People, principles, and data: How to develop effective governance amid healthcare technology modernization

In today’s rapidly evolving healthcare landscape, technology is the driving force behind clinical and operational outcomes. However, without a strategic governance framework, any attempts at healthcare technology modernization are bound to come up short. You need a framework that coordinates with organizational goals, drives value, tackles risk head-on, and manages IT resources and performance.

Health IT governance is a particularly hot topic with the explosive growth of artificial intelligence (AI). ECRI, an authority on healthcare technology and safety, listed “insufficient governance of AI in medical technologies” on its 2024 list of top 10 health technology hazards. Furthermore, a study with 35 healthcare leaders from 34 health systems reveals only 16% of organizations have a systemwide governance policy to address AI usage and data access.

Whether you’re developing governance around AI, cloud technology, or other digital initiatives, a successful approach should prioritize people, build on practical guiding principles, and enable data-driven discoveries.

Keeping people front and center

Ideally, health IT governance should center on the needs of the individuals who receive and provide care, supporting a people-centered vision of enhancing patient engagement and care access, improving clinician wellness, and strengthening the patient-provider relationship. When developing and implementing health IT governance, you must acknowledge the impact on end users and keep them top of mind when making decisions. Involve key stakeholders across the enterprise at every stage of the process, earn executive buy-in, provide adequate training and education, and regularly review governance practices, adjusting as needed based on feedback, outcomes, and priorities.

Designing and adopting guiding principles

Once the vision is set, you can establish guiding principles that help with decision-making, strategy execution, and managing project/program scope. The developers of the Stanford University course, “Principled Entrepreneurial Decisions,” believe the best guiding principles are distinctive (express your uniqueness), debatable (not everyone will agree), transferable (can be applied in multiple situations by different individuals), and integral (essential to the service provided). Consider these suggestions for designing successful guiding principles:

  • Limit to five to nine statements.
  • Express in as few words as possible to keep the principles concise, clear, and memorable.
  • Start each principle with “We will…”.
  • Offer specificity for the project/program and avoid broad generalization.

To ensure guiding principles are effectively implemented by your teams, you must consistently promote them as core enablers of your initiative. Repetition is critical, as people tend to forget half of newly learned knowledge within days/weeks unless we consciously review the material. Start your meetings with a quick refresh of the guiding principles so they become second nature for all team members.

Empowering data-driven decisions

Effective decision-making hinges on solid data governance. It’s the bedrock for constructing a state-of-the-art platform that delivers actionable clinical and operational insights to the right people at the right place and time. When data is connected, easily accessible, and usable, it can help transform every aspect of the healthcare experience. By investing in data governance, you can enable patients, clinicians, and administrators to make better decisions that ultimately lead to better outcomes.

Case study: Health IT governance at SouthEast Alaska Regional Health Consortium

SouthEast Alaska Regional Health Consortium (SEARHC) partnered with Nordic to implement a new electronic health record. The collaboration began with a vision to advance the health of SEARHC’s patients and communities. It resulted in guiding principles designed to streamline decision-making and elevate organizational goals and objectives, including better data use and collection.

The table below shows how the guiding principles were used to align with SEARHC’S order set standardization and change methodology efforts.

Guiding principles Order set-specific principles Change management-specific principles
We will operate as a cohesive team with the health of our patients and communities as the goal. We will standardize order sets across SEARHC. 

We will not create custom order sets for individual providers.

We will adopt clinical best practice where available.
We will ensure that all users and patients are supported with a change management plan.
We will make choices that are feasible and sustainable. We will limit the number of order sets.

We will budget for resources to ensure review of our order set content on a two-year cycle.
We will embed our change methodology in our operating model and build our change maturity.
We will choose adaptability over specificity. We will create modular sets that allow for adaptability while maintaining standardization.

We will allow providers to personalize the standard order sets within the realm of best practice.
We will use a blend of change tools that address the entire process and leverage our culture and strengths.
We will build user-centric solutions and minimize cognitive load. We will treat clicks as appropriate opportunities for reflection.

We will minimize redundancy.

We will use change management engagement to drive continuous improvement.
We will gather data that will be used and not for the sake of data collection alone. We will define benefits realization metrics and use them to guide order set decisions.

We will review the utilization of order sets yearly and remove from the maintenance cycle those that are no longer needed.
We will right size the change management effort to the change and refine our efforts over time.

As the industry continues to digitize data and processes and embrace cutting-edge innovations, health IT governance is the foundation that will help ensure high standards, transparency, security, and accountability. You can position your organization to address challenges and prepare for the future through a strategic framework held up by people, guiding principles (consistently used and promoted at all levels), and data.

To hear more from Dr. Copeland, watch her Vive 2024 panel on re-establishing trust in healthcare: