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Governance team key to driving technology adoption in healthcare

The key to a good governance team is involving leaders from every department within a healthcare organization.

Implementing new technology in a healthcare organization can be a daunting task. But a strong governance team can be the difference between success and failure.

For Patty Lavely, CIO at Gwinnett Medical Center, implementing new software or hardware into a healthcare organization starts by creating an overall IT governance process. 

"Project approval occurs at the high level of IT governance, where the business case is presented to include financial analysis, resource requirements, goals and objectives of the project, and the governance team gives it a yes or a no," Lavely said.

With a yes, Lavely and the governance team implement a project structure that includes a steering committee to drive the project forward. But establishing an effective governance team takes legwork and strategy, according to Lavely. Doing so will help healthcare CIOs gather the right people to serve on the team -- a task that is necessary if a new technology project is to be adopted, she said.  

"If you don't have buy-in, you have pushback," she said. "If you're trying to implement technology in an organization that's pushing back, it's very difficult to be successful."

Establishing the right team is key

Governance allows for the oversight of a healthcare organization's IT resources and IT investments by involving key players in the project approval process. It creates a bridge between the healthcare organization and its IT staff, according to Cheryl Martin, chief knowledge officer at the American Health Information Management Association (AHIMA), based in Chicago.

As such, healthcare CIOs will have to help define the scope of what the governance team is empowered to do, something Martin said should be done at the very start of establishing governance. Defining the scope of what a governance team can do includes providing a budget and guidelines for project approval.

"Scope and definition are really, really important," Martin said.

Figuring out who to include on the governance team is the next step, Lavely said. While governance structure can vary from organization to organization, healthcare CIOs should work on getting to know the key stakeholders of IT outside of the IT department, she said. Doing so can help identify the right people to serve on a governance team.

When Lavely first arrived at Gwinnett Medical Center, a nonprofit network of healthcare facilities based in Lawrenceville, Ga., she spent her first month formally and informally interviewing about 30 of the organization's leaders in an effort to identify the stakeholders of IT.

The key stakeholders of IT aren't always easy to spot. Lavely spent time looking for leaders who drive adoption of technology in their departments and have a significant amount of knowledge and expertise about technology benefits.

She said members like this can be critical to a governance team's effectiveness and can "add so much to the discussion," because they have a good understanding of how technology works -- a challenge healthcare CIOs may face when establishing a multidisciplinary team.

Patty Lavely, CIO, Gwinnett Medical CenterPatty Lavely

"The hard conversation to have with a multidisciplinary governance team is when you have to invest in infrastructure and help them understand why we have to spend $5 million on the network or on storage and what those benefits are and to really have a group that can understand maybe not the technology as much as the benefits and why you would need to do that," Lavely said.

She added it's also important to educate the organization's leaders on the benefits of governance, while also keeping organizational representation in mind, making sure someone from every major area of the organization is represented on the team.

Following the monthlong interview process, Lavely set about creating her governance team, which includes Gwinnett Medical Center executives and a handful of physicians.

She recommended healthcare CIOs refrain from serving as a chairperson so the governance team remains objective and thinks about the organization as a whole, rather than focusing on their individual areas.

Physicians bring user voice to governance team

Not only are technology experts needed on a governance team, but healthcare CIOs need to include physician and nursing employees who will be using the technology the health IT team may want to deploy within the organization.

"You've got to have the people who are going to be using the system involved in making decisions about the system," Martin said.

At Gwinnett, the organization's chief medical information officer plays the role of balancing the opinions and experience of medical staff on the team with organizational needs, according to Lavely.

Medical professionals "can help us determine how we're going to get buy-in and if this is going to be a benefit to the provider," she said. "We may think it's going to, but we can hear from our physician partners that, 'This is going to be a problem in our workflow,' or, 'This is not giving us data we need.'"

Most importantly, when medical professionals serving on a governance team help to approve a project, they can then become champions for that particular project, according to Lavely.

"I put them in front of groups of physicians when we're talking about the project," she said. "They become champions for the change, whatever it is we're doing."

Challenges healthcare CIOs may face

Beyond forming a governance team, healthcare CIOs should expect to encounter additional challenges, such as competing agendas, according to Lavely.

Limited resources can inadvertently cause organizational leaders to put blinders on, causing them to sometimes have difficultly looking beyond their own needs, she said. 

While a governance team can also help ensure the appropriate allocation, AHIMA's Martin said healthcare CIOs may struggle to get leaders on the team to set aside their egos. Doing so is crucial, she said.

You've got to have the people who are going to be using the system involved in making decisions about the system.
Cheryl MartinChief knowledge officer, AHIMA

"They need to be listening to each other, because that is what hasn't happened in the past, and we've ended up with systems that don't work for the people that actually use them," Martin said.

Another issue Lavely said she sometimes runs into is lack of understanding among healthcare leaders about what IT is and does. When creating a governance team, Lavely said her tactic is to educate.

"What I find is that leaders that push back the most on IT just don't understand it, and they don't really want to say, 'I don't understand,'" she said. "So, I just proactively educate. And that way, if they don't understand it, they don't have to tell me that or raise their hand and say, 'I don't understand.' They're getting the education anyway."

Lavely said she thinks every organization can have a leader who doesn't understand the technology or technology initiatives, which can negatively affect the governance process. Along with education, Lavely said building relationships with every member on the team can be critical to a governance team's cohesiveness and success.

"If there is a particular person that is problematic, I'll make sure that I am talking to that person regularly outside of governance," Lavely said. "One-on-ones or lunch to make sure that I have face time with that person on a regular basis and really what that ends up doing in the long run is it develops trust between two people."

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