HIT Governance - Stratis Health

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Adoption of practice guidelines/care paths. Clinical work flows. Core data sets. Customization of screens and templates. Clinical decision support rules.

Section 1.4 Assess HIT Governance

Identify the decision-making tasks you may encounter while making health information technology (HIT) decisions and at what level each decision should be made.

|Time needed: 8 – 16 hours | |Suggested prior tools: NA |

How to Use

Establishing an HIT governance structure provides authority for decision making at the lowest level possible for each type of decision to be made. Many organizations find themselves in analysis paralysis over HIT decisions—how they should plan strategically, which vendor to select, when to implement and who should be involved. Frequently, this is because HIT may still be somewhat unchartered territory and definitely is expensive.

Languishing in decision making has an opportunity cost, such as taking time away from normal duties, and sometimes actual costs are incurred, such as missing out on vendor pricing offers or spending money on site visits to view vendor products when the organization is not ready yet for a certain type of product. As a result, organizations are finding that creating an HIT governance structure is helpful.

Adaptability to Various Types of Organizations

Organizations vary in size and governance. But all need to plan for decision making that provides authority and responsibility and that everyone understands and accepts. This expedites decision making and removes second guessing. It avoids the need for everyone to have to be involved in every decision-making task, which leads to inefficiency and potential cost.

An organization that is part of a larger, multi-site corporate structure may not create its own governance structure, but should urge the corporation to adopt such a structure if it does not already exist and should understand how it fits into the overall structure.

Large independent organizations may already have an HIT steering committee and/or HIT project manager. If an HIT governance structure describing the organization and its decision-making does not yet exist, there is no time like the present to create one. If one exists—whether functional or not—it can be helpful to review and modify the structure as needed before any major HIT investment is made.

Small independent facilities may not feel an HIT governance structure is needed. However, smaller organizations sometimes need structure the most, as they are often accustomed to decision-making by committee or unilaterally by one individual.

The sample organization chart below depicts where in the organization various decisions would be made relative to an HIT project.


Copyright © 2014, Margret\A Consulting, LLC. Used with permission of author

How to Use

Following is a list of many of the decision-making tasks an organization may encounter in its HIT projects. Identify, for your organization, at what level each of the decisions should be made. Add or delete decision-making tasks that don’t apply.

In assigning decision-making authority, bear in mind that one individual may be an option for some decision-making tasks. In general, if a group of users will be affected by the decision, the decision should be made by the group as a whole, or representatives of the group if it is a larger organization.

|Decision-Making Task |Organizational Unit to Make Decision| |Release of funds | | |Contract approval | | |Contract negotiation | | |Benefits expectation | | |setting/benefits realization | | |Project staffing/steering committee | | |formation | | |Community engagement | | |Contract management | | |Communication plan | | |Code of conduct | | |Goal setting | | |Strategic planning/migration path | | |IT acquisition strategy | | |Acceptance testing | | |Project management/domain team | | |formation | | |Project budget | | |Functional requirements | | |HIE participation | | |Chart conversion strategy | | |Turnover and roll-out strategies | | |Input devices | | |Issues management | | |Super user identification | | |Clinical documentation standards | | |Design of screens | | |Adoption of practice guidelines/care| | |paths | | |Clinical work flows | | |Core data sets | | |Customization of screens and | | |templates | | |Clinical decision support rules | | |Customizations of reports | | |Data dictionary/master files and | | |tables | | |Data conversion | | |Contingency planning | | |Clinical staff development | | |Medical staff development | | |End user training | | |Data quality management | | |Interface testing | | |System testing | | |Go-live readiness | | |Archive requirements | | |Network bandwidth requirements | | |Change control | | |Document management and control | | |Security controls | |

Copyright © 2014, Margret\A Consulting, LLC. Used with permission of author

Copyright © 2014 Updated 03-19-2014