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IHealth Governance

IHealth Governance Structure

The IHealth Governance Structure is in place to provide strategic clinical leadership, accountability and transparency. Its purpose is to ensure that the transformation to electronic health records reflects the needs of Island Health.

The Island Health Board is financially accountable for the successful delivery of IHealth, and closely monitors progress, risk management, and benefits realization. 

Within the Island Health Board, an IHealth Clinical Steering Committee reviews and discusses IHealth-related materials. Independent experts have joined the steering committee to provide both advice and external validation to the Board. This steering committee, including the IHealth Executive Leads, is responsible for managing progress, risks, and benefits. The Executive Sponsors have established a Clinical Design and Operations Team (CDOT) to oversee activities and meet with IHealth leadership and project team members, including the practising clinicians and patients participating in the IHealth work streams. As the work streams and teams are established, additional project-level structures are put in place to support timely decision making and issues management.

IHealth Governance Context

Clinical Standards and Practice

Clinical Working Groups, which include medical department head leaders and subject matter experts, provide the primary clinical governance vehicle for IHealth.

The Health Authority Medical Advisory Committee (HAMAC) continues to play an important role in IHealth governance, specifically related to standards and practice considerations that involve ordering providers. The HAMAC Medical Quality sub-committee reviews and recommends policy changes related to ordering providers to HAMAC and clinical working groups as appropriate.

What is a working group?

What Constitutes a Working Group?

  • A program area that has a unique or specialized application or use of electronic tools (e.g. Emergency, Anesthesia, Surgery, Critical Care)
    A new enterprise application for the organization (e.g. Capacity Management)

Who attends working groups:

  • Representatives from all health care professionals within that program area (Regional – representing tertiary, community, and rural remote)
    Accountable decisions makers from the program area who are closest to the work (e.g. CNLs, CNEs, coordinators, etc.)
  • Should be some form of a linkage to your programs quality council
  • A member from your quality council sitting at the working group OR
  • A reporting mechanism into and out of the quality council (to ensure there is a quality & practice lens to the decisions made)

Activation Readiness

To ensure local ownership and readiness for change, local leadership and clinical teams will make go/no-go activation decisions following completion of readiness activities and approvals by the appropriate IHealth governance bodies.

This approach ensures that local leaders are visibly leading the IHealth related changes, with the support of their local clinical teams. Depending on the activation scope and risks, HAMAC will also assess readiness and provide independent advice to the Board. 

Adoption, Use, and Impact

Clinical working groups will play an important ongoing role in the oversight of adoption, use, and impact of IHealth related tools and processes, which will be critical to stabilization activities and the realization of benefits and value. Local sites and/or care teams will identify opportunities for review or improvement.  The Clinical Design and Operations Team will share achievements and lessons learned to support awareness and spread.

Leadership roles of clinical and medical staff in IHealth

The involvement of medical and clinical staff in leadership roles for IHealth is critical to the success of the project. IHealth positions described below each play a role in improving the quality of care and standardization of information across the continuum of patient care in our region.

  • Leads the strategy and toolset development in collaboration with Clinical Informatics and application teams in their role as physician informaticists.
  • Primary liaison for the site on behalf of the Chief of Staff or Site Medical Director.
  • Provides effective communication to the medical staff at the site, actively gathers medical staff experience feedback, and provides information to the local medical advisory committee, appropriate quality councils or the Medical Staff Association (MSA).
  • Responsible for leading the development of specialty-specific standards required for the transformation to electronic clinical documentation.
  • Ensure that health care providers within their department are involved in discussions regarding the standardization of features in the EHR that support specific patient populations.
  • Ensure that specialty-specific requirements are developed and adopted for EHR functionality.
  • As the appointed representative, leads groups of health care providers in creating, standardizing and harmonizing electronic instructions and directions.
  • Specialty-based physicians responsible for ensuring that health care providers within their department or division participate in discussions regarding specialty-specific EHR capabilities.
  • Have deep understanding of specialty-based electronic documentation, order set content and EHR-enabled workflows.
  • Support change activities, including advising on education and training.
  • Represent their specialty as members of the appropriate Program Quality Councils and IHealth Working Groups.
  • Practicing physicians who provide elbow-to-elbow support during the implementation phases for the EHR.
  • Provide direct, hands-on experience and expertise using the advanced EHR functionality implemented through IHealth at previous activations.
  • Nurse informaticists who have deep understanding of advanced EHR capabilities and identify improvement opportunities to advance EHR functionalities.
  • Conduct workflow validation sessions and support prioritization of improvements and change requests.