Start here: the outcomes your executives will judge

• To start, which three measurable outcomes must this program deliver within 12 months to satisfy your executive sponsors? Options: Reduced clinician documentation time, Fewer medication or safety events, Shorter inpatient length of stay, Faster patient throughput and throughput variability, Improved interoperability with external partners, Accelerated revenue capture / fewer billing delays, Other
• Tell me about a recent technology project where executive expectations were missed, what specifically failed, and who was held accountable
• Walk me through how budget and clinical acceptance get approved today, who must sign for commercial commitment and who signs clinical go-live Options: CIO or delegated IT authority, CMIO or clinical steering committee, Chief Nursing Officer or nursing governance, VP Finance or CFO, Board or CEO approval required, Other
• How many facilities, service lines, or EHR tenants must be addressed in your initial consolidation or first-phase deployment Options: Single facility, 2 to 5, 6 to 20, 21 to 50, More than 50

Where routine clinical workflows leak time, money, or safety

• When was the last time a workflow breakdown produced a measurable operational or patient safety impact, and what broke first
• Who on your team reports the highest daily rework from documentation or orders, and what change would relieve them most quickly Options: Attending physicians, Residents or trainees, Advanced practice providers, Registered nurses, Pharmacy or medication management, Scheduling and registration staff, Other
• If you had to name the single workflow gap creating the most downstream cost, what is it and why
• Name the monthly costs you can tie directly to those workflow failures, for example overtime, delayed billing, or preventable readmissions Options: Overtime and agency spend, Delayed or lost revenue from billing lag, Regulatory fines or penalties, Increased length of stay, Patient complaints and reputational cost, Other
• Give an example of a workflow failure that would make you stop evaluating a vendor immediately

Who must buy in and who can veto

• Estimate how many clinical and operational leaders must explicitly sign off before you can execute a multi-year agreement Options: 1 to 2, 3 to 5, 6 to 10, More than 10
• Where does the strongest resistance live today, by specialty, department, or role, and what is the root cause Options: Physician groups, Nursing leadership and bedside staff, Pharmacy informatics, Allied health and therapy services, IT operations and integrations, Finance and revenue cycle
• Identify the person or committee whose veto would stop the project and describe their primary concern
• Assuming that person or committee does not support the change, what contingency would keep the program moving Options: Phased rollouts with pilot sites, Contractual performance milestones, Executive escalation and steering committee intervention, Accept limited scope initially, Not feasible to continue without support

If data migration stalls, the whole program stalls

• If a single data source were unreadable or unavailable during cutover, which source would break your go-live and why Options: Inpatient clinical documentation, Outpatient clinic notes, Medication administration records, Lab and results history, Scheduling and registration, Radiology/imaging reports, Other
• List the owners for each major data extract and whether they can provide a representative test extract within 30 days Options: Owner identified and test extract available, Owner identified but needs time, No owner identified, Some extracts under legal or regulatory hold, Unsure
• Do you have a complete inventory of interfaces and whether each is API enabled, HL7/FHIR, or file based Options: Complete inventory with interface type noted, Partial inventory, No formal inventory, Unsure
• Are any parts of the record subject to legal holds, research restrictions, or privacy orders that could block migration Options: Yes, multiple holds, Yes, a subset of records, No known holds, Unsure
• Describe the single data quality threshold, for example percent of structured medication history or duplicate patient rate, below which you would not proceed

Practical readiness and internal capacity

• Has anyone on your team published a realistic internal FTE and calendar commitment for implementation over the next 12 months Options: Yes, detailed plan exists, High level estimate only, No plan published, Unsure
• In your current IT organization, who will be the day to day integration owner and do they have capacity to run this alongside other projects Options: Dedicated owner with capacity, Owner assigned but limited capacity, No owner assigned yet, Third party integrator will lead
• Describe the test and integration environments you can provide and whether they contain representative, deidentified production data
• Rank the following technical risks by impact on your timeline, 1 highest: interface readiness, security approvals, network capacity, test data availability Options: Interface readiness, Security approvals, Network capacity, Test data availability

