Start here: How clinicians on the pilot unit actually spend their time

• Tell me about the clinical unit you want to pilot on, including typical patient mix and shift patterns.
• How many clinicians on that unit document in the EHR per shift? Options: 1-5, 6-15, 16-30, 31-50, 50+
• Walk me through a typical patient encounter from admission to discharge, focusing on where clinicians spend the most documentation time.
• Select your primary EHR deployment profile for orders, notes, and charge capture. Options: Vendor-managed cloud release, On-premise standard release, On-premise highly customized, EHR built in-house, Unsure
• Who currently owns decisions about order sets, discharge templates, and charge reconciliation in your organization?
• In a typical month, how many encounters does that unit record? Options: <500, 500-1,499, 1,500-4,999, 5,000-14,999, 15,000+

Where the friction actually lives and what it costs you

• When you add automation, safety or billing risk is often the real obstacle rather than clinician resistance, what single documentation failure here would make you pause a pilot immediately?
• Describe the specific documentation tasks clinicians say they dread or routinely skip because they are low value and time consuming.
• How often do order sets or templates diverge between shifts or providers, causing measurable variability in care? Options: Daily, Weekly, Monthly, Quarterly, Rarely
• What downstream consequences have you measured or observed when a required billable item is missed, in terms of revenue, denials, or rework?
• If a pilot recovered 3 percent of missed charges and saved an average of 12 minutes per encounter here, what would stop your leadership from approving a broader rollout that quarter?

Where clinicians quietly opt out and why adoption stalls

• Many tools add more clicks rather than remove them, which clinician workflow here do you suspect will be most resistant to change and why?
• Who are the clinician champions and skeptics you expect to influence adoption on day one? Options: Attending physicians, Resident physicians, Nurse managers, Clinical pharmacists, Advanced practice providers, Other
• Tell me about the last time a workflow automation was rolled back on a unit, what exactly failed and who owned the decision to revert?
• Which training formats have historically driven the fastest uptake for clinical changes here, e-learning, in-person practice, embedded prompts, or peer coaching? Options: E-learning, In-person simulation sessions, Embedded EHR prompts, Peer-to-peer coaching, Blended approach, Other
• If clinician uptake in the pilot unit falls below your target, what exact threshold would make you call the pilot unsuccessful?

Safety and billing, the twin tests the team will apply

• You mentioned fear of automation introducing errors, where would an automation-induced safety error have the biggest clinical consequence on this unit?
• How do you currently detect mismatches between documented care and billed items, and who reviews those exceptions?
• List the clinical scenarios or procedures that carry the most complex billing rules and routinely worry your coding or compliance teams.
• When an error is found in documentation or billing, how long does it usually take to reconcile and who signs off on the correction?
• Is there any regulatory or compliance constraint that would prevent automated suggestions from being used for billing or clinical decisions on this unit? Options: Yes - privacy or data handling, Yes - billing or coding rules, Yes - local medical staff rules, No known constraints, Unsure

Barriers that will stop this from moving forward

• Run me through the one technical dependency that, if missing, would force you to pause integration work entirely.
• List the data feeds or interfaces you believe the pilot depends on, for example order, charge, or results feeds. Options: FHIR read-only, FHIR read-write, HL7 v2 inbound/outbound, Queued batch files, Direct database access, Unsure
• Name the IT owners who will be accountable for test and production endpoints and confirm whether they can commit time to the schedule.
• Estimate how long it would take to enable a test endpoint from request to active, in calendar days. Options: <7 days, 7-14 days, 15-30 days, 31-60 days, >60 days
• Would you stop the pilot if your security review requires custom data handling the seller cannot provide, or would you prefer an alternative, shallower scope? Options: Stop the pilot, Modify scope to remove sensitive data, Proceed with compensating controls, Unsure

