Getting Comfortable — Who’s in the Room?

• Who will be our primary sponsor and daily contact for this project (name, role, email)?
• Which stakeholders must sign off for a pilot to move to contract (select all that apply)? Options: Chief Pharmacy Officer (CPO), Chief Quality Officer (CQO), CMIO, Patient Safety Officer, VP of Nursing, Chief Medical Officer (CMO), IT Director / CTO, Legal / Compliance, Finance
• Which of these describes how decisions are typically made here? Options: Single executive decision (fast), Small committee (2–3 people), Cross-functional committee (4+ people), Cabinet/board-level approval required, Ad hoc depending on scope
• Who do clinicians listen to most when something changes in the EHR—pharmacy leadership, informatics, quality, or clinical chairs? Options: Pharmacy leadership, Informatics/IT, Quality/Patient Safety, Clinical chairs/service line leaders, Varies by department
• If you had to pick one person who will champion this internally, who is it and why?

What if Alert Fatigue Cost a Patient?

• Have you had a sentinel event, near-miss, or regulatory finding in the last 24 months tied to medication safety or missed alerts? Tell us what happened. Options: Yes — sentinel event, Yes — near-miss, Yes — regulatory finding (CMS/Joint Commission), No known events
• How did that incident change the mood or urgency among leadership and frontline clinicians?
• If nothing changes, how likely is a repeat incident in the next 12 months? Options: Very likely, Somewhat likely, Unlikely, Unsure
• Which consequence worries you most if alerts keep failing to influence care? Options: Patient harm / ADEs, Regulatory penalties / citations, Reputational damage, Clinician burnout / disengagement, Financial loss
• Who outside your immediate team becomes involved when an adverse event occurs (e.g., legal, media, board)? Options: Legal/Risk, Communications/PR, Board/Executive Committee, External regulators, Other

Are Your Alerts Helping—or Hiding—Harm?

• What is your current overall alert override rate (all alerts)? Please include timeframe and any known caveats. Options: <25%, 25–40%, 41–60%, 61–80%, >80%, We don't have this metric
• Which alert types drive the most overrides or clinician complaints? Options: Drug–drug interactions, Dose checks/limits, Duplicate therapy, Allergy alerts, Imaging appropriateness, Antimicrobial stewardship, Other
• How confident are you that your content library reflects current guidelines and recent safety communications? Options: Very confident, Somewhat confident, Not confident, Don't know
• How often is your clinical content reviewed and updated today (and who owns that process)? Options: Weekly, Monthly, Quarterly, Ad hoc / after events, Never formalized
• Tell us about a time when an alert successfully prevented harm—or when an alert failed. What was the context and outcome?

Where Workflow Breaks Down (and Clinicians Voice It)

• When clinicians tell you 'the CDS gets in the way', what do they mean—interruption, timing, wording, or false positives? Options: Interruptive timing, Poor wording/clarity, Too many low-value alerts, Slow performance/latency, Clinician distrust of recommendations, Other
• Which EHR(s) and versions are you running, and are there any embedded CDS constraints we should know about?
• Where in the order-entry or documentation workflow do most problem alerts need to run to actually change behavior? Options: Order entry (CPOE), Medication reconciliation, Pharmacy verification, Nursing documentation, Imaging order entry, Other
• How tolerant is your IT/ED integration team of external APIs, latency, and scheduled maintenance windows? Options: Very tolerant — flexible, Somewhat tolerant — limited windows, Low tolerance — strict change control, Unsure
• Have clinicians ever bypassed or disabled an alert module because of workflow impact? If so, where and why?

If Success Was Measured in Numbers, Which Ones Matter?

