1.1 HIT Project Governance

Section1.1Adopt – Assess

Section 1.1. Adopt – Assess – HIT Project Governance -1

HIT Project Governance

Many small offices are accustomed to working on projects as one large committee. While getting all stakeholders engaged is necessary for the success of health information technology (HIT)and electronic health record (EHR) projects, the intensity and frequency of HIT/EHR decision-making can be overwhelming. Languishing in decision-making has an opportunity cost, as staff takes time away from normal duties, and incentives available in only certain years can be missed. Sometimes actual costs are incurredand savings or additional revenue opportunities are lost. Having a formal project governance structurethat describes who can make what decisions, and when,can help prevent delays andoften produce more informed decisions.

In general, planning for decision-making that provides authority and responsibility at the lowest level possible for each type of decision to be made is helpful. It expedites decision-making, removes second guessing, and discourages everyone from having to be involved in every decision.

The sample organization chart below depicts where in an organization decisions can be made, such as selection of an EHR. Although this chart represents a somewhat large ambulatory care organization, the decision-making factors are the same for any size office. Having all stakeholders involved is critical. Too often, small offices make the mistake of having only the chiropractors or a trusted assistant make the decisions. Decision-making should be a collective process.

Many chiropractic offices do not and will not have a chief information officer or a medical director of information systems, but as more HIT is acquired and as electronic health records (EHR)are more fully implemented, individuals may be called upon to serve these roles. Domain teams may be subsets of the larger group or a cross-cutting group of individuals focused on a workflow that extends across a variety of functions (1.2 HIT Steering Committee).

Instructions for Use

Following is a list of many of the decision-making tasks your office may encounter. The list is sequenced so tasks requiring senior-level individuals to make decisions are first. Identify for your office at what level each decision should be made. Add or delete decision-making tasks that don’t apply.

In assigning decision-making authority, one individual may be considered for some decision-making tasks. However, if a group of users will be impacted by the decision, they or their representative should be included when making the decision.

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 plan
Acceptance testing
Project management/domain team formation
Project budget
Functional requirements
Chart conversion and pre-load strategies
Turnover and rollout strategies
Issues management
Super user identification
Clinical documentation standards
Design of screens
Adoption of care plan templates, order sets
Clinical work flows
Customization of screens and templates
Alert rules
Customizations of reports
Data dictionary/master files and tables
Data conversion
Contingency planning
Staff development
Medical staff introduction
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
Other (specify):

Adapted from Stratis Health’s Doctor’s Office Quality – Information Technology Toolkit, © 2005, developed by Margret\A Consulting, LLC. and produced under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services.

For support using the toolkit

Stratis Health Health Information Technology Services

952-854-3306 

Section 1.1 Adopt – Assess –HIT Project Governance - 1