Other paths you are weighing, including build versus buy

• What would have to be true about your current approach for you to decide to stay with it instead of switching to a new platform? Options: Meets performance targets, Lower total cost, Simpler governance, No integration risk, Clinician preference
• Has anyone internally proposed building a similar automation in-house rather than contracting an external partner? Options: Yes, active proposal, Yes, informal idea only, No one has proposed it, Unsure
• Name the vendors or solution categories you have evaluated or plan to evaluate, including incumbents, point solutions, and EHR-native tools.
• Identify the one metric that would make you keep the incumbent instead of switching to a new platform.
• How much would a one-time implementation cost or resource investment have to be for you to prefer buying rather than building? Options: <$50k, $50k-$150k, $150k-$500k, $500k-$1M, >$1M, Unsure
• Are procurement or contracting terms from prior vendors blocking faster decision cycles, for example indemnity, uptime commitments, or data residency requirements? Options: Yes - indemnity/insurance, Yes - uptime or SLA terms, Yes - data residency or handling, No, Unsure

Can we actually deploy this where you need it

• Most pilots fail for simple readiness gaps, what is the one internal approval or resource you do not yet have that will stop the timeline?
• Provide the name, role, and availability of the deployment owner from your side, and whether they are dedicated to this project.
• Detail the available test accounts, service accounts, or API credentials and who controls them. Options: Test patients available and fully provisioned, Limited test accounts only, No test environment available, Unsure
• Rate the cleanliness of your order-set and template library from 1 to 5, where 1 is fragmented and 5 is standardized and annotated. Options: 1, 2, 3, 4, 5
• Is there a hard freeze window for EHR upgrades or blackout dates in the next 6 months that would prevent pilot activities? Options: Yes - scheduled upgrades, Yes - expected maintenance windows, No known freeze, Unsure
• Select the internal teams that must sign off before pilot start. Options: Clinical informatics, Nursing leadership, Revenue cycle or coding, IT integration, Security and compliance, Procurement, Legal, Other

If the pilot proves the numbers, what happens next

• Suppose the pilot delivers your target savings and recovered charges, what exactly needs to align for you to sign a systemwide agreement within 30 days?
• Identify the approvers for commercial terms and the person who controls the capital or operational budget for this purchase. Options: CMIO or Medical Director, CNO, VP Clinical Operations, CFO, IT Director, Procurement, Other
• Provide the measurable acceptance criteria you will require before we begin measuring pilot success, for example minutes saved per encounter, percentage variability reduction, and recovered charges. Options: Minutes saved per encounter, Documentation time reduction percent, Clinician satisfaction score, Recovered charges percent, Order set adherence percent, Other
• Specify the preferred calendar days after pilot end by which you want a go or no-go decision scheduled on your calendar. Options: 7 days, 14 days, 30 days, 45 days, 60 days
• Assuming pilot success, would you prefer phased milestone invoices or a single go-live invoice, and which payment terms does your finance team typically require? Options: Phased milestone invoices, Single invoice at go-live, Subscription with monthly billing, Other
• Select your preferred pilot duration. Options: 4 weeks, 8 weeks, 12 weeks, One quarter, Other

• Solution Experience Session

• Confirm the current state and its cost
• Provide three representative patient scenarios and corresponding EHR screenshots from the proposed pilot unit.
• You confirm the demonstrated workflows eliminate the manual rework and variability you described.
• You confirm the automation preserves patient safety and billing accuracy in the shown scenarios.
• Walk through a clinician scenario: order-set standardization
• Provide the current order-set definitions and a charge capture exception report for the proposed pilot unit.
• You agree on specific pilot success metrics, the pilot unit, and the measurement period required for a go/no-go decision.
• Walk through a clinician scenario: automated charge capture
• Configure a tailored demo using the provided scenarios and deliver an annotated runbook of expected system behaviors before the pilot.
• Safety and integration assurance
• Draft pilot acceptance criteria with numeric targets for time saved per encounter, variability reduction, and recovered charges.
• You identify any remaining evidence you require before progressing to pilot commitment.
• Validation checkpoint
• Schedule the technical feasibility call to confirm EHR-version compatibility, test endpoints, and integration dependencies.

