There are numerous requirements for the ideal EHR Steering Committee's membership. As with all large projects, the optimal size of the Steering Committee is less than 12. The membership should include executives from the key areas being impacted by the project with well defined alternates.  As would be expected, the membership will be tailored to the individual organization.  Although there is a trend to use more teleconferences and/or videoconferences, the value of a face-to-face Steering Committee should not be underestimated.  From a frequency perspective, the EHR Steering Committee will realistically only be able to meet monthly.  One consideration to keep in mind is doing off-site full day meetings.  One typical issue experienced by EHR projects is waiting a month for EHR Steering Committee's to meet to make key decisions can introduce significant delays into the project.

To guard against the natural constraints of the EHR Steering Committee, identify four individuals as Project Champions from the Steering Committee.  We'll consider this the second key leadership team.  The four individuals should be capable of representing physician, nursing, administration, and IT.  This sub-committee of the EHR Steering Committee needs to commit to attending reliably and being active participants in the team's activities - we suggest meeting weekly so as to not allow a decision to stall beyond 1 week.  Critical to this groups effectiveness is there being championed by senior most administrative leadership (e.g. Officers) who give the team decision making power.

Successful implementation requires that these individuals be "link-at-the-hip" since success is evidently dependent on both. Without such ability, critical decisions become delayed and potentially damaging. Consideration of individual members who "get along," while seemingly evident, can too often receive inadequate attention; lack of attention to this requirement can lead to interactions influenced excessively by personality and which distract from the teams primary purpose. Important to the overall process is the need for the members to consistently relay information gleaned from the team's activities widely among their constituents in the organization. The importance of this communication cannot be overstated as it not only serves to allay fears which occur as a natural consequence of such a large scale project, but avoids frustration resulting from individuals concerns and issues being not being heard and addressed.

In addition to the Project Champion's key role of making decisions for the project, this key Executive team should have the responsibility for being evangelists of the project and thus setting the right tone for the initiative.  Ultimately an EHR implementation is a large exercise in change management.  The Project Champions are in a unique position to start managing the change with early and often communications to all employees.  A series of town hall "roadshow" sessions are valuable to explaining the end product that is coming, progress being made, and how it will impact every stakeholder.  These sessions should also be used as an opportunity to ask the important question "what are you concerned about."  What you will typically find is the participants may flag items that were not considered in the scope, requirements, and workplan of the project.

The third leadership team for the EHR initiative should be a strong Project Management Committee.  The Project Management Committee will vary by the specific modules being implemented; however, there are some key components of this committee that should be in place regardless.  The key roles includes:  project metrics lead, project administrator for documentation, and the vendor's Program Director.  Beyond that, a Project Manager should exist for each key workstream on the project based completely on the scope of your project.  The Project Managers are the leaders focused on making sure tasks are being completed on time and on schedule.  They are also focused on addressing the constant onslaught of changes, issues, and risks.  A common thread between the Steering Committee, Project Champions, and Project Management Committee should be the Program Director.  Ideally, this role is leading both teams.