• Which of these metrics will determine pilot success for you? Options: Override rate reduction, ADE reduction, Alert volumes per 100 orders, Clinician time impact per workflow, CMS/QAPI metric improvement, User satisfaction/qualitative feedback, ROI / cost of harm avoided
• What is your current baseline for the top metric you chose (include timeframe and how it's measured)?
• What absolute or relative target would make you say the pilot was successful (e.g., override rate <40%, X% reduction in ADEs)? Options: Specific numeric target (we will provide), Relative reduction (e.g., 30% fewer), Qualitative acceptance by clinical committee, Unsure / need to define
• How long do you need to run a pilot to feel confident in the results? Options: 4 weeks, 8 weeks, 12 weeks (1 quarter), 6 months, Depends on metric
• What evidence will the clinical leadership require to accept the pilot outcomes (statistical analysis, case reviews, clinician surveys)? Options: Statistical significance, Case-level chart reviews, Clinician qualitative feedback, Operational impact metrics, Regulatory alignment documentation
• Which service line(s) would be the best pilot candidates and why?

Who Decides 'Good'—and What Are They Comfortable Betting On?

• If you had to name three people who must endorse 'good enough' to move forward, who are they and what will convince each?
• What budget guardrails or spend thresholds exist for pilots and proof-of-value projects? Options: No budget required — operational funds, <$25k, $25–50k, $50–100k, >$100k, Budget must be approved case-by-case
• How do you weigh clinical benefit versus upfront cost—are you willing to pilot with shared-risk commercial terms tied to outcomes? Options: Open to shared-risk, Prefer fixed-fee pilot, Need internal funding only, Undecided
• What timeline pressures drive urgency (regulatory deadlines, board reporting, leadership changes)? Options: Regulatory deadline, Recent sentinel event, Board/Executive reporting, Leadership transition, No immediate pressure
• Who in procurement/legal needs to review an agreement for a pilot and how long does that typically take? Options: Procurement only, Procurement + Legal, Legal + Compliance + Security, Depends on dollar value

What Would Make You Trust Our Alerts Tomorrow?

• How important is rapid content update cadence to you (e.g., 72-hour guideline updates) vs. slower, heavily curated changes? Options: Critical — must be <1 week, Important — monthly, Neutral — quarterly, Prefer minimal frequent change
• Who would own content governance locally (clinical editors, pharmacy, quality committee, or vendor-managed)? Options: Local clinical editors, Pharmacy team, Quality committee, Vendor with local sign-off, Shared governance
• Which types of evidence or references build the most trust for your clinicians (guideline citations, peer-reviewed studies, internal case reviews)? Options: Professional guidelines, Peer-reviewed studies, Regulatory advisories (FDA, CMS), Internal adverse event reviews, Local expert consensus
• What rollback or kill-switch safeguards would you require before going live in a pilot? Options: Immediate global disable, Service-line disable, Patient-level suppression, Alert-only sandbox, Other
• Who do we need to involve from pharmacy, informatics, and safety to validate clinical logic before deployment?
• Describe one concrete trust-building action (e.g., joint chart review sessions) that would make clinicians more willing to accept new CDS behavior.

If We Ran a Pilot, Could We Prove It in One Quarter?

• Do you have a sandbox or test EHR environment where we can integrate and validate without affecting production? Options: Yes — full sandbox, Yes — limited test environment, No — only production, Unsure
• What data feeds can you provide for pilot measurement (medication orders, eMAR, ADE reports, override logs)? Options: CPOE/order logs, eMAR/administration data, Pharmacy verification logs, ADE/adverse event reports, Override tracking, Other
• What access or credentials will the integration team need and how long does provisioning usually take?
• Are there institutional data-sharing agreements or DPA templates we must use, and who negotiates them? Options: We have a standard DPA, Vendor must use our template, Legal negotiates case-by-case, Unsure
• Who will run day-to-day pilot tuning and how many FTE hours per week can they commit? Options: Pharmacy analyst, Informatics analyst, Shared clinical lead, Vendor-led with local oversight, Other
• Are there specific security or penetration testing requirements before connecting to internal systems? Options: Yes — strict testing required, Basic security review, Vendor attestation sufficient, Unsure

What Would Stop This Project Dead in Its Tracks?

