Table 2.

Recommendations for rapidly building, deploying, and evaluating an electronic health record (EHR) during a health emergency.

Process stage	Recommendations
Predevelopment	Hire full-time professional staff to complete the product (ie, do not rely purely on volunteer efforts)
	Select a product owner who is a key stakeholder, deeply knowledgeable of the ground-level needs, and will remain engaged throughout the project
	Ensure that development team is proficient in Agile software approaches
	Set up mechanisms for regular (daily) communication
	Test and select hardware early to ensure (1) suitability based on needs (eg, waterproof, low power, and long battery life) and (2) that software designs are compatible with hardware
	Conduct review of working environment, clinical situation, and needed functionality with health workers
Development	Define the MVPa based on both ground-level priorities and time to develop features
	Communicate with ground-level team at least daily, if possible, including demonstrations and review of work in progress
	Conduct operational assessments of hardware and infrastructure needs
	Reprioritize MVP and other phases regularly based on ground-level feedback
Predeployment	Create communication mechanisms for user feedback to reach development team regularly and set up test and training servers to support this
	Ensure that operations team has appropriate staffing and skills required for EHRb rollout and troubleshooting
	Prepare training materials in advance and have plans for training and refresher training
	Make sure all hardware is ordered well in advance of user testing and training
	Determine strategy for selecting and training users (eg, all users vs superusers)
	Set up deployment pipeline to load and update software on production server
	Create contingency plans for anticipated problems (eg, locks for hardware, backup paper data collection, and backup power supplies)
Deployment	Ensure that deployment lead is proactive and can create and maintain buy-in from staff
	Conduct regular trainings with user-friendly material (eg, videos and annotated examples) and refresher trainings when needed
	Confirm that communication and feedback channels with development team are functional
Evaluation	Plan evaluation (including templates for pre- and postdeployment user surveys) during early development
	Keep records of informal feedback throughout the process
	Plan for contingencies (eg, obtaining consent and contact information for a Web-based follow-up user survey if emergency ends earlier than anticipated)

^aMVP: minimal viable product.

^bEHR: electronic health record.