Big Bang vs. Incremental Roll-out

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== In Support of Gradual Implementations == Once site used a gradual implementation with the old TDS system in the early 1990's after complete rejection of the TDS system the previous year by the docs. They brought on things that were useful to the docs first ... xray reports, labs, rounding lists, etc.... This allowed everyone to get accustomed to the user interface. Then they brought on ordering with the least dangerous things first .. so by the time they brought on pharmacy, using the interface was not an issue.. by this time, most saw the benefit of doing things online in spite of the old-fashioned interface. It took about a year or year and a half to get to full CPOE ..(93% of all orders by peds residents) We always had paper orders as a fall back ..with great pressure not to use them .. There was a big psychologic benefit to this fall-back system in my opinion. Docs get REALLY angry when they are in a hurry and can't order because they can't navigate the system ... We tried the