• Solution Experience Session
• Solution Experience Deck
• Solution Brief

• meeting
• slides
• document

• Configure Automated Order Sets
• Deploy Smart Discharge Summaries
• Implement Nurse Handoff Automation
• Activate Charge Capture Auto-Suggestions
• Automate Care Plan Assignments
• Configure Clinical Alert Rules
• Integrate Workflows with EHR Interfaces
• Map EHR Data Fields and Mappings
• Implement Event-Driven EHR Triggers
• Deploy Unit-Specific Workflow Templates
• Deliver Clinician Training on Workflows
• Maintain Integration Through EHR Upgrades

Configure Automated Order Sets

• Specify the clinical unit(s) and exact order set name(s) you want automated (for example: 'Sepsis protocol - adult ICU' or 'Joint replacement perioperative').
• List the encounter types that must trigger automated order sets (select any that apply). Options: Inpatient acute care, Emergency department, Observation status, Ambulatory/outpatient clinic, Perioperative/procedure
• Identify the inclusion and exclusion clinical criteria for each order set (for example: age limits, active allergies, pregnancy status, anticoagulation).
• State the measurable acceptance criteria for the order set pilot (for example: average order entry time reduced by >=X minutes, order variance reduced to <=Y% across the pilot unit).

Deploy Smart Discharge Summaries

• Specify which discharge summary template(s) and note types will be replaced or augmented (for example: 'General Medicine discharge summary - inpatient adult').
• Name the structured fields that must be auto-populated on the discharge summary (for example: discharge medications with MAR reconciliation, final diagnosis ICD-10 codes, follow-up appointment entries).
• Indicate which downstream systems must receive the generated discharge document and the required transport/format (for example: HIE via HL7 CDA, patient portal PDF, billing queue via FHIR DocumentReference).
• Describe the acceptance criteria you will use to validate discharge summary automation in pilot (for example: average clinician time per summary reduced by >=X minutes, documentation completeness score >=Y%).

Implement Nurse Handoff Automation

• State the handoff format used on the pilot unit(s) that must be automated (for example: SBAR, I-PASS, or a named local shift-change template).
• List the discrete data elements to include in auto-populated handoffs (for example: recent vitals trend, active problems with ICD-10 codes, outstanding tasks with due dates, isolation status).
• Describe any required integration with the Medication Administration Record (MAR) or pending medication orders that must surface in the handoff summary.
• Confirm the evidence you will accept for nurse handoff readiness (for example: handoff completeness checklist pass rate >=90% on spot audits).

Activate Charge Capture Auto-Suggestions

• List the chargeable item categories to include in auto-suggestions and, where available, provide Charge Description Master (CDM) codes or local charge IDs (for example: implants, operative procedures, advance imaging contrast).
• Estimate your baseline missed-charge rate from revenue cycle analysis and select the recovery target you expect for the pilot. Options: Undetermined / need analysis, Recover 1-2% of missed charges, Recover 3-5% of missed charges, Recover >5% of missed charges
• Name the EHR documentation triggers that should map to charge suggestions (for example: completed operative note with CPT code, device implant entry, signed procedure consent).
• How would you like charge suggestions presented to clinicians (for example: inline suggestion in the charge capture screen, a charge checklist at discharge, or a confirmation modal)? Options: Inline suggestion, Charge checklist, Confirmation modal, Dashboard for coder review, Other

Automate Care Plan Assignments

• State the care plan templates or named problem-list entries to be auto-assigned (for example: 'Post-op pulmonary toilet', 'Diabetes inpatient management plan').
• Indicate which clinical events should create or update care plans (for example: new diagnosis coded with ICD-10, admission to specific service, lab result crossing a threshold).
• Name the multidisciplinary recipients for care plan tasks and preferred notification channels (for example: PT via task list, case management via secure inbox).
• Detail any regulatory or quality-measure elements that must be captured in care plans (for example: CMS measure IDs, required screening fields).

Configure Clinical Alert Rules

• Indicate the clinical alert types to configure or suppress and the intended severity grading (for example: critical lab alerts, duplicate therapy, allergy conflict).
• State the numeric thresholds or rule logic that should generate an alert (for example: potassium <2.8 mmol/L, INR >5, or hemoglobin fall >2 g/dL within 24 hours).
• Describe the routing and escalation paths for each alert type and the expected response SLA (for example: primary nurse within 15 minutes, on-call physician within 60 minutes).
• Indicate target monitoring metrics for alert performance you want captured during pilot (for example: false positive rate target, alert acknowledgement time, alert fatigue dashboard cadence).