What other paths are on the table

• Which alternative would make you stay with your current approach instead of selecting a new platform, and what would have to be true about it Options: Current incumbent meets performance targets, A competitor offers lower total cost, An internal build solves the gap, Phased in-place upgrades suffice, No compelling alternative
• Has anyone proposed solving this through an internal build or extension rather than a vendor relationship Options: Yes, internal build proposed, Yes, hybrid internal plus vendor, No internal build proposed, Unsure
• Do you currently have an incumbent vendor or multi-vendor arrangement covering overlapping services under contract Options: Single incumbent EHR vendor, Multiple vendors cover scope, No incumbent for this scope, Unsure
• List the commercial or technical outcomes that would need to be demonstrably better for you to pick a competing vendor instead of proceeding with us
• Given the tradeoff where staying with the incumbent reduces migration risk but switching promises performance gains, which tradeoff would your executive team accept Options: Accept some performance loss to avoid migration risk, Accept migration risk to gain performance, Require pilot proof before deciding

Regulatory, legal, and approvals that can stop timelines

• Tell me the timeline constraints regulatory reviews or privacy boards place on procurement approvals or go-live windows Options: Regulatory review required before contract, Privacy board approval needed before data migration, No major regulatory gating expected, Unsure
• Where do you expect procurement, legal, or compliance reviews to add the most delay, for example terms, privacy, or risk allocation Options: Commercial terms and pricing, Data protection and privacy, Liability and indemnity, Service levels and warranties, Other
• Which contract contingencies would you require to accept phased delivery or running pilots before full roll out Options: Milestone-based payments and acceptance, Pilot-based commercial escape clauses, Limited warranty during pilot, Performance guarantees for phased scope, Other
• Who is enabled today to approve exceptions to your security or hosting standards that could otherwise block critical integrations Options: CISO or security council, CIO, Legal or privacy officer, Executive steering committee, No one currently enabled
• If our standard contract cannot meet one mandatory legal term, would you stop the procurement or pursue internal approval for an exception Options: Stop the procurement, Pursue exception approval, Depends on the specific term, Unsure

A tight decision test, who and what accelerates signature

• If the pilot proves the promised clinical time savings and data fidelity, which path gets you to an enterprise agreement fastest Options: Executive memo and approval, Clinical sign-off then procurement, Immediate commercial close with phased sites, Extended pilot then broader roll
• How would you prefer evidence presented to your board or steering committee to enable a rapid yes or no decision Options: Quantified time and cost savings, Live testimony from pilot clinicians, Technical acceptance reports and test data, Regulatory and privacy sign-off, Other
• Who would need to sit in a single decision meeting to authorize moving forward without further delay Options: CEO or COO plus CIO, CIO, CMIO, and CNO, CIO, CMIO, CNO, and VP Finance, Procurement and legal only, Other
• When do you need a commercial proposal and technical delivery plan on the table to meet internal fiscal or program deadlines Options: Within 2 weeks, Within 1 month, Within 2 months, More than 2 months
• Name the single unresolved risk, if answered positively, that would let you sign this week

• Solution Experience Session

• Confirm the current state and its cost
• You confirm that the demonstrated workflow removes the duplicate documentation and clinician rework described in Discovery.
• Provide three representative patient scenarios and the primary clinical order sets to be used in hands-on testing.
• Walk through representative inpatient documentation workflow
• You confirm that the sample migration and integration proof provide the traceability and acceptance evidence you will require.
• Provide a sample extract of legacy records for the three scenarios, including identifiers and one known reconciliation issue for validation.
• Walk through representative ambulatory-to-inpatient handoff
• Run the scenario-based migration and integration test on the provided extract and deliver the reconciliation report and scenario run recordings before the follow-up session.
• You and the seller agree the remaining test scope and list of stakeholders required for sign-off to proceed to Solution Evaluation.
• Confirm the list of stakeholders who will attend the Solution Evaluation to provide clinical and operational acceptance decisions.
• Demonstrate the migration and interoperability proof steps
• Validate alignment with your acceptance needs
• Agree remaining evidence and next steps

• Solution Experience Session
• Solution Experience Deck
• Solution Brief

• meeting
• slides
• document

• desired_state
• current_state
• stakeholders
• gaps
• success_criteria
• decision_readiness
• desired_state
• decision_readiness
• current_state
• success_criteria
• gaps
• stakeholders
• desired_state
• success_criteria
• stakeholders
• gaps
• current_state
• decision_readiness
• decision_readiness
• decision_readiness
• decision_readiness
• decision_readiness

• Configure Clinical Documentation Templates
• Deploy Computerized Physician Order Entry (CPOE)
• Implement Medication Management and eMAR/BCMA
• Configure Clinical Decision Support Rules
• Migrate Historical Clinical Records from Legacy Systems
• Build Interfaces to Labs, Radiology, and Ancillary Systems
• Integrate with Revenue Cycle and Billing Systems
• Deploy Patient Scheduling and Appointment Workflows
• Activate Patient Portal and Secure Messaging
• Implement Interoperability (FHIR/HL7) and HIE Connections
• Deliver End‑User Role‑Based Training Programs
• Provide Go‑Live Onsite Support and Hypercare
• Post‑Live Optimization and Workflow Tuning Program
• Configure Regulatory and Quality Reporting Packages

