Checklist

EHR Optimization & CDS Review Checklist

Interactive pre-launch checklist to review, approve, and record decisions for Clinical Decision Support (CDS) interventions. Covers clinical validity, alert frequency and priority, override tracking, usability testing, A/B testing, rollback criteria, post-deployment monitoring, and deployment planning. Saves review results for audits and follow-up.

Interactive Tool

EHR Optimization & CDS Review Checklist

Purpose

This interactive checklist helps teams evaluate CDS changes before they reach production. Use it to document clinical validation, reduce alert fatigue, define tracking and rollback criteria, plan usability testing, and set up post-deployment monitoring. Complete the form as part of change-control and retain the saved record for audits and follow-up.

How to use

  1. Fill each section with current evidence, numbers, and owners.
  2. If you plan an A/B test, capture sample size and success criteria.
  3. Define rollback triggers and monitoring metrics before go-live.
  4. Save the checklist and attach it to the change-control record; review monitoring metrics post-deployment.

Note: This checklist is a structured starting point. Adapt fields and thresholds to your local governance, clinical policies, and EHR capabilities.

Section: clinical evidence, intended use, population, contraindications, clinical owner. (This readout field is used as a header; complete the fields below.)
Select the best description of the evidence supporting this CDS intervention.
Describe precisely what clinician action or decision this CDS is intended to influence.
Who should receive the alert or suggestion? Include age, diagnosis, setting, specific orders, or labs.
List conditions, medications, or contexts where the CDS must be suppressed.
Person or group responsible for clinical validity and sign-off.
Has the clinical owner formally signed off on the intervention?
Section: alert type, expected frequency, priority, and soft-stop vs hard-stop decision.
Choose the most appropriate delivery type for this CDS.
Estimate how often an average user will see this alert; use baseline logs if available.
Operational priority for deployment and monitoring.
Soft-stops give clinicians information without preventing action. Choose based on risk and workflow.
Document the reasoning that justifies the design choice, including patient safety considerations.
Section: tracking definitions, baseline estimates, thresholds, logging and analytics ownership.
Define precisely how you will count an override (e.g., clinician dismissed without action, dismissed then order placed).
If available, provide the current override rate for similar alerts or an expected baseline.
Set a target threshold that, if exceeded, will trigger review or rollback.
Logging is required to evaluate override behavior and safety signals.
Person or team responsible for producing monitoring reports.
Section: plan, sample users, observed issues, and time impact. Usability testing reduces workflow friction and unsafe workarounds.
Describe scenarios, tasks, and metrics for usability testing (think task success, clicks, time, and qualitative feedback).
How many representative clinicians will run the test scenarios?
Capture notable observations, workarounds, or confusion from testing. Fill after usability sessions.
If known, enter the baseline to measure improvement or regression.
How much time change (positive or negative) is acceptable post-deployment.
Has the usability or human factors lead signed off on deployment?
Capture whether you will run an experiment and the core success metrics. If A/B testing is not feasible, document why.
If yes, complete the fields below. If no, explain in 'AB_successCriteria'.
Choose the primary metric you will use to judge success.
Rough estimate of number of events/users required (consult analytics/statistics team).
How long the experiment will run to collect meaningful data.
Define the statistical or practical thresholds that will be used to decide success.
Clear rollback criteria minimize patient risk and clinician disruption. Specify triggers, owners, and timeline.
If yes, fill the triggers and owners below. If no, this must be resolved before deployment.
List metric thresholds, adverse event counts, or qualitative reports that would trigger rollback.
Who is authorized to initiate rollback and communicate status.
Specify monitoring metrics, thresholds, reporting cadence, and escalation. Use automated dashboards where possible.
Select the metrics you will track post-deployment.
Example: override rate > 40% for 3 consecutive days triggers immediate review.
How often will the analytics owner review metrics (daily, weekly)?
Who maintains the dashboard and generates reports.
Who gets notified and what are the next steps when a threshold is exceeded.
Document the rollout window, stakeholders, training, and go-live support.
Date/time window for go-live and immediate support.
Teams, units, and leaders who should be informed before and after deployment.
Confirm that quick-reference guides, tip-sheets, and in-system help are available.
Describe who will be available (superusers/IT) and for how long after go-live.
Capture final decision and required open actions.
Team judgment after completing the checklist.
List actionable items, owners, and target dates.
Person who approves technical deployment.
Date of final approval. Use ISO format (YYYY-MM-DD).
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