Integrate Workflows with EHR Interfaces

• Provide test and production endpoint information and expected message formats for integrations you will allow during pilot (for example: HL7 v2 ADT, FHIR R4 resources, SFTP for batch exports).
• Name the interface engine or middleware that will mediate messages and indicate whether you can share an Interface Control Document (ICD). Options: Yes, ICD available, No, ICD not available, We will provide credentials for a sandbox
• Identify supported authentication methods for your EHR endpoints and confirm whether API credentials or certificates are provisioned for pilot (for example: OAuth2 client credentials, mutual TLS). Options: OAuth2, Mutual TLS, API key, Basic auth, Other
• Report the throughput and latency constraints we should design to (for example: ADT events within 5 seconds, bulk sync window nightly between 02:00-04:00).

Map EHR Data Fields and Mappings

• Map the specific EHR data objects to be used (for example: MedicationRequest.medicationCodeableConcept, Procedure.code, Condition.code) and include any local field names.
• Define the code systems authoritative at your site for diagnoses, labs, and procedures (for example: ICD-10-CM, SNOMED CT, LOINC, CPT). Options: ICD-10-CM, SNOMED CT, LOINC, CPT, Other
• Clarify acceptable mapping tolerance and fallback logic for unmapped values during pilot (for example: unmapped codes <=2% with manual review workflow).
• Enumerate the sample data extracts or test records you will provide for mapping validation, including expected column set and date ranges.

Implement Event-Driven EHR Triggers

• Report the exact event types that should act as triggers (for example: ADT A01 admit, ADT A03 discharge, lab result final, medication administration event) and any event codes you use locally.
• Quantify the trigger-to-action latency expectations for each event class (for example: stat lab triggers <10 seconds, admit notifications <30 seconds).
• Verify the idempotency and duplicate-suppression approach you require for event processing (for example: dedupe on message control ID or encounter ID with 5-minute window).
• Capture the test scenarios and sample event messages you will supply to validate trigger handling during pilot.

Deploy Unit-Specific Workflow Templates

• State the pilot unit name(s) and service line(s) with estimated daily encounter volume (for example: '3 West - Adult Medicine, ~40 encounters/day').
• Outline the local workflow steps or standard operating procedures the template must reflect (for example: bedside rounding sequence, order reconciliation steps).
• Select which elements must be unit-customized versus inherited from system defaults (for example: nursing task order, order-set preferred defaults). Options: Fully customized for unit, Partially customized (mix of defaults and unit overrides), Use system defaults
• Assign the local clinician champions and validation owners for each pilot unit (role and contact responsibility).

Deliver Clinician Training on Workflows

• Choose the training delivery format you prefer for pilot clinicians (for example: live EHR sandbox walkthroughs, short recorded modules, or in-person sessions). Options: Live sandbox walkthrough, Recorded video modules, In-person classroom, Hybrid
• Estimate target training time and cadence per clinician role (for example: 30-minute session for attending physicians, 15-minute for bedside nurses).
• Document the readiness metrics you will track during training (for example: completion rate target, competency quiz score threshold).
• Share who will own scheduling and collection of training completion records (role/title responsible for attendance and competency tracking).

Maintain Integration Through EHR Upgrades

• Provide your EHR sandbox and production version numbers and any planned upgrade windows in the next 12 months that should be considered for compatibility testing.
• Establish your expected rollback and contingency approach if an EHR upgrade causes automation to fail (for example: automatic disable, fall back to manual workflow, or emergency patch window).
• Agree whether ongoing compatibility testing and upgrade verification are in scope for this engagement or should be treated as a separate support activity. Options: Included in fixed-fee scope, Excluded and billed separately, Require discussion
• List any items explicitly out of scope for this configuration and pilot engagement (for example: full EHR upgrade validation, long-term post-pilot support, custom connector development beyond standard APIs).