Configure Clinical Documentation Templates

• For which clinical services do you require new or adapted documentation templates (examples: inpatient progress note, emergency department triage, operative note)?
• How many specialty-specific templates need to be authored or converted (approximately)? Options: 1-10, 11-50, 51-200, 200+
• Who will be the final approver for each template type and what role signs clinical acceptance for note layouts? Options: CMIO, Chief Nursing Informatics Officer, Service Line Medical Director, Clinical Documentation Committee, Other
• What discrete data fields must be captured in templates for quality reporting (examples: problem list coded in SNOMED CT, structured allergies, smoking status LOINC)?
• Describe required templating features such as SmartPhrases, SmartForms, conditional fields, or structured problem lists.
• Which existing note templates need conversion from your current platform and what export formats can you provide (CCD, HTML, CSV)? Options: CCD/Consolidated CDA, HTML, CSV/spreadsheet export, Other

Deploy Computerized Physician Order Entry (CPOE)

• Identify the clinical areas targeted for initial CPOE rollout (examples: adult med-surg, emergency department, perioperative).
• How many standardized order sets require authoring or conversion for the pilot wave? Options: 0-10, 11-25, 26-100, 100+
• Who will govern CPOE order set changes and approve clinical content updates? Options: Pharmacy Clinical Lead, CMIO, Nursing Informatics Lead, Service Line Director, Other
• What mandatory order-entry controls do you require (examples: indication required, dose by weight, allergy hard stop, renal dosing alerts)?
• List the external systems CPOE must query at order time (for example formulary/therapeutic interchange, external medication history, ADT for patient context).
• When do you plan to begin a CPOE pilot relative to contract signature (month/quarter)? Options: Within 1 month, 1-3 months, 3-6 months, 6+ months

Implement Medication Management and eMAR/BCMA

• Specify the inpatient and outpatient drug formulary source and code set mappings required (examples: RxNorm, local formulary codes).
• Estimate the number of medication administration locations that will require BCMA scanning workstations at go-live. Options: 1-10, 11-50, 51-200, 200+
• Name the clinical approvers for high-risk medication order sets and override policies.
• List the barcode hardware models and scanning standards to be supported at bedside (examples: USB scanners, IEEE-11073 compliant devices).
• Explain the eMAR reconciliation cadence you expect and the acceptable discrepancy tolerance at cutover (percent or absolute thresholds).
• Specify the interfaces the medication module must consume or send (examples: HL7 v2 RXE/ORM to pharmacy, barcode middleware, automated dispensing cabinet events).

Configure Clinical Decision Support Rules

• Select the guideline categories you want encoded as CDS rules (examples: sepsis screening, VTE prophylaxis, antimicrobial stewardship). Options: Sepsis screening, VTE prophylaxis, Antimicrobial stewardship, Diabetes management, Other
• Provide the number of alert tiers you require (informational, soft stop, hard stop) for drug-drug and allergy checks. Options: 1 tier, 2 tiers, 3 tiers
• Identify the team responsible for ongoing CDS rule maintenance and tuning after go-live. Options: Clinical Informatics, Pharmacy Informatics, Service Line Leads, Other
• Provide the patient data elements that must be available in real time for CDS evaluation (examples: active medications, allergies, latest labs with LOINC codes).
• State the performance targets for CDS rule evaluation latency you require (for example under 200 milliseconds per rule evaluation). Options: <100 ms, <200 ms, <500 ms, No SLA
• Detail the audit and override log retention requirements including which fields to capture and retention period (months/years).

Migrate Historical Clinical Records from Legacy Systems

• Enumerate the source record types to be migrated (examples: structured problem lists, medication history, discrete labs mapped to LOINC, scanned notes).
• State the number of years of historical encounter data you expect to include in the migration scope. Options: 0-1 year, 1-3 years, 3-7 years, All available history
• Name the stakeholder group responsible for validating migrated discrete lab mappings and accuracy to LOINC. Options: Laboratory Informatics, Clinical Engineering, Clinical Documentation Team, Other
• Document the measurable migration acceptance criteria that will confirm successful ingest for clinical notes and discrete data (examples: 95% mapped LOINC coverage, under 1% data loss).
• Explain the approach you expect for legacy document OCR and discrete extraction for scanned records.
• Confirm the file formats and transport methods you will provide for extracts (examples: CCD, HL7 CCD, CSV via SFTP). Options: CCD/Consolidated CDA via SFTP, HL7 v2 message export, CSV via SFTP, Other

