User Governance

According to the HIMSS-SIIM Enterprise Imaging Community, enterprise imaging governance is “the decision-making body, framework, and process to oversee and develop strategies for the enterprise imaging program, technology, information, clinical use, and available financial resources.” Governance can serve many ends for your health system, including strategic planning and implementation, quality of care improvement, financial responsibility, positive work culture, transparent communication, compliant process adherence, and risk management. Ideally, governance body participation is multispecialty, including a broad cohort of physician, administrative, and technical experts. Because so many medical imaging specialties, care provider roles, and hospital departments are involved, enterprise imaging is, by nature, a diffuse and horizontal discipline to govern. High-performing governance bodies also create a mindset of vertical governance both from the top down, where leaders and boards make decisions, and from the bottom up, where frontline hospital staff make decisions that are broadly adopted and supported by leadership. Prioritizing areas to deploy people and dollars can require charged and difficult discussions for a governance body. Systematic scoring and prioritization guidelines have been deployed to encourage governance bodies to employ a degree of objectivity when comparing strategic opportunities with variable health outcomes, project complexities, the numbers of users impacted, cost reductions, potential revenue generation, research wins, and innovation. These imaging governance bodies, diverse by design, should speak with one voice. While disagreements may occur during governance body meetings, ultimately, the directive from the board on a given issue must be singular.

Duke Scholars

Author Christopher John Roth Radiology, Neuroradiology