Hospitals and health systems have invested heavily in EHRs and ERPs. But despite these investments, many still struggle with clinician frustration and stalled optimization efforts. The reason often comes down to one thing: weak or ineffective governance.
When governance is overlooked, side-stepped or not as strong as it should be, clinical and operational needs can be missed, leading to underutilized systems, frustrated providers, and missed opportunities to improve patient care. Without an effective governance strategy, your organization will develop an ever-expanding chasm between your technology, people, platforms and processes.
Effective Governance Matters – And Here's Why
- Aligns IT with Clinical Objectives
Strong governance ensures that projects are directly tied to clinical workflows and patient care priorities. Instead of technology leading the way, governance ensures the tech supports the mission. Governance may also work as a form of defense for patients, ensuring that the technology is safe and can be implemented without interrupting patient care.
- Enhances Innovation with Informed Decision-Making
Clear governance structures help leaders make more informed choices. Organizations can prioritize initiatives that deliver the most value and avoid wasted effort with the proper framework.
- Improves User Satisfaction
When multiple departments are active members of governance discussions, innovative projects can evolve more seamlessly to meet organizational goals better. This engagement can improve adoption and create a stronger sense of ownership.
Healthcare Leaders' Guide to Effective Governance
There is no one right way to develop governance for every health system. It all depends on the goals, size and staff of each organization. For larger health systems, governance groups can be broken down into specific projects, such as AI, while smaller health systems may only have a limited number of subject matter experts on staff.
In a recent episode of the Visionary Voices podcast, Northeast Georgia Health System (NGHS) Chief Information Officer Chris Paravate and Chief Technology Officer Stuart Samples discussed what their team observed and the ‘why’ behind creating a more inclusive and structured governance model.
Leadership Engagement
NGHS brought together IT and clinical leaders to ensure decisions reflected broad perspectives. Samples and Paravate discussed the importance of educating organizational leaders about technology shifts with as much advance notice as possible.
“It makes for a much easier conversation with the board when you can educate them far earlier than ‘Hey, I need a whole bunch of money'”, said Samples. “You want to begin that education many months, if not years, in advance, and then it’s an easier conversation.”
As crucial as executive buy-in is, it’s also important to understand the workflow and change impact a proposed project may have across the organization. Bringing leaders together from across the organization helps diversify the viewpoints so that any hesitations can be caught before any investment of time and resources is provided.
Clear Governance Structures
NGHS defined roles and responsibilities within its governance framework, making it clear who made what decisions. Those roles were also developed for multiple groups within the organization—from board members and executives to its clinical and IT staff.
NGHS isn’t the only one taking this approach. During a panel discussion at ViVE25, Optimum Healthcare Chief ServiceNow Architect Louie Gomez shared some best practices when developing your governance structure.
“As ideas are coming in from multiple different departments, how are we going to put a value to those and decide whether something is going to be implemented or not? That value is what determines the priority,” said Gomez.
Continuous Feedback Loops
NGHS implemented feedback mechanisms so staff could share input and drive improvements continuously.
Strategies for Building and Empowering Governance
Every healthcare organization can take steps to improve its governance model. Here are four proven strategies:
1. Establish Inclusive Governance Committees
Include IT, clinical, administrative, and operational representatives to ensure that all voices are heard and decisions reflect the entire organization’s needs. Having an executive steering committee is also something worth implementing.
For a large healthcare organization like Advocate Health, ensuring representation across the organization is key. During the ViVE25 panel discussion, Sullivan discussed how Advocate Health has developed an AI governance committee that evaluates the programs, acts quickly and provides guidance. He also mentioned the importance of having a human in the loop to ensure the organization’s safety.
2. Define Clear Roles and Responsibilities
Make sure every committee member knows their duties and decision-making authority. Clear accountability builds trust and transparency. While building out roles and responsibilities, a critical piece of the puzzle is building internal champions across multiple departments.
3. Implement Regular Review Processes
Schedule periodic reviews of both performance and governance effectiveness. Be ready to adapt structures as the organization’s needs change. Is this safe? What’s the risk involved? It’s not just standing up the governance – it’s how the governance integrates with what you already have. Defining an escalation path and risk management protocols will prepare you for success.
4. Foster Open Communication Channels
Encourage continuous dialogue between end-users and governance bodies. Feedback loops are critical to ensuring the system evolves with frontline needs. These channels need to be tailored to fit your organization.
The Bottom Line
Governance is more than a committee—it’s the foundation that ensures technology truly supports patient care. By building inclusive structures, defining roles, and creating feedback loops, health systems can unlock the full potential of their technology investments. The payoff is better alignment with organizational goals, more informed decisions, and happier employees—all leading to stronger patient outcomes.
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