• Looking at past CDS or integration projects, which failure modes repeat most often here? Options: Too many false positives, Lengthy procurement, Clinician resistance, Integration latency, Insufficient measurement, Other
• Which internal politics or competing priorities could deprioritize this work mid-pilot? Options: Budget cuts, Staffing changes, EHR upgrades, Other strategic projects, Leadership turnover
• If clinicians push back publicly, who supports the change and who could amplify resistance? Options: Service line leaders support, Pharmacy supports, Nursing leaders mixed, Clinician champions needed, Unsure
• What legal, compliance, or regulatory questions do you expect to arise and who owns responses?
• If we outline a clear mitigation plan for top risks, would that materially increase your willingness to proceed? Options: Yes — much more willing, Somewhat, Not really, Unsure

The Next Step That Feels Safe and Decisive

• What is the smallest, lowest-risk next step that would move you toward a pilot (e.g., demo with your cases, chart review workshop, data readiness call)? Options: Demo using our cases, Scenario-based session with your cases, Data readiness and access call, Clinical validation workshop, Legal/data agreement review
• Who else needs to be present for that next meeting (name + role)?
• Realistically, when could you commit to that first next-step meeting? Options: This week, Next 2 weeks, Next month, Next quarter, Unsure
• What concerns would you want resolved before committing to a pilot kickoff?
• If we proposed a 6–8 week integration plan followed by a 12-week tuning window, what about that timeline feels achievable or not? Options: Completely achievable, Achievable with adjustments, Too aggressive, Need internal discussion

Getting Oriented — A quick snapshot of who you are and why we're here

• Who is joining this conversation today? List names, titles, and primary decision area (pharmacy, quality, informatics, patient safety).
• What triggered interest in improving your decision support right now? Options: Sentinel event, CMS/QAPI pressure, Joint Commission finding, Routine quality initiative, Other
• Who will be the final internal decision-owner for a pilot or purchase? Options: Chief Pharmacy Officer, VP/Director Quality, CMIO, Chief Nursing/Patient Safety Officer, Other
• What timeline are you aiming for from kickoff to pilot launch? Options: <4 weeks, 4–8 weeks, 8–12 weeks, 3–6 months, Undecided
• How would you rank urgency of this initiative right now? Options: Critical — must start immediately, High — prioritize this quarter, Medium — next quarter, Low — exploratory

If This Were a Crime Scene — Tell Us About the Last Time Things Really Failed

• Describe the most recent sentinel event, near-miss, or regulatory finding that pushed this project forward—what happened, and who was affected?
• How often do events of that severity occur across your system? Options: Once in past year, Several times in past year, Monthly, Weekly, Multiple times per week
• What root causes were identified (e.g., missing alerts, false negatives, poor clinician workflow fit, delayed content updates)? Options: Missing alerts, Excess low-value alerts, EHR workflow mismatch, Content out-of-date, Integration latency, Other
• What were the downstream consequences — patient harm, extended LOS, fines, or reputational impact? Options: Patient harm, Readmission/longer LOS, Regulatory citation, Financial penalty, Reputational risk, None of the above
• How did clinicians and leadership react emotionally and operationally after the event?

Do Clinicians Trust the Alerts — or Just Click Through?

• What is your current average override rate for medication-related alerts (by service line if available)? Options: <20%, 20–40%, 40–60%, 60–80%, >80%, Don't know / tracking not in place
• Which alerts tend to have the highest override rates (e.g., drug–drug, dose checks, renal adjustments, duplicate therapy)? Options: Drug–drug interactions, Dose limits/verification, Renal/hepatic adjustments, Duplicate therapy, Allergy checks, Other
• Where do you currently capture override data and who reviews it? Options: Pharmacy analytics/dashboard, Quality team reports, Informatics logs, Not routinely captured, Other
• Tell us about specific alerts clinicians complain about—what do they say and how long has that sentiment been building?
• Do you have qualitative clinician feedback channels (e.g., alert feedback button, frontline interviews)? If so, how often is feedback reviewed? Options: Real-time feedback button, Monthly clinician interviews, Ad-hoc / event-driven, No formal channel

What’s the Actual Workflow in the EHR — Walk Us Through a Real Order

• Map the typical clinician journey for placing a medication order in your EHR—where do decision points and alerts appear?
• Which EHR and modules/versions are you running where the pilot would live? Options: Epic (Ambulatory), Epic (Inpatient), Cerner/Oracle, Meditech, Allscripts, Other
• Are your alerts presented as interruptive modals, inline suggestions, order set recommendations, or passive banners? Options: Interruptive modal, Inline suggestion, Order set recommendation, Passive banner, Combination
• How many different clinician roles (attendings, residents, RNs, pharmacists, advanced practice) interact with the same alerts for the pilot scope? Options: 1–2, 3–4, 5–6, 7+
• Do order workflows differ significantly across facilities or service lines? If yes, give an example.

