1. EHR: Change Management & Clinical Adoption Standard Based in Standard EHR Approach (see Standard-Adaptive Approach to EHR Implementation) Use extensive amount of technology to solve care process problems Educate/tell caregivers what will change for them post go-live Adaptive Based in Adaptive EHR Approach (see Standard-Adaptive Approach to EHR Implementation) Use minimal amount of technology to get the largest gain; problem- solving & innovation to solve care process problems Staff and leaders understand current work; improve work processes; identify what is needed to enable ideal care; identify impact of EHR as designed; identify adaptation needs – of technology or of workflows Barbara Balik barbara@theCommonFire.com

2. EHR: Change Management & Clinical Adoption Standard Complete surveys for implementation readiness; identify high-risk issues Complete day-in-the-life walk through based on systems as designed If problems arise with EHR, provide more training or 1 st order problem solving Schedule set by EHR team with “on time/on budget” as key metric Adaptive Teach adaptive learning skills to all departments and leaders as EHR preparation Understand current work directly through observation; identify impact of technology through application to real-life scenarios When problems arise with EHR, signals go to teacher/coach who does 2 nd order problem solving Schedule set to meet patients needs ideally short- and long-term; continually decrease resource use Barbara Balik barbara@theCommonFire.com

3. EHR: Change Management & Clinical Adoption Standard Teach EHR functionality in classes IT staff are experts and removed from care/support processes Create new role – e.g. Optimization Specialists - to aid clinicians in using functionality Adaptive Teach EHR-enabled care in the care setting to observe process variability and workarounds IT staff are partners who have IT expertise and learn problem-solving to support staff & provider customers Better use of existing roles to provide teacher/coaches; to partner with clinicians to understand current work, respond to problems as the are signaled, & rapidly improve Barbara Balik barbara@theCommonFire.com