40 percent of organizations have no EHR governance in place

Despite the increase in efficiency they affect and the meaningful use incentives they garner, electronic health record systems are not usually well-received when a practice begins the process to implement the technology into its workflow. Like any new technology, there is a learning curve to EHR systems. Unlike paper records, the manner of data entry can be categorically different, and certain functionalities may be new and confusing to some people who have never handled such an intensive software system before.

However, organizations employ many different strategies to make the transition to the full use of an EHR system a relatively uneventful one. One of the most popular may be a governance committee that oversees the implementation of and changes to a new software system. This body may be comprised of executives, physicians or a mix of staff members from every level.

According to a recent survey from the Healthcare Information and Management Systems Society, despite the seeming viability and necessity of such a supervisory body when EHR systems are being adopted at a breakneck pace by organizations seeking meaningful use incentives, only 60 percent of health care companies have a codified governance structure in place.

Looking at governance
In an ongoing look at how organizations are coping with the stages of meaningful use, the HIMSS survey collected responses from 238 health care professionals on their companies' respective approaches to EHR implementation. The majority of respondents were at the executive level, such as chief executives, information officers and nursing officers, though primary care physicians and mid-level administrators participated as well.

According the survey's findings, 60 percent of health care organizations employ some form of EHR governance. However, 21 percent indicated that there was no such supervisory committee within their company. An additional 19 percent were uncertain of the existence of any such body, though if the purpose of an effective governance is to ensure that all staff members are communicated to about best practices, uncertainty cannot bode well for such a policy.

While 60 percent is no small number of organizations with effective governance practices, the Centers for Medicare and Medicaid Services is pushing for full adoption of EHR systems. Such a large portion of organizations with unstructured approaches to EHR implementation may pose problems for that initiative.

"How organizations make decisions around enhancements to EHRs, including implementation, can dramatically impact their ability to meet regulatory measures and create workflow efficiencies," Brendan FitzGerald, analytics research director for the HIMSS, said in a statement.

Clear policies lead to smooth transitions
Health care professionals have had enough to worry about lately with the recent ICD-10 delay. Adding unclear EHR implementation policies on top of that can only lead to improper adoption practices and lost resources. Organizations that may have gotten by without clear governance in the past may have to adapt as EHR systems become an unavoidable fact of the industry.

"Health care organizations know that they can't do business as it's always been done," Shane Pilcher, vice president of Stoltenberg Consulting, told EHRIntelligence. "The first thing they must do is identify their governance processes. Who owns this information? Who has access to it? How do they make sure the data they're collecting is there when they need it?"

To best answer these questions, the American Health Information Management Association called for not only unified governances within individual organizations, but across the industry, FierceEMR reported. With standardized data practices, companies would be able to more easily share information across networks. This functionality is expected to become crucial as interoperability becomes an unavoidable aspect of later meaningful use stages.

Whether it is for long- or short-term goals, organizations without clear EHR governance policies should institute them as quickly as possible to ensure as few disruptions to workflows as possible.