Case Study: State Level Governance of Health Information Exchange - Data Governance: Creating Value from Information Assets - page 199

overcome the major technical barriers to interoperability among health
IT systems. The HIT Standards Committee was expected to represent all
healthcare sectors, including providers, health plans technology vendors,
researchers and experts in privacy and security, and to serve as a forum
for health IT stakeholders to provide input to ONC on the development
of technical standards for HIEs. The HITECH Act outlined the need for
governance through inclusivity and stakeholder buy-in from each com-
mittee, but provided no powers to either committee to actually govern the
development of HIE at the national level. This was left to ONC as a federal
agency (American Recovery and Reinvestment Act, 2009).
In 2010, the HIT Policy Committee formed a governance workgroup to
consider the requirements of governance for the newly renamed NwHIN.
The governance workgroup issued a draft recommendation on its gov-
ernance roles and responsibilities at the end of the year. The workgroup
recommended nine principles of governance for the NwHIN (Health IT
Policy Committee, 2010b):
1. Transparency and openness: Governance approach should maxi-
mize openness and engage the public and data-sharing participants.
2. Inclusive participation and adequate representation: Demonstrate
preference for including diverse stakeholders and encourage
robust participation.
3. Effectiveness and efficiency: Functionality of HIE governance should
have a goal of maximizing efficiency and effectiveness.
4. Accountability: Stakeholders must be held accountable and respon-
sible to the national agenda, which should be reflected in gover-
nance mechanisms.
5. Federated governance and devolution: Governance structure should
allow multiple entities to take ownership of decisions closest to them
and with the greatest stake in resolution. The federal government
should take the lead in areas essential to maintaining public trust in
its meeting NwHIN goals.
6. Clarity of mission and consistency of actions: The rights, responsibili-
ties and obligations of all stakeholders should be clearly documented
and decision making should be consistent.
7. Fairness and due process: Governance processes should include due
process and responsiveness to stakeholders and governance decisions
should be fair for participants.