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

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 Paula.Scariati@fastmail.com.