NR534A- Informatics & Healthcare Tech

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Sharla Kurtz 

Implementation and Governance of EHR Systems The implementation and governance of health information technology systems are among the main steps of adopting the systems. Choosing the proper performance and governance strategies allows facilities to ensure minimal costs while installing an EHR system. It will enable them to ensure that the system is appropriate to the facility and therefore streamlines processes. This essay analyses the strategies for implementation, governance and management of health IT systems and consideration made in the process. One of the strategies used in implementing health IT systems is building the right team for implementation. The execution process of the system requires the application of skills from several professionals to reduce the related costs. One of the considerations in the process is to ensure that the system is appropriate (Afrizal et al., 2019). The appropriateness of a team is based on their ability to inform the system’s requirements that serve the most patient needs and the most cost-effective. Making them shareholders in implementing the health information systems allows them to apply their expertise and knowledge in creating a good plan. Another implementation strategy is the engagement of all the related staff. Thirdly, the facility needs to provide the critical information and resources of the system’s implementation, allowing the chosen team to implement and evaluate it (Afrizal et al., 2019). This strategy requires the implementation team to consider the costs related to the process and their resources to ensure that the system is functional. Finally, continuously collecting information on the challenges experiences while using the techniques from the main accessors. The implementation process takes multiple steps that involve an introduction, evaluation, modification and observation. Communicating similar data allows the implementation team is fundamental for integrating the technology (Afrizal et al., 2019). This approach considered the appropriateness of the systems and the training the employees have received, allowing them to operate the new technologies. One of the strategies used to improve management and governance of health information systems is using a strategy throughout the facility. The management team must consider if enough or excessive focus has been placed on frontline interventions. An overall design for governance allows the facility to create priorities and goals that drive them through the health information systems (Ramachandran et al., 2020). Secondly, the facility should ensure that information is shared consistently and accurately without legal holds. The facility needs to provide the infrastructure that securely offers information. Thirdly, the facility needs to develop the standard framework used for governance. Many facilities operate under the impression that their governance strategies are effective. However, they need to be evaluated to ensure that the framework is adjusted to help the governance team utilize the mature information security and privacy elements to help their blood information security (Ramachandran et al., 2020). Management and governance of EHR systems emphasize data security and information privacy, and the framework needs to facilitate this requirement. Finally, the facility should empower the employees. As the governance strategy is implemented into the facility, as the systems become more adopted, the facility needs to offer training to the personnel. This approach helps them use the system and ensures that they are part of maintaining data security (Ramachandran et al., 2020). Mature training programs help boost the ability of staff to maintain information confidentiality. Some considerations made on choosing a governance strategy is the integration of the data in the facility, the level of training offered to the staff and the health priorities and goals set by the facility. The implementation process takes multiple steps that involve an introduction, evaluation, modification and observation. The execution process of the system requires the application of skills from several professionals to reduce the related costs. An overall design for governance allows the facility to create priorities and goals that drive them through the health information systems.   References Afrizal, S. H., Hidayanto, A. N., Handayani, P. W., Budiharsana, M., & Eryando, T. (2019). Narrative review for exploring barriers to the readiness of electronic health record implementation in primary health care. Healthcare Informatics Research, 25(3), 141-152. Ramachandran, S., Kiruthika, O. O., Ramasamy, A., Vanaja, R., & Mukherjee, S. (2020, September). A review on blockchain-based strategies for managing electronic health records (EHRs). In 2020 International Conference on Smart Electronics and Communication (ICOSEC) (pp. 341-346). IEEE.




Technology continuing advancements require IT equipment to keep up with its new changes. IT specialists need supportive staff and strategies to integrate these changes (Wang & Kricka, 2018). Successful technological implementations frequently involve individuals who serve as mediators between end-users, management, and information technology personnel (Umstead et al., 2021, p. 1544). Effective implementation of health information technology is associated with technical, social, organizational, and wider-socio-political factors (Cresswell et al., 2013). One strategy, in accordance with Umstead et al. (2021), to successfully implement technology is using individuals as mediators amongst end-users, management, and technology developers, i.e., technology use medication (TUM) (p. 9). The work of mediators is described as changing the organizational context and providing users with mental models and other interpretive resources to draw upon as they learn and use the technology (Novak et al., 2012). In addition to selecting an excellent strategy to implement technology, it is important to consider limitations such as equipment cost. According to Cresswell et al. (2013), a system should be both fit for organizational purpose and fit for clinical practice – it must be affordable. There are also risks involved when considering building a customized system tailored to local needs, customizing an existing system, or using an ‘off-the-shelf’ standardized solution. Cresswell et al. (2013) cited home-grown customized systems as being better accepted by local users than standardized solutions – authors also suggested that home-grown customized systems are more expensive and do not easily integrate with other systems. Health systems governance ensures that strategic policy frameworks exist and are combined with effective oversight, coalition building, regulation, attention to system design, and accountability (Lehmann et al., 2015, as cited in Bigdeli et al., 2020). Additionally, Bigdeli et al. (2020) suggested that the health systems governance framework tringle is composed of policymakers, people, and providers. References Bigdeli, M., Rouffy, B., Lane, B. D., Schmets, G., Soucat, A., & Bellagio Group. (2020). Health systems governance: The missing links. BMJ Global Health, 5(8), e002533. Cresswell, K. M., Bates, D. W., & Sheikh, A. (2013). Ten key considerations for the successful implementation and adoption of large-scale health information technology. Journal of the American Medical Informatics Association: JAMIA, 20(e1), e9-e13. Novak, L. L., Anders, S., Gadd, C. S., & Lorenzi, N. M. (2012). Mediation of adoption and use: A key strategy for mitigating unintended consequences of health IT implementation. Journal of the American Medical Informatics Association: JAMIA, 19(6), 1043-1049. Umstead, C. N., Unertl, K. M., Lorenzi, N. M., & Novak, L. L. (2021). Enabling adoption and use of new health information technology during implementation: Roles and strategies for internal and external support personnel. Journal of the American Medical Informatics Association: JAMIA, 28(7), 1543-1547. Wang, P., & Kricka, L. J. (2018). Current and emerging trends in point-of-care technology and strategies for clinical validation and implementation. Clinical Chemistry (Baltimore, Md.), 64(10), 1439-1452. 




