Key Facts (At-a-Glance):
- Technical readiness does not equal operational readiness: An EHR can be built, tested and ready to launch while teams are still figuring out how new workflows, responsibilities and decisions will work in practice.
- Decision-making capacity is a critical readiness factor: Months of decisions around workflows, system settings, legacy data and ownership can create decision fatigue and leave important issues unresolved as go-live approaches.
- Cross-functional handoffs are where gaps often surface: Teams may understand their individual roles but still struggle with what happens between departments, particularly across clinical, administrative and revenue cycle workflows.
- “Resistance” can signal a readiness gap: When employees question or avoid a new workflow, leaders should understand whether they have the context, communication and support needed to understand why the change matters.
- Real-world scenarios reveal what training alone can miss: Day-in-the-life exercises, preparation labs and integrated tabletop sessions can help teams identify workflow gaps, unclear ownership and escalation points before go-live.
- The first week can expose deeper readiness gaps: When employees are unsure who owns the next step, where work should go or whom to contact for help, those issues can signal breakdowns in the connections between workflows.
- Go-live is the beginning of the next phase: Health systems should establish post-go-live priorities and optimization plans before launch, with clear ownership for stabilizing workflows and addressing issues as they emerge.
FARMINGTON HILLS, Mich., Oct. 07, 2026 (GLOBE NEWSWIRE) -- A go-live rarely announces that it’s in trouble. It usually starts quietly with a user who can’t log in.
A registrar cannot access the tools needed to check in a patient. A nurse is unsure who owns the next step in a new workflow. A physician cannot find information from the legacy system. A payer issue that seemed minor during testing later contributes to a denied claim.
Individually, these may look like isolated issues. Together, they can reveal a larger problem: The organization was prepared to launch the technology, but not necessarily prepared to operate differently.
According to Healthrise, a health care consulting and technology firm, that distinction is at the heart of operational readiness. While implementation teams focus on building, testing and deploying the system, health systems also must prepare for the decisions, handoffs and workflow changes that begin once the system is live.
“Operational readiness is not a checklist you complete before go-live,” said Michele Woodley, MBA, PMP, CPC, CHAM, CRCR, vice president, EHR Readiness and IT, Healthrise. “It is about understanding how the organization is going to function in a completely different environment. The technology is one part of that. The bigger question is whether the people, processes and leadership are prepared to work together when something does not go according to plan.”
The Decisions Behind the System
Health systems can spend years preparing for an EHR transition, yet the operational impact can accelerate dramatically in the final months. Teams are making decisions about system settings, workflow design, legacy accounts, staffing and access, often while managing their existing responsibilities.
According to Woodley, decision-making capacity is one of the most underestimated resources during an implementation.
“You are facing an almost relentless pace of decisions,” she said. “Every one has downstream consequences, and the people making those decisions still have their day jobs. The lift is enormous, and the margin for decision fatigue is real.”
Healthrise recommends beginning operational readiness work as early as 18 months before go-live to identify where decisions are accumulating, ownership is unclear or workflow changes could create downstream consequences.
That same disconnect can affect how employees respond to change. Teams may be told what a new workflow requires without understanding why it was designed that way or how their actions affect another department.
“I don’t think what we’re seeing is really resistance,” Woodley said. “Often, people do not have the context they need to understand why a workflow change matters or how it affects the people downstream from them.”
Healthrise recommends framing readiness around the full patient journey rather than treating clinical, administrative and revenue cycle processes as separate tracks. An incorrect payer selection, for example, may begin as a registration issue but ultimately affect reimbursement.
“When people can see how their decisions affect the next team, the conversation changes,” Woodley said. “It becomes less about who owns the problem and more about how everyone contributes to the patient experience.”
Where Workflows Break Down
The most revealing readiness exercises are not necessarily the ones that test whether an employee can perform a single task in the new system. They are the scenarios that force multiple teams to work together.
Healthrise recommends using day-in-the-life scenarios, preparation labs and integrated tabletop exercises to recreate situations employees will encounter after go-live. The goal is to determine whether people know what happens next, who owns the next step and how to recover when something goes wrong.
“Training someone to register a patient is different from preparing them to understand how registration affects the entire patient journey,” Woodley said. “You have to put people into the situations they will actually encounter and see how the organization responds.”
The final 90 to 180 days before launch can serve as a critical stress test. Health systems should validate access and staffing models, test integrated workflows with actual end users and identify where work changes hands between departments.
What Week One Reveals
No go-live is completely free of issues. The difference is often how quickly an organization can identify, route and resolve them.
In the first week, Healthrise recommends watching workflow ownership and integrated processes closely. Do employees know who owns the step before them? Do they know where to take an issue when something goes wrong? Can departments resolve problems directly, or do issues repeatedly move up the leadership chain?
“If people are hunting for answers, forwarding emails or escalating issues that should be resolved laterally, that tells you something,” Woodley said. “The technology may be working, but the organization is showing you where its readiness gaps are.”
These gaps can surface as patient delays, employee frustration, registration errors, denials and other downstream problems.
Go-Live Is Not the Finish Line
Readiness also should extend beyond launch. Healthrise recommends defining post-live optimization priorities before go-live, including what the organization wants the EHR to accomplish and what success should look like 12 to 18 months later.
Some organizations may need to stabilize core workflows before adding complexity. Others may be prepared to implement more capabilities immediately. The key is making that decision intentionally and understanding the tradeoffs.
“What is important is having that conversation intentionally and understanding the tradeoffs before you commit,” Woodley said.
Ultimately, the question is not whether an EHR can be configured, tested and turned on. It is whether an organization can make decisions, connect workflows and respond to problems when the technology becomes part of everyday patient care.
“Go-live is not the finish line,” Woodley said. “It is the point when the organization has to prove that all of the decisions, preparation and change management can come together in the real world.”
For health systems preparing for an EHR transition, that work starts long before the first patient arrives. The strongest readiness strategies account not only for what the technology can do, but for how people will make decisions, work across boundaries and adapt when the reality of go-live does not perfectly match the plan.
To learn more about EHR go-live readiness and Healthrise’s approach to helping health systems prepare for a smoother transition, visit www.healthrise.com.
About Healthrise
Healthrise is a healthcare consulting and technology firm that provides revenue cycle management, electronic health record optimization and strategic advisory services to hospitals and health systems across the United States. Founded in 2012, the company partners with organizations to improve financial and operational performance through customized, data-driven solutions. Healthrise has supported more than 25 health systems and managed over $35 billion in net patient revenue, helping clients strengthen long-term sustainability and care delivery. For more information, please visit www.healthrise.com.
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