Table 2.

Key EHR transition practices described by interview participants

Practices	Key components
Pre-go-live
Communicate rationale and anticipated outcomes of the EHR change	• Emphasize the rationale for the change and address clinician concerns • Tailor communication to the specific experiences of the healthcare system • Set realistic expectations and address expected outcomes
Understand existing workflows	• Work with local stakeholders to understand existing workflows • Re-evaluate inefficiencies with current workflows • Use existing workflows as foundational knowledge for EHR changes
Plan for appropriate customization	• Align expectations with vendors early on and continuously revisit shared understanding about customization • Seek frontline clinician perspectives and input in meaningful ways • Identify engaged clinicians and provide protected time/support • Foster communication that limits inefficiencies and redundancies
Go-live
Personalize training and support	• Tailor training to user needs • Engage local clinicians to contribute to training and support
Invest in robust internal support	• Identify influential and supportive superusers that can champion EHR transition efforts • Ensure adequate protected time and funding for local clinician training
Reduce workload expectations	• Find ways to mitigate additional work-related stressors • Decrease clinic capacity during go-live and tailor when to resume normal clinic load
Proactively address EHR transition challenges	• Listen to and engage frontline clinicians • Ensure transparent communication about challenges
Post-go-live
Continue to invest in change	• Ongoing support and training following the first few weeks of the implementation are essential • Commit to continued system optimization • Communicate the approach, timing, and rationale for system optimization