Background In order to facilitate the advancement of health care organizations’ transition to increasing compliance with the use of electronic health records (EHRs), the American Health Information Management Association (AHIMA) (2013) explains that Congress mandated associated legislation in the HITECH Act of 2009. In addition, The Office of the National Coordinator for Health IT (ONC) was created to promote the national health information technology (HIT) infrastructure and oversee development.

Principles of Governance Bresnick (2019) describes healthcare data governance as providing oversight for payment reforms and compliance with established rules for providers regarding payment, communication, protecting patient data, and evaluation of risk management. In addition, Bresnick (2019) explains that data governance is “geared towards making sure that users can trust their data, which is especially important when making patient care decisions” (para. 10).

AHIMA’s 8 Principles of Information Governance (Washington, 2014) Top 2 Priorities for the implementation, management, and governance of health IT systems

Principle of integrity: Information management will maintain the reliability of the data. The integrity of the information within the EHR is a priority because it is imperative that the data stored, shared, and used for clinical decisions is accurate and reliable. Otherwise, health care organizations (HCOs) risk patient-care outcomes, patient safety, and degrade patient trust.

Principle of disposition: Any information the organization no longer needs will be disposed of in a safe and legal manner. Personal health information (PHI) can be a valuable resource for criminals to gain sensitive knowledge and use it in a nefarious manner. In addition, PHI could be used for research purposes where the patient has not given consent. Data breaches can also cause people to be denied coverage or reimbursement by their medical insurers. Finally, data breaches can cause damage to credit ratings and scores (FTC, 2021).

Resources to consider (risks, assumptions, limitations, costs) The responsibility of ensuring data accuracy, security, and legitimacy lies within the organizational structure and planning for future costs. Management needs to be able to forecast future trends and expenses and look for creative solutions. Open communication and support for the sharing of ideas, training, implementation, and reevaluation of projects will ensure governance and sustainability for an IT system’s operations success (Lennox, 2018). References

AHIMA. “Understanding the HIE Landscape” Journal of AHIMA 84, no.1 (January 2013): 56-63. Bresnick, J. (2019, December 18). The Role of Healthcare Data Governance in Big Data Analytics. HealthITAnalytics. Retrieved May 6, 2022, from 

Federal Trade Commission. (2021, October 25). What To Know About Medical Identity Theft. Consumer Advice. Retrieved May 6, 2022, from 

Lennox, L., Maher, L., & Reed, J. (2018). Navigating the sustainability landscape: a systematic review of sustainability approaches in healthcare. Implementation Science, 13(1), 1–17. 

Washington, L. (2014). Information governance is essential for realizing the value of health IT. Journal of AHIMA Website.





Policies and procedures that manage data across a healthcare enterprise include strategies for monitoring health information and enforcing security to implement effective data governance (Reeves et al., 2013). Furthermore, implementing data management programs is critical to ensuring data integrity and accuracy in health IT systems. Maximizing the value of data governance can be achieved by aligning its developments and use with organizational goals (Benfeldt et al., 2019). Additionally, data quality involves deciding what and whom the data is used for and assigning accountability and rights accordingly. An initial investigation to highlight where data may be at risk by examining an organization’s existing policies around data security is an important step and a priority to identify key risks to which an organization is exposed (Gregory, 2011). Formulating a data governance council and establishing a data stewardship role is crucial to finding the right people to define responsibilities and establish accountability (Cochrane, 2009). Furthermore, enabling equal emphasis on technology processes will better help stewards manage data in a centralized location. References: Cochrane, M. (2009). 5 Steps to Data Governance: Challenges will surface when balancing the many parts involved in data governance, but a comprehensive program will keep everything in check. Information Management, 19(2), 33. Gregory, A. (2011). Data governance — Protecting and unleashing the value of your customer data assets: Stage 1: Understanding data governance and your current data management capability. Journal of Direct, Data and Digital Marketing Practice, 12(3), 230-248. Olivia, B., Persson, J. S., & Madsen, S. (2020). Data Governance as a Collective Action Problem. Information Systems Frontiers, 22(2), 299-313. Reeves, M. G., & Bowen, R. (2013). Developing a data governance model in health care: Although the term may be unfamiliar, data governance is a longstanding obligation of the healthcare industry. Healthcare Financial Management, 67(2). (Library link)

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