What Hidden Tech Limits Are Quietly Slowing You Down?

• What integration methods are available for third-party CDS in your environment (SMART on FHIR, CDS Hooks, HL7 interfaces, custom APIs)? Options: SMART on FHIR, CDS Hooks, HL7 v2/v3, Custom APIs, Direct DB access, Other
• How fast must a decision support response be to avoid clinician frustration (acceptable latency in seconds)? Options: <0.5s, 0.5–1s, 1–2s, 2–5s, >5s
• Do you have isolated test/sandbox environments and who controls access? Options: Yes — full sandbox available, Partial sandbox / limited data, No sandbox available, Unsure
• Who owns integrations internally (EHR vendor team, internal IS, third‑party integrator) and who will be our day-to-day technical contact?
• Tell us about any data governance or security constraints that would affect integration—data residency, PHI redaction, or 3rd‑party review timelines.

How Do You Keep Clinical Content Fresh — Is It Working or a Constant Struggle?

• Who currently owns clinical content for alerts (pharmacy, medication safety committee, clinical editors, other)? Options: Pharmacy, Medication safety committee, Clinical informatics/CMIO, External vendor, Shared governance
• What is your current content review and update cadence for high-risk rules (e.g., interaction lists, dose thresholds)? Options: Real-time / within 72 hours, Weekly, Monthly, Quarterly, Ad-hoc
• How long does it take, on average, to update or retire an alert once a change is requested? Options: <24 hours, 24–72 hours, 3–7 days, 1–4 weeks, >4 weeks
• Have there been times when outdated content contributed directly to harm or near-miss? Please describe briefly.
• How confident are your clinicians in the accuracy and timeliness of the current content library? Options: Very confident, Somewhat confident, Neutral, Somewhat distrustful, Do not trust

If We Tuned Alerts Perfectly, What Would Change for You?

• What concrete target(s) would define pilot success for you (override rate threshold, ADE reduction %, clinician time saved, acceptance criteria)? Options: Override rate target, ADE reduction target, Clinician time saved, Specific regulatory/quality improvement, Other
• What specific service line or unit would you prefer for a pilot, and why do you think it’s the best test bed? Options: ICU, General medicine, Surgery/OR, Emergency Department, Pediatrics/Neonatal, Other
• How many orders/alerts per day would need to be observed to feel confident the pilot results are meaningful? Options: <500, 500–2,000, 2,000–10,000, >10,000, Unsure—need guidance
• What acceptance evidence would leadership need to move from pilot to enterprise (metrics, case reviews, clinician testimonials, financial ROI)? Options: Quantitative metrics, Case-level clinical validation, Clinician satisfaction, Financial analysis/ROI, Regulatory / compliance sign-off
• If this pilot does not meet your targets, what would be the tolerable outcome or acceptable next step? Options: Extend tuning period, Narrow scope, Rollback to previous state, Reassess governance and content, Other

How Ready Are Your Teams to Move Fast — and What Could Stop Us?

• Who are the essential operational owners who must be engaged for real-time tuning during a pilot (names/roles)?
• What is your procurement and legal timeline for approving third‑party integrations and DSAs? Options: Already approved, 2–4 weeks, 1–2 months, 2–3 months, Longer / unknown
• Do you have budget guardrails or caps for pilot implementation and content maintenance we should respect? Options: Yes—fixed cap, Yes—range provided, Flexible within approval, Not yet defined
• What internal change fatigue or competing priorities might pull resources away during the pilot, and how have you handled similar conflicts before?
• If we needed quick clinical validators for rapid cycle tuning, who would be available and at what cadence (daily/weekly/as needed)? Options: Daily, Several times weekly, Weekly, Ad-hoc on request, Not available

Practical Next Steps — How Would You Like Us to Start?

