Finally, Program Director is a critical leadership appointment and needs to be identified at its outset and can be the most difficult position to staff because of the idiosyncracies of organizations. The most important item to keep in mind when selecting the Program Director is finding someone that can be closely aligned with the Officers on the Project Champion's Committee.  This position must be an employee and fully dedicated to the EHR project.  When selected, the initial role of the Program Director may best be described as that of a facilitator. Labeled as such in the early phase of the team may be less intimidating to the senior most members of the organization; more specific expectation of the Program Director's role generally comes as a natural consequence of time and greater confidence in the process.

Ideal functioning of the Program Director is best supported by a strong set of project governance processes.  At a minimum, the project governance processes should include the following:

• scope management – defines how the scope is protected and managed
• communication management – defines content, target audience, communication channel, and frequency
• meeting management – defines rules of meetings such as agendas, meeting minutes, timelines, and logistics
• resource management – defines roles/responsibilities and appropriate staffing
• schedule management – defines how changes to the project schedule will occur
• change management – defines how changes to budget, schedule, scope, and requirements will occur
• issue management – defines how issues will be triaged and addressed
• risk management – defines how risks will be mitigated
• quality management – defines the plan to ensure the highest quality in the end product and resulting processes
• budget management – defines a process for ensuring the project is delivered on or under budget
• records management – defines where the enormous volume of project artifacts will be stored and easily accessed
• performance management – defines reporting of key metrics regarding the project performance such as earned value
• defect management – defines expectations around defects

These pre-defined processes provide a process framework to the EHR initiative  that have important implications to the success of the team.  You will find that the most successful Program Directors, Steering Committees, and Project Management Committees manage the process around the project versus the content. Whereas the details of these pre-defined processes ultimately are strikingly similar from one organization to another, it is critical for the Program Director to work with the Steering Committee, Champions, and Project Management Committee to define organization specific processes.  For no other reason, this builds buy-in into the governing processes that are used day-to-day for a very long endeavor.

In addition to the above actions helping to ensure that the team succeeds in meeting its goal(s), functioning as described has a number of secondary benefits. These benefits include building a strong sense of camaraderie among team members. A highly effective EHR team has addressed one of the most challenging projects in health care today; such a team is likely to be similarly successful in a number of health care endeavors.