1st Edition
EHR Governance A Practical Guide to User Centric, Consensus Driven Optimization
Organizations spend large amounts of money to purchase, deploy, and optimize their Electronic Health Records (EHRs). They are not plug-n-play systems so a commitment to an ongoing improvement cycle is necessary. When done well, this responds to the people, the process, and the technology. When not done well, complete failure of the system could result in costing the organization thousands of dollars.
Based on the foundational premise that EHR governance done right speeds up change and leads to a positive user experience, this book draws upon more than a decade of work with government, academic, and nonprofit organizations using Epic, Allscripts, McKesson, Meditech, and Cerner. Designed to be practical and pragmatic, it outlines a strategic process that can scale to small and large organizations alike. It begins with how to articulate a clear vision to organizational leaders so they can champion strong EHR governance both theoretically and financially. It then walks through each step required for leading successful change, calling out critical lessons learned to help the reader avoid pitfalls and achieve measurable improvement more rapidly. It concludes with a commitment to ongoing growth and refinement through benchmarked metrics, innovation, and out-of-the-box thinking.
Section 1: CONTEXT
Chapter 1: WHY GOVERNANCE
No Software Survives Contact With The End User
Make It Easy to Do the Right Thing
Burnout vs Moral Injury
CHAPTER SUMMARY
CHAPTER EXERCISES
Chapter 2: WHEN GOVERNANCE
Earlier Is Better
Setting Expectations
Voice of the Customer
CHAPTER SUMMARY
CHAPTER EXERCISES
Chapter 3: HOW GOVERNANCE
Governance Dependencies
Software Needs for EHR Governance
A Roadmap For Leading Change
CHAPTER SUMMARY
CHAPTER EXERCISES
Section 2: CHANGE
Chapter 4: CREATE URGENCY
The Eisenhower Box
Solution Jumping
The Case for a Good Business Case
CHAPTER SUMMARY
CHAPTER EXERCISES
Chapter 5: FORM A POWERFUL COALITION
It’s a Team Sport
We’re In This Together
Try To See It My Way
CHAPTER SUMMARY
CHAPTER EXERCISES
Chapter 6: CREATE A VISION AND A STRATEGY
Core Values
Governance Framework
Decision-Making Bodies
CHAPTER SUMMARY
CHAPTER EXERCISES
Chapter 7: COMMUNICATE THE VISION
Assumptions Are The Termites Of Communication
Communication Skills and Traditions
Who Told You That?
CHAPTER SUMMARY
CHAPTER EXERCISES
Chapter 8: REMOVE OBSTACLES
The Allure of Inertia
Change is the Only Constant in Life
Resistance is Futile
Confusion Over Decision Rights
CHAPTER SUMMARY
CHAPTER EXERCISES
Chapter 9: GENERATE SHORT TERM WINS
One Size Doesn’t Fit All
The Pain of Documentation
Tell a Story with the Data
CHAPTER SUMMARY
CHAPTER EXERCISES
Chapter 10: CONSOLIDATE GAINS AND PRODUCE MORE WINS
Automate
Scale
Virtual Governance
CHAPTER SUMMARY
CHAPTER EXERCISES
Chapter 11: ANCHOR NEW APPROACHES IN THE CULTURE
Culture Eats Strategy For Breakfast
Culture Styles
The Way We Do Things Around Here
CHAPTER SUMMARY
CHAPTER EXERCISES
Section 3: COMMITTMENT
Chapter 12: USER EXPERIENCE
People, Process and Technology
The KLAS Arch Collaborative
Design Standards
CHAPTER SUMMARY
CHAPTER EXERCISES
Chapter 13: ACCELERATING CHANGE THROUGH INNOVATION
Intrapreneurship and Entrepreneurship
Design Thinking
Never Waste a Good Crisis
CHAPTER SUMMARY
CHAPTER EXERCISES
Chapter 14: IT’S A JOURNEY NOT A DESTINATION
Order Set Management
Legal and Ethical Considerations
Land and Expand
CHAPTER SUMMARY
CHAPTER EXERCISES
Chapter 15: EPILOGUE
Biography
Paula Scariati, DO, MPH, MS, is a Preventive Medicine & Public Health physician specialty trained in informatics who loves using technology to improve patient access and care. With more than 25 years of experience in government, academic, private, and nonprofit organizations, Paula’s approach to digital transformation combines her unique clinical perspective with her expertise in medical informatics, governance, and change management. Throughout her career, she’s partnered with high-performing, multi-functional teams in fast-paced environments to develop innovative apps, lead EHR go lives, optimize workflows, and map improvement processes. Her work is data-driven, and at the heart of everything she does is an unrelenting commitment to user experience. Paula’s informatics repertoire spans the continuum of care using software tools from Allscripts, McKesson, Meditech, Cerner, and Epic, along with ADT, CDI, population health, and best of breed platforms.
A seasoned national speaker, an award-winning medical school instructor, and an ASQ Lean Six Sigma Green Belt, Paula has authored over 100 articles including 14 peer review publications. In her free time, she enjoys tackling house remodeling projects and refining her Italian language skills. She can be reached for a curbside consult or a more formal engagement through LinkedIn or by email at [email protected].