• Which of these would be the most helpful immediate next step to keep momentum? Options: Technical discovery call, Clinical governance workshop, Data and logs export review, Pilot scoping session, All of the above
• What artifacts can you provide up front to accelerate discovery (sample alert logs, override datasets, a recent sentinel event report, EHR workflow screenshots)? Options: Alert logs, Override datasets, Sentinel report, EHR screenshots, None readily available
• Who should receive the initial discovery deliverable and what format do they prefer (presentation, executive summary, raw data files)? Options: Presentation, Executive summary, Raw data files, Dashboard access, Other
• Realistically, when could your team commit to a 60–90 minute kickoff to validate these answers and begin technical planning? Options: This week, Next week, In 2–4 weeks, Later / please follow up
• Is there anything we haven’t asked that you consider critical for us to understand about your current state?

Set the Scene: Who's Driving This?

• Which roles will be the active sponsors and decision-makers for this pilot? Options: Chief Pharmacy Officer (CPO), Chief Quality Officer (CQO), CMIO, Patient Safety Officer, VP of Nursing, Director of Pharmacy, Other
• Who is the single executive ultimately accountable for a go/no‑go decision at pilot close? Options: CPO, CQO, CMIO, Patient Safety Officer, Other — name/role
• What is the target timeline from integration kickoff to pilot launch? Options: 4–6 weeks, 6–8 weeks, 8–12 weeks, Custom/Other
• What level of budget or guardrails have you allocated for integration, tuning, and evaluation? Options: Pre-approved budget, Budget requires executive approval, Pilot funded by departmental discretionary, No budget yet — exploratory
• Briefly describe the one immediate pain or event that made you start this conversation now (sentinel event, regulatory pressure, quality metric, other).

If Our Integration Struggled, What Breaks First?

• If the EHR integration introduced even intermittent lag or mismapped alerts, which stakeholder’s trust would erode fastest? Options: Clinicians (physicians/nurses), Pharmacy leadership, Quality/safety team, Informatics/IT, Executive leadership, Other
• Which EHR vendor and version will we be integrating with for this pilot? Options: Epic (specify version in next field), Cerner/Oracle, Allscripts, Meditech, Other — please specify
• Do we already have API/integ credentials and test accounts for the EHR (ADM/INT environments)? If yes, who holds them? Options: Yes — credentials available, Credentials pending with IT, No — need to request, Unsure
• What latency threshold would you consider unacceptable for clinician workflow (e.g., response > X seconds)? Options: <100ms, <300ms, <500ms, <1s, Acceptable up to >1s/other
• Describe any recent EHR projects or integrations that succeeded or failed and why—what should we learn from them?

Are Your Test Environments Real Enough to Tell the Truth?

• Does your test (non‑prod) environment mirror production data models and workflows closely enough to validate clinician experience? Options: High parity — good for validation, Medium parity — some gaps, Low parity — not reliable, No test environment available
• How often is test data refreshed from production and who owns that refresh process? Options: Daily, Weekly, Monthly, Ad hoc / manual, Not refreshed
• Can we provision clinician test accounts in the environment that replicate typical order-entry workflows (including pharmacy roles)? Options: Yes — clinical test accounts available, Limited — some roles missing, No — cannot create test clinician accounts, Unsure
• Are protected health information (PHI) de-identified in the test environment, and is a data use protocol required? Options: PHI de-identified — OK to use, PHI present but covered by DUA, PHI present — restrictive policies, Unsure
• If we need to simulate high alert volume or a sentinel-event scenario in test, how easy is it to inject or replay cases? Options: Easy — replay tools available, Possible with lift from IT, Difficult — manual only, Not possible

If Data Stops, Does the Pilot Stop?

