CIA Principle 2: Clinical Information is designed centrally and adopted by all regional clinical systems; EHR Steering Committee approves Clinical Information design.
“Clinical Information is designed centrally and adopted by all regional clinical systems; EHR Steering Committee approves Clinical Information design.”
Clinical Information Architecture (CIA) is complex and has far reaching impacts across the entire region. Information design will impact activities from direct care delivery all the way to health planning activities. The organization needs a body with broad representation but also deep skills in information management / information design to set direction and review / ensure broad applicability / sustainability of the CIA.
The Clinical Architecture Review Board (CARB) will provide this detailed design function in VIHA. The CARB, therefore, will need to have a dedicated group of individuals that can represent the organizational needs for care delivery across sectors and for health planning. It will also need to have the analysis skills for understanding clinical systems integration into workflow, as well as the information modeling and management functions that are central to the CARB.
The EHR-SC will superintend the CARB and provide approval for designs that have clinical impact.
The IM/IT Steering Committee will review for approval any recommendations that have a significant operational impact.
The CARB will review IM/IT clinical projects for information design. The CARB will make recommendations on improving projects as part of project planning. The CARB will also act as a gate to design or review CIA that is part of the scope of specific projects. The CARB has the obligation to escalate any concerns that have long-term impacts on patient care delivery to the appropriate committee. Working Groups will be established as needed for information design.
Tools will be required both to manage the content and to manage the process of design and review of the Clinical Information Architecture and Clinical Systems Architecture.
Commentary:
This principle relates, obviously, to the governance and reporting of an information design group within the IM/IT portfolio. The challenge for many organizations is being heavily project focused. It allows for a lot of parallel activity, but that can lead to components that do not fit that well together. Preferably, a central body can support the alignment without getting in the way of the projects, and ideally streamlining and supporting the design process so information (a) is consistent and (b) does not have to be rebuilt from scratch for each project.
Some of the functions of the “CARB” will also need to be supporting the projects to start to use business process redesign techniques and standardized notation for analysis so that project artifacts and knowledge can be shared more widely.
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