• Master Services Agreement (MSA)
• Order Form / Subscription Agreement
• Statement of Work (SOW)
• Service Level Agreement (SLA)
• EHR Compatibility & Integration Addendum
• Pilot Acceptance & Go/No-Go Criteria
• Data Processing Addendum (BAA)
• Change Order Agreement
• Termination & Data Portability Addendum

• Go-live Health Check (weeks 1-4)
• First Measurement Review (weeks 4-10)
• Acceptance Gate — Pilot Outcome Decision (around day 90)
• Quarterly Performance Review (recurring)
• Clinician Feedback and Enhancement Planning (recurring)

• Deliver a prioritized enhancement plan with estimated effort, expected metric impact, and proposed rollout windows.
• Confirm incumbent decommissioning or retention status to avoid dual-system workarounds where applicable.
• Publish the formal acceptance record showing pass/fail per criterion and the documented signatory or buying-owner decision.
• Create a remediation backlog item for each failed or conditional criterion with required evidence and completion deadlines.
• If incumbent is being retired, produce the decommission checklist showing contract/renewal handling, data archive completion, and training to close fallback habits.
• Trend review of primary metrics
• Confirm whether primary metrics are sustained or improving relative to targets recorded in Solution Scope.
• Reduce the open critical incident count and assign timelines to remaining items.
• Prioritize the enhancement backlog items that will most improve time saved and charge recovery in the next quarter.
• Reconfirm success criteria and owners
• Update the incident tracker with resolution dates and validation steps for remaining critical defects.
• Produce a quarterly operational health snapshot showing integration uptime and any EHR-version compatibility items to watch.
• Clinician satisfaction and qualitative feedback
• Verify that clinician satisfaction trends are stable or improving and that top usability issues are captured for remediation.
• Reduce documentation variability by selecting 1-2 high-impact enhancements to implement and test in the next rollout window.
• Agree whether a targeted training refresh is required and a schedule for that work.
• Create tickets for prioritized clinician-facing enhancements with acceptance criteria tied to clinician satisfaction or order-set adherence improvements.
• Prepare a short training refresh and a one-page communication summarizing recent changes and expected clinician benefits.
• Collect and distribute a representative sample of before-and-after workflow sessions that illustrate the impact of recently implemented enhancements.
• Confirm production integration endpoints and core data feeds are live and validated against test plans.
• Identify and assign remediation for any critical blockers that would prevent measurement in the first measurement window.
• Ensure all success criteria and metric owners recorded in Solution Scope remain accurate and current.
• Publish a remediation log with issue descriptions, temporary workarounds, target resolution dates, and accountable owners.
• Validate and document production API credentials and integration endpoint connectivity with test records.
• Circulate an early-adoption snapshot showing active users, automated suggestions accepted, and any clinician-reported safety concerns.
• Present first measurement dataset
• Reach a clear determination whether primary KPIs (average time saved per encounter and order-set adherence rate) are on track or require remediation.
• Document a prioritized list of corrective actions with target dates that will move metrics toward targets recorded in Solution Scope.
• Confirm the dataset and acceptance evidence required for the Acceptance Gate meeting.
• Deliver the measurement dashboard extract and raw data files used for the review to the shared workspace.
• Implement the agreed configuration or training fixes and report completion dates and validation checks.
• Schedule the Acceptance Gate meeting and circulate the acceptance evidence checklist referencing Solution Scope targets.
• Restate acceptance criteria from Solution Scope
• Produce a documented acceptance decision that states pass/fail per acceptance criterion recorded in Solution Scope.
• For any conditional or failed criteria, capture a remediation plan with measurable closure criteria and target dates.
• Deployment and integration validation
• Root-cause analysis for gaps
• Documentation variability and order-set adherence
• Present outcome data against each criterion
• Incident and defect burn-down
• Document pass/fail decision and acceptance record
• Enhancement backlog triage
• Agree configuration or workflow fixes
• Enhancement request backlog review
• Early adoption signals and usage patterns
• Agree remediation plan for conditional items
• Open issues and incident triage
• Training refresh and communication plan
• Confirm timeline to acceptance gate
• Operational health and integration uptime
• Agree immediate remediation actions
• Agree next quarter actions and success checkpoints
• Incumbent system wind-down status