• Which clinical data feeds can we access for the pilot (select all that will be available)? Options: Medication orders (BCMA/Order Entry), Medication administration records (MAR), Allergies, Lab results, Problem list/diagnoses, CPOE context, Other
• What integration standards are supported on your side (HL7 v2, FHIR R4, custom APIs, other)? Options: FHIR R4/R3, HL7 v2, Custom REST API, Direct DB access, Other
• How frequently do feeds need to refresh to meet clinician expectations (near real‑time, every minute, batch hourly)? Options: Near real‑time (<1s), Seconds to 1 minute, 1–5 minutes, Hourly batch, Daily
• Who are the technical owners for each feed (names/emails) and how responsive have they been historically?
• Are there security controls, IP whitelists, or VPN requirements that will affect our ability to receive feeds quickly? Options: Yes — strict controls (detail required), Yes — standard controls (SAML/OAuth), No unusual requirements, Unsure

Who Decides What ‘Correct’ Looks Like Clinically?

• Who will own content governance and approvals for alert logic, severity, and suppression rules? Options: Pharmacy clinical editors, Medication safety committee, CMIO/clinical council, Informatics team, Joint committee, Other
• Which clinicians will participate in clinical validation sessions and how many per specialty/service line? Options: Physicians (name/est), Pharmacists (name/est), Nurses (name/est), Advanced practice providers (name/est), Other (name/est)
• What evidence will satisfy clinicians that an alert is actionable (e.g., literature reference, internal guideline, case example)? Options: External guideline citation, Internal protocol, Local case review, Aggregate analytics, Combination
• How fast do you expect content updates to be approved and published during pilot tuning? Options: 24–72 hours, 1 week, 2+ weeks, Depends on committee schedule
• If clinical validators disagree with an alert decision, what escalation path and timeline should we follow? Options: Immediate stop & review, Tuning within 24–72 hours, Committee review next meeting, Other — please describe

If Clinicians Push Back, Do You Have a Safe Exit?

• Do you have an approved rollback plan that can remove or suppress our module without degrading EHR performance or data integrity? Options: Yes — documented rollback, Planned but not documented, No rollback plan, Unsure
• What operational steps and owner assignments are required for an emergency rollback (who phones whom, within what timeframe)?
• Are there legal, compliance, or regulator notifications that must occur if we change live CDS behavior during the pilot? Options: Yes — requires notifications, No formal notifications, Depends on change severity, Unsure
• How will clinician feedback be captured in real time during rollout (in‑EHR feedback, hotline, daily huddles)? Options: In‑EHR feedback tool, Daily/weekly huddles, Designated email/hotline, Direct to clinical champion, Other
• What monitoring and alerting will you want from us to detect adverse workflow impact immediately? Options: Latency dashboards, Override spikes, Helpdesk tickets, Clinician sentiment surveys, Other

What Would Make This Pilot a Clear Win—or a Stop?

• Which pilot success metrics matter most to you (rank up to three in the next field)? Options: Override rate reduction, ADE reduction, Alert latency, Clinician time per order, Content update speed, Adoption rate / acknowledged alerts
• What absolute thresholds would prompt you to pause or cancel the pilot (e.g., override rate > X%, latency > Y seconds)?
• Who must sign the pilot acceptance (names/roles) and what evidence package do they require at handoff? Options: CPO, CQO, CMIO, Patient Safety Officer, Other — specify
• How frequently do you want interim readouts during tuning (daily, weekly, fortnightly) and which stakeholders should receive them? Options: Daily, Twice weekly, Weekly, Biweekly, Monthly
• If early signals look positive but not definitive, what minimum extension or scale would you approve to reach confidence? Options: Extend tuning by 4 weeks, Expand to additional unit, Increase clinician validators, Do not extend — require decision

Practical Commitments: Who Does What, When?

• Please list the technical and clinical owners (name, role, email) who will be available for daily standups during integration and tuning.
• Which days/times are best for technical cutovers or validation sessions to minimize clinician disruption? Options: Weekday daytime, Weekday evenings, Weekend low-traffic, Specific windows — provide details
• Are there scheduled organizational events (governance meetings, accreditation deadlines, EHR upgrades) during the pilot period we should avoid? Options: Yes — list dates, No known conflicts, Unsure — will confirm
• What internal reporting format do you prefer at pilot close (slide deck, analytics workbook, executive 1‑pager)? Options: Slide deck + appendix, Interactive dashboard access, Analytics workbook (CSV), Executive 1‑pager, Combination
• What are the next three actions you can commit to now to get us to a validated test environment and named clinical validators?

