By: Dottie Schindlinger, VP/Governance Technology Evangelist, BoardEffect, and James Rice
The move from good-to-great healthcare system governance is a journey that demands better information for smarter decision-making by more experienced community leaders. Over the past decade, one tool has become a valuable resource to support this journey: the web based “board portal,” or board management software. Our work with hundreds of nonprofit, hospital, and health system boards suggest it is time to re-examine advances in board management software, and the manner in which it is being used by boards and their C-Suite partners.
You might already know what a board portal is, and the options governance management software provides. You probably know that paper is heavy, hackers are a risk, and some documents are difficult to read on small computer or tablet screens. You also know there are multiple vendors that offer board-management software.
You might not fully realize, however, that by making the right choice, a board can improve its governance effectiveness and efficiency while collaborating in a secure setting.
We encourage your board to have a conversation about web-based tools for collaboration and decision making. For private, public, nonprofit and government boards alike, finding a system that excels will lead to better information security and a more productive board. Your conversations should be about:
- Industry turbulence that demands faster and smarter board decision-making
- Board work complexity and competencies that need better information for decision-making
- Cyber-attacks that can disrupt care and financial vitality
- User convenience and confidence in the decision support system.
Industry turbulence demands faster and smarter board decision-making
Public and payer calls for health systems to deliver on the challenges of “value for money,” “population health”, and “Triple Aim” services push board members into uncomfortable conversations about the complexity, speed, costs, and uncertainty of board room decision-making. It seems that every quarter, boards are expected to make decisions that impact more patients’ health and lives, more employees, bigger capital investments, more complex community health partnerships, confusing computer systems, innovative facility designs and long-term human resources development issues.
These decision processes require boards to: (1) engage with more collaborators in their decisions (physicians, service line managers, risk managers, community partners, and payers); (2) embrace a longer range (3-10 years) strategic planning horizons; and (3) quickly understand and master more complicated information, data, and opinions about investment decisions in areas they may have little prior experience or knowledge.
How can rapidly changing and complicated information to support board decision-making in such turbulent demands best meet at least these characteristics?
- Information and data that has been mined, distilled or curated by C-Suite experts into easy to digest graphics, charts and illustrations. The essential facts need to sing to the board members about the essential observations and conclusions/options.
- Information must be trustworthy from trusted sources; and
- Information must be easily accessible 24/7 as board members seek updated insights at any day of the week or time of day.
Board work complexity and competencies
From viewing and signing documents to having the ability to vote on items and share notes with colleagues, new PC, tablet, phone applications with governance-focused features can help your board collaborate more productively and securely. Having an app that allows board committee collaboration outside of full board meetings also frees up more in-person time for strategic work.
Facilitating director evaluations on an app can also make that process less anxiety-inducing. The portal should also accommodate the confidentiality of the baord’s decision-making materials and results. Discoverability is a major concern in the US health sector, and a board app should be able to mitigate discoverability worries.
- What kind of decision enhancing features will our board have access to you with your app?
- What kind of governance library can clients build on your app?
- What ability do users have to make real-time updates?
- How often do you add governance features to the app?
- What new features have you launched in the past 12 months?
Cyber-attacks that disrupt care and financial vitality
Board room conversations about cyber risk and cost are more common and more confusing.
Hospital systems must anticipate their vulnerability to cyber-attacks that unveil stolen data that can be confidential medical information, as well as patient names, addresses, birth dates, telephone, social security numbers and payment details. To the extent that such data is accessible from a board portal, cyber risk can escalate and further complicate the work and attention of the board.
Security therefore should be a key worry of boards adopting any new technology, and with good reason. Hackers work 24/7 trying to break electronic security and gain access to an organization’s systems to spy, steal, or extort. Often, hackers are able to do this without a company even knowing its security has been compromised.
A secure board portal solution, requires state-of-the-art security methodologies and encryption, not just another file management system. However, the most secure route must also be the most user-friendly or board members may try to find a (less-secure) workaround. Ask potential vendors:
- Has your company’s security ever been breached?
- How did you alert users?
- How often do you conduct third-party penetration and security testing?
- Which third-party certifications do you have and how long have you had them?
- How will you protect our information and any notes added on the app?
- How does security differ when the app is online vs. offline?
User convenience and confidence
If the board’s decision support system you choose isn’t adopted, it’s a wasted investment that may leave you less informed and secure than you were before.
For an application to be embraced by your board, it needs to be accessible from a multitude of devices, easy-to-use, and accompanied by live support at any time. Having the ability to read and annotate board materials like you could do with a hard copy is comfortable and functional; an electronic board book should be as simple to flip through as paper, but with lots of additional advantages, of course.
- How can you be sure your portal solution will be suitable for your unique group of board members?
- How will your board and staff users access a dedicated success team from the portal supplier?
- How much training/onboarding support is included with the subscription?
- What percentage of board members actually end up not using the portal’s resources?
- What percentage only partially adopt (i.e., the board ends up using paper in addition to the software)?
- What kind of staff support must be provided your board users?
As boards and their C-Suite colleagues explore new tools to enhance the quality and efficiency of their decision-making, at both the board and committee levels, they will need to consider the questions outlined above. Executives can also develop a comparative assessment that parallels the work by GreatBoards.
 See: http://trustees.aha.org/transforminggovernance/Workbook2012-11.pdf and also: http://trustees.aha.org/boarddev/center-voices-10-15.pdf
 For a general overview of Decision Support Systems (DSS) see: https://en.wikipedia.org/wiki/Decision_support_system
 See https://www.hhnmag.com/ext/resources/inc-hhn/pdfs/PartnerArticles/2016/EnviroScan_2017.pdf
 See: https://www.scientificamerican.com/article/u-s-hospitals-not-immune-to-crippling-cyber-attacks/
 See: https://cnmsocal.org/wp-content/uploads/2014/06/Handout-From-Board-Portal-Buying-Guide-final.pdf and also https://www.idealware.org/few-good-tools-board-portals-and-other-ways-collaborate/