, and defined the same way everywhere. Data dictionaries, standardized terminologies, and validation rules at the point of entry protect quality far better than retrospective cleanup. Information governance assigns accountability for definitions, access, retention, and secondary use.
Interoperability. HL7 version 2 remains common for messaging, HL7 CDA for clinical documents, and FHIR for modern application programming interfaces. Health information exchanges move data across organizations, but semantic interoperability requires shared terminology, not just a shared pipe.
Privacy, confidentiality, security. Privacy is the patient's right to control information; confidentiality is the duty to protect it; security is the safeguards that enforce both. The HIPAA Privacy Rule governs use and disclosure and requires minimum necessary access; the Security Rule addresses administrative, physical, and technical safeguards, with encryption an addressable, risk-based safeguard. Role-based access, audit trails, and break-the-glass functions balance care needs with oversight. Safe Harbor de-identification removes 18 identifiers, including dates finer than year and ages over 89.
Knowledge generation. Descriptive, diagnostic, predictive, and prescriptive analytics build on each other. Nursing-sensitive indicators such as falls, pressure injuries, CAUTI, and CLABSI are benchmarked across units and organizations. Quality improvement using PDSA, evidence-based practice, and formal research answer different questions and require different review; research with human subjects needs IRB approval.
Rule of thumb: whenever a scenario involves sharing data, apply two tests in order. Does this person need to know, and is this the minimum necessary? Both must pass.