Build Interfaces to Labs, Radiology, and Ancillary Systems

• Enumerate the lab, radiology, and ancillary systems to interface initially and indicate interface types for each (HL7 v2, DICOM, FHIR).
• Detail the message sets and event triggers required for each interface (examples: ADT, ORM, ORU, MDM, DICOM study notifications).
• Supply the technical contacts who will provide endpoint access, test accounts, and network whitelisting for each system.
• Define the acceptance tests and success thresholds that will confirm each interface is production-ready (examples: end-to-end ORU with LOINC mapping verified, first-image DICOM load under 5 seconds).
• Declare the middleware or interface engine names and versions in use to validate compatibility.
• Outline the performance and acceptable error-rate SLAs you require for lab and radiology interfaces (examples: message delivery within 30 seconds, error rate under 0.1%).

Integrate with Revenue Cycle and Billing Systems

• For each billing system, specify which revenue cycle components require integration (claims, charge capture, eligibility, remittance) and the supported interface standard (for example EDI 837, HL7).
• Estimate the number of charge capture interfaces required and identify specialties that generate the highest chargemaster volumes.
• Designate the team responsible for mapping clinical encounter codes (ICD-10, CPT) to billing charge items.
• Indicate the reconciliation cadence you expect between clinical documentation and charge capture (options: daily, weekly, monthly). Options: Daily, Weekly, Monthly, Other
• Define the acceptance criteria for end-to-end charge posting to the billing system without data loss (examples: 99.9% successful posts, reconciliation variance under 0.5%).
• Explain required denial-management interfaces to receive remittance advice and automated adjustments (examples: ERA/835 parsing, automated posting).

Deploy Patient Scheduling and Appointment Workflows

• For scheduling domains in scope, indicate which apply (outpatient clinics, ambulatory surgery, imaging, emergency department follow-up). Options: Outpatient clinics, Ambulatory surgery, Imaging, ED follow-up, Other
• Approximate the number of appointment types and custom scheduling buffers you need per specialty.
• Designate the owner for scheduling templates and rules (time blocks, double booking, resource allocation).
• Outline the integration points required for appointment reminders, patient check-in, and eligibility verification (examples: SMS gateway, insurance eligibility API).
• Indicate expected no-show rates and the waitlist logic you require per clinic. Options: <5%, 5-10%, 10-20%, 20%+
• Articulate the monitoring metrics and KPIs you will require to judge scheduling deployment success (examples: reminder delivery rate, booking accuracy).

Activate Patient Portal and Secure Messaging

• Select the patient portal features to enable at launch (messaging, record view, appointment booking, online bill pay). Options: Secure messaging, View records, Appointment booking, Online bill pay, Other
• Approximate the number of patient accounts expected to require batch activation or invitation at go-live. Options: <1,000, 1,000-10,000, 10,000-100,000, 100,000+
• Assign the role responsible for secure message triage and defining response SLAs.
• Confirm required portal authentication methods (single sign-on, two-factor authentication, SMS one-time passcode). Options: Single sign-on (SSO), Two-factor authentication (2FA), SMS one-time passcode, Other
• Outline the data release and proxy access rules required for minors and caregiver proxies (examples: age cutoffs, segmented access).
• Clarify the reporting or audit extracts you need for portal message logs and patient access events and the retention period required.

Implement Interoperability (FHIR/HL7) and HIE Connections

• For interoperability, indicate which FHIR resources and HL7 v2 feeds you want enabled with the HIE (examples: Patient, Encounter, Observation, Medication).
• How will patient matching be handled for HIE exchange (deterministic matching, probabilistic matching, enterprise master patient index) and which identifiers will be authoritative? Options: Deterministic, Probabilistic, EMPI, Other
• Supply the contact who will manage HIE onboarding and execute connectivity agreements.
• Document the consent model and segmentation rules you require at the FHIR resource level (examples: opt-out flags, restricted sensitivity tagging).
• Articulate expected throughput and latency targets for HIE transactions and acceptable failure rates (examples: ADT reconciliation within 60 seconds).
• Confirm the test plan elements you will require to validate interoperability during system integration testing and user acceptance testing (examples: FHIR create/update tests, ADT reconciliation).