Quick Check-In: Who's in the Room?

• Who from your team will be directly involved in running and signing the validation tests (select all that apply)? Options: Chief Pharmacy Officer, VP/Director Quality, CMIO/Clinical Informatics Lead, Patient Safety Officer, Pharmacy Informatics Pharmacist, Nursing Lead, IT/Integration Lead, Data/Analytics Lead, Clinical Review Board Member, Other
• Which service line(s) is the pilot focusing on? Options: Adult inpatient medicine, ICU, Emergency Department, Surgery/OR, Oncology, Pediatrics, Other
• What is your target go-live window for starting the validation tests? Options: ASAP (within 2 weeks), 2–4 weeks, 1–2 months, 2–3 months, Unsure
• Which single metric would you consider most important for passing validation? Options: Override rate reduction, Latency (end-to-end), Alert suppression accuracy, Clinician time impact, ADE/near-miss reduction, Analytics correctness
• In one sentence, what is the single biggest worry you have about running acceptance tests in your EHR environment?

If 'Accepted' Means 'We're Safe' — Are We Sure?

• If the system meets the numeric thresholds but clinicians continue to ignore high-severity alerts, would you call the pilot successful? Options: Yes, No, Depends — please explain
• What specific acceptance thresholds do you require for the following: override rate, latency, and suppression accuracy? (Please list thresholds and current baselines if available)
• What minimum observation window (continuous days or weeks) do you require before signing off on results? Options: 2 weeks, 1 month, One quarter, Depends on service line
• What statistical or sample-size criteria do you expect (e.g., minimum encounters, confidence interval) to feel the results are reliable? Options: Predefined minimum encounters, Statistical significance (e.g., p<0.05), Operational threshold approach, Unsure — need help defining
• Who has final veto authority even if acceptance metrics are technically met? (roles or names) Options: Chief Pharmacy Officer, VP Quality, CMIO, Patient Safety Officer, Steering Committee, Other

Data Truths: Can We Trust What We'll Measure?

• If your analytics feed missed 10% of events during the pilot, would you still consider the validation meaningful? Options: Yes, No, Maybe — depends which events, Unsure
• Which data sources will we rely on for each metric (select all that apply)? Options: EHR audit logs, Clinical Data Warehouse (CDW), Middleware/Interface engine logs, Pharmacy dispensing logs, Manual chart review / RCA, Other
• What is the expected update frequency and lag for each feed (real-time, minute-level, hourly, daily)? Options: Real-time (<5s), Near-real-time (5s–1min), Minute-level (1–5min), Hourly, Daily, Unsure
• Are there known mapping, normalization, or data-quality gaps we should plan to reconcile before tests start?
• Who owns the ground-truth for adverse events, override reasons, and denominators for rates? Options: Pharmacy, Quality/Patient Safety, Clinical Review Board, Shared governance, Other
• Would you permit a blinded manual chart-review sample to validate automated analytics if discrepancies appear? Options: Yes, No, Maybe — conditionally

Clinician Experience Under the Microscope

• If dashboards look good but clinicians report increased cognitive burden, would that be acceptable? Options: Yes, No, Depends on magnitude, Unsure
• How should we measure clinician time impact (choose all methods you're open to)? Options: EHR timestamps/logs, Time-motion observation, Short post-use surveys, Self-reported activity logs, Other
• Which clinician cohorts should we prioritize for observation and feedback during validation? Options: Attending physicians, Residents/trainees, Pharmacists, Nurses, Advanced practice providers, Other
• Do you have baseline measures for order-entry time, override rates, or reason codes we can compare against? Options: Yes — full baselines available, Partial baselines available, No baselines available
• Are clinicians permitted to opt out or bypass the pilot workflow, and if so, how will those exceptions be tracked and reported? Options: Opt-out allowed and tracked, Opt-out allowed but not tracked, No opt-out allowed, Unsure
• Would you be willing to support short qualitative interviews or focus groups after initial runs to capture emotional responses and trust levels? Options: Yes, Maybe, No

Technical Performance: What's Invisible but Critical?

