Implementation

Managing the First 90 Days After Go-Live

Go-live is the start, not the finish. The first 90 days determine whether the practice stabilizes into productive use or settles into permanent frustration. Plan this window as deliberately as you planned the build. The temptation, once the system is technically live, is to declare victory and send the project team home — but the days right after launch are when the practice is most fragile and when steady leadership pays the largest dividend. The structure that follows divides the window into three stages, each with a different goal and a different definition of success.

Days 1-14: stabilize

The first two weeks are about keeping the practice running while everyone learns. Expect a productivity dip — it is normal and temporary if you manage it, and warning people in advance keeps a predictable slowdown from being mistaken for a failing system. Your job in this stretch is triage, not improvement: keep the doors open, keep patients safe, and fix the things that are actively blocking work.

  • Keep super-users and a command center active; triage issues by patient-safety and workflow-blocking impact.
  • Track and rapidly fix high-frequency problems (a broken template, a missing order, a routing error).
  • Maintain the reduced schedule until throughput recovers.
  • Communicate daily: what is fixed, what is known, what to do as a workaround.

Days 15-45: recover productivity

Once the system is stable, shift from firefighting to recovery. Watch the metrics that reveal where people are struggling, and resist the urge to interpret every complaint in isolation — patterns in the numbers tell you where to invest your limited optimization time.

MetricWhat it tells you
Visit cycle timeWhether the workflow is back to baseline
Documentation time per encounterWhere note workflows still drag
In-basket / message volumeRouting and workload distribution problems
Claim lag and denial rateWhether charges and coding flow correctly

Compare these against your pre-go-live baseline wherever you captured one. A metric drifting back toward normal is reassuring; one that stays stuck weeks in points to a workflow or build problem that training alone will not fix. Share the trend lines with staff so they can see the recovery is real and underway, which does as much for morale as it does for management.

Days 46-90: optimize

By week six, users know enough to tell you what is wrong with specifics. This is the highest-value moment for optimization. Run short, focused sprints: personalize templates, build the shortcuts people requested, and fix the workflows that survived go-live but still annoy everyone.

The requests you receive now are dramatically better than the ones you got in week one, because people finally understand the system well enough to articulate what would help. Capture them, group them by theme, and tackle the highest-frequency frustrations first so the benefit lands across the whole practice rather than for one vocal user.

Close the loop on the issue backlog

  1. Maintain a single prioritized issue list from day one — do not let requests scatter across email and hallway conversations.
  2. Categorize: bug, training gap, build change, or enhancement.
  3. Resolve training gaps with quick refreshers; route build changes through change control.
  4. Report progress to the steering group so leadership sees momentum.

Declare stabilization deliberately

Do not let the project drift into limbo. Define exit criteria — productivity within a target of baseline, issue backlog under a threshold, billing flowing normally — and formally transition from project mode to operational support. Make the handoff explicit so everyone knows who now owns the system, how requests are submitted, and what the response expectations are. At that point, ongoing optimization becomes a standing program owned by the practice, with a defined intake process for future requests, rather than a project that quietly never ends.