• Master Services Agreement (MSA)
• Order Form / Subscription Agreement
• Statement of Work (SOW)
• Service Level Agreement (SLA)
• Data Processing Agreement & HIPAA Business Associate Addendum (BAA)
• Implementation Schedule and Project Plan
• Change Order Agreement
• Go-Live Acceptance and Cutover Signoff
• Governance and Steering Committee Charter
• Payment and Invoicing Schedule

• Go-live Health Check (Weeks 1-4)
• First Measurement Review (Weeks 4-10)
• Acceptance Gate — 90-Day Outcome Review and Formal Acceptance
• Post-Acceptance Optimization Review (Quarterly)
• Operational Safety and Compliance Review (Quarterly)
• Annual Outcomes and Continuous Improvement Review (12 months)

• Ensure evidence for regulatory submissions is complete and accessible for audits.
• Reduce outstanding high-severity tickets and demonstrate measurable improvement in ticket burn-down rate.
• Agree the prioritized enhancement list for the next quarter with delivery windows aligned to operational risk.
• Confirm targeted training or workflow changes that will improve medication order processing time and adoption.
• Publish the prioritized enhancement backlog with estimated delivery windows and acceptance criteria.
• Execute the agreed training plan and provide completion metrics before the next quarterly review.
• Update the open-ticket register with remediation owners and weekly progress updates.
• Present safety and compliance metrics
• Confirm medication error rate and regulatory reporting timeliness are on track or have a documented mitigation plan with milestones.
• Re-confirm success criteria and owners
• Assign concrete mitigation steps for any safety risks and schedule follow-up verification.
• Document and circulate the incident remediation plan with dates for verification.
• Archive the compliance submission evidence and confirm access rights for audit reviewers.
• Schedule a targeted clinical workflow review to address recurring error modes.
• 12-month outcomes presentation
• Validate 12-month performance against Solution Scope targets for documentation time and clinician adoption and record any gaps requiring multi-quarter remediation.
• Agree the next year's continuous improvement priorities, metrics, and review cadence.
• Confirm the operational support and escalation approach for long-term stability and enhancement delivery.
• Publish the 12-month outcomes report with gap analysis and the approved continuous improvement plan.
• Schedule the next 12 months of operational reviews and assign owners to each improvement initiative.
• Prepare an evidence binder for each prioritized initiative to track progress against the agreed metrics.
• Confirm the deployment completed to the checklist in Solution Scope and that the environment is stable for hypercare.
• Identify the top 5 operational blockers and agree target resolution dates.
• Ensure the buyer's frontline teams have immediate escalation and support paths documented.
• Publish the deployment validation summary and the open-issue register for hypercare.
• Run the agreed data verification scripts and report results before the next review.
• Distribute the short-term remediation plan with target completion dates.
• Present first-measurement dashboard
• Establish whether weekly active clinical users and data migration completeness are trending to targets or require intervention.
• Agree a timebound corrective action plan that closes observed gaps before the Acceptance Gate.
• Confirm the evidence package required at the Acceptance Gate and the owner who will compile it.
• Deliver a metrics packet that includes raw data, validation scripts, and variance analysis for each metric ahead of the Acceptance Gate.
• Execute the agreed corrective actions and update the open-issue register with progress markers.
• Schedule targeted training or workflow remediation sessions addressing top adoption blockers.
• Restate acceptance criteria and numeric targets
• Produce a documented pass or fail for each numeric acceptance criterion from Solution Scope and capture the named signatory for the acceptance decision.
• Ensure a single touchpoint owns incumbent system retirement and that archival and contract closeout tasks are scheduled.
• Where criteria are unmet, assign a remediation plan with clear deliverables and deadlines to reach acceptance.
• Circulate the formal acceptance record for signature and archive the signed copy in the shared workspace.
• Publish the incumbent retirement checklist with dates for contract closeout, data archival, and access deprovisioning.
• Launch the remediation workstream for any conditional or failed criteria and report weekly until closed.
• Review outcome metrics and trendlines
• Deployment and migration validation
• Present outcome data against each criterion
• Diagnose gaps and root causes
• Root cause analysis for safety incidents
• Outstanding initiatives and enhancement status
• Outstanding issue and defect burn-down
• Pass/fail determination and formal acceptance
• Operational support and escalation summary
• Agree corrective actions and dates
• Early adoption signals and usage patterns
• Enhancement and backlog prioritization
• Compliance evidence and reportability
• Blockers, defects, and open support tickets
• Confirm readiness timeline to Acceptance Gate
• Agree annual continuous improvement plan
• Incumbent retirement and fallback closure
• Training and process adjustments
• Mitigation and prevention plan