• Would you accept a slight increase in end-to-end latency if it materially reduces low-value alerts? Options: Yes, No, Maybe — please define acceptable threshold
• What maximum end-to-end latency (ms) would be a deal-breaker for clinician workflow? Options: <50 ms, <100 ms, <250 ms, <500 ms, >500 ms
• What peak concurrent transaction volume should validation design target (pick closest)? Options: Baseline, 2x baseline, 5x baseline, Unsure — need data
• Which metric best represents alert suppression accuracy for your team (choose one)? Options: Precision/recall, False positives per 1000 orders, Classifier accuracy, Other
• Which environment(s) should we run tests in (select all that apply)? Options: Sandbox, Full test environment, Production mirror (read-only), Limited production traffic
• Who will triage integration or logging errors during test runs (customer IT, vendor, or joint response)? Options: Customer IT on-call, Vendor on-call, Shared rotation, Other

Analytics and Acceptance: Who Signs Off and When?

• If results vary across service lines, who decides whether the overall pilot is accepted or requires rework? Options: Chief Pharmacy Officer, VP/Director Quality, CMIO, Joint steering committee, Other
• How would you like to weight acceptance criteria across metrics (for example: override reduction 40%, latency 30%, clinician impact 30%)? Options: We have a predefined weighting, We want the vendor to propose weighting, Equal weighting across selected metrics, Unsure — need facilitation
• Do you require independent verification of analytics (third-party audit or internal peer review)? Options: Yes — third party, Yes — internal independent team, No, Maybe — for critical metrics only
• What is your preferred cadence for interim validation reviews and who should attend each update? Options: Daily operational stand-up, Weekly review, Biweekly steering update, Only at end of test window
• Who will sign the final acceptance document and what artifacts do you expect attached (final report, logs, RCA, clinician feedback)?

Safety Nets and Rollback: What If Things Go Wrong?

• If a suppression error is implicated in an adverse event during the pilot, should testing stop immediately? Options: Yes — immediate stop, No — investigate before deciding, Depends on severity
• Which real-time triggers should automatically halt or rollback the deployment (select all that apply)? Options: Spike in overall overrides, Latency above threshold, Increase in reported ADEs, System errors/exceptions, Clinician safety reports
• How quickly must a rollback be executable (choose one)? Options: <5 minutes, <30 minutes, <2 hours, <24 hours
• Who is authorized to approve a rollback during business hours and after hours? (roles or names)
• What notification and escalation path should be used to inform clinicians, leadership, and regulators if an incident occurs?
• Do you have an existing incident review and RCA cadence and who leads it? Options: Yes — patient safety leads, Yes — pharmacy leads, Yes — shared committee, No, Unsure

Pilot to Scale: What Counts as Learning vs. Failure?

• If tuning reduces total alerts but also lowers detection of rare severe events, would you consider that a successful trade-off? Options: Yes, No, Depends on net patient harm
• What minimum evidence (quantitative and qualitative) would justify moving from pilot to wider rollout?
• Which operational prerequisites must be in place before scaling (select all that apply)? Options: Governance owner assigned, Dedicated tuning resources, Training/enablement plan, Stable data pipelines, Budget committed, Other
• How long should the post-deployment tuning window be before committing to scale? Options: 4 weeks, 8–12 weeks, One quarter, Unsure
• How would you like us to capture lessons learned and prioritize a shared backlog (tooling, meetings, owners)? Options: Shared backlog tool (preferred), Weekly joint tuning meeting, Monthly steering updates, Other

Ready to Run the Tests?

• If an item on this checklist is incomplete at handoff, would you allow testing to proceed under a risk-mitigated plan? Options: Yes — with documented mitigations, No — must be complete, Maybe — discuss case-by-case
• Please confirm we have the following accesses and artifacts (select all that we already have): Options: Test EHR credentials, Event/log exports, Data extracts to analytics, Clinician participants roster, Sandbox/integration accounts, Rollback scripts/procedures
• Who will own scheduling the acceptance test runs and who must be present for each run (roles/names)?
• Please provide target dates for: test start, interim review, test end, and final report delivery.
• Is there anything else you want us to measure, observe, or include in the acceptance report that we haven't covered?