Much has been written about the pros and cons of leadership teams composed of senior healthcare administrators and clinicians, but there is little debate that active involvement by both parties is essential to the successful management of the hospital organization.

This is particularly true with regard to the strategic planning for and management of large scale projects; in no area is this truer than in the planning, selection, and implementation of an electronic health record (EHR). Given the increasing conversion of hospitals to an EHR, this article attempts to summarize a number of items which optimize the likelihood of this endeavor proceeding in an effective manner.

It is tempting for both administrative and clinical groups to view conversion from paper to electronic records as an information technology (IT) project. In fact, the optimal approach recognizes the integral role played by IT but recognizes such activity as an operations effort supported by IT and lead by Project Management.  The most successful EHR initiatives will concentrate on project management governance first.  The most common groups to look to for this governance will be a formal enterprise project management office or the IT department.  There is no single governance structure that fits all organizations; rather, it is imperative for the Program Director to facilitate a process of aligning roles & responsibilities based upon the idiosyncracies of the specific organization. With this caveat in mind, what are the keys elements to ensuring the highly functional and successful EHR team?

First of all, how do we define the EHR Steering Committee? Can this be defined as a committee or as a task force? The former is generally applied to an entity with a common purpose and function but without a foreseeable end date. Conversely, a task force generally has a specific task to accomplish and may cease to exist once that is completed.

The EHR Steering Committee is often a hybrid of both because of its relatively long-term nature and the possible morphing into an entity with a temporally indefinite function. Regardless of how defined, the team needs to initiate its existence with a clearly defined goal and timeline. This necessity is apparent both from the standpoint of buy-in by the team's membership but also to put the activities in a context which is relevant to the organizations senior most governing body for the purposes of budgetary, resource allocation, and strategic planning.