Why Most Technical Dress Rehearsals Miss the Mark and How to Get it Right
The Hidden Risks in Electronic Health Record Go-Live
Launching a new Electronic Health Record (EHR) system is one of the most complex and high-stakes initiatives a healthcare organization can undertake. A smooth go-live can accelerate clinician adoption, improve patient care, and protect financial performance. When things go wrong, the consequences ripple across the organization: delayed care, revenue loss, and burned-out staff. One of the most overlooked but critical phases of an Epic implementation is the Technical Dress Rehearsal (TDR). Often treated as just another milestone to check off, TDRs are intended to stress-test the system, devices, workflows, and people before go-live. The problem? Too many organizations mistake a “complete” TDR for a successful one, failing to uncover vulnerabilities that will inevitably surface on Day One.
Where Most Technical Dress Rehearsals Miss the Mark
Even well-intentioned TDRs often fall short because they don’t mirror the true pressures of a live environment. Here are the most common pitfalls:
Lack of Clinical Alignment
TDRs are frequently led by IT teams without adequate involvement from frontline clinicians. Without simulating real-world workflows such as charting in Epic during peak hours, scanning medications, or routing labs, organizations miss critical gaps that directly impact patient care.
Understaffed and Underplanned
Teams are often too lean, timelines too short, and scope too vague. When device inventories aren’t fully validated or testing scripts are rushed, the results don’t reflect true readiness.
No Command Center or Real-Time Triage
Logging issues without resolving them in real time defeats the purpose of a rehearsal. A TDR without a functioning command center delays remediation and increases the likelihood of repeat failures at go-live.
Failure to Simulate Go-Live Conditions
Many TDRs run controlled, predictable scripts instead of chaotic, variable scenarios. Real-world go-live stressors like login bottlenecks, downtime, and user errors go untested. That’s why organizations are often blindsided by preventable issues on launch day.
The Cost of a “Good Enough” Technical Dress Rehearsals
Cutting corners in a TDR has significant consequences. A poor rehearsal doesn’t just delay stabilization, it drives up costs and erodes trust.
Escalated Support Costs & Longer Stabilization: More help desk tickets, more overtime, and higher consultant fees.
Revenue Cycle Disruptions: Lost billing days and workflow errors directly impact financial performance.
Delayed Patient Care: Device failures, login delays, and missed communication slow providers down and compromise patient experience.
Clinician Frustration & Burnout: Every glitch reinforces resistance to the system and decreases trust in leadership.
Delayed ROI: Productivity delays mean organizations wait longer to realize the benefits of their Epic investment.
What a Successful TDR Looks Like
A successful technical dress rehearsal doesn’t just check boxes, it stress-tests every layer of the organization’s go-live readiness. Here’s what that looks like:
Integrated Planning
Align IT, clinical, and operational stakeholders early.
Build the TDR playbook around site maps, device inventories, and workflow priorities.
On-Site Execution
Walk surgical suites, scan barcodes, test printers, and validate routing.
Design scenarios that mimic real-time use, including peak-volume stress testing and variable user behavior.
Command Center Coordination
Run a fully operational command center with real-time dashboards, daily reporting, and triage.
Partner with Epic and client teams to address and resolve issues on the spot.
Pilot and Remediation Cycles
Start by testing 3–5% of devices, remediate, and retest before scaling.
Build in remediation checkpoints with clear ownership and timelines.
Expert-Led Teams
Leverage consultants with Epic-specific expertise and clinical fluency.
Involve end users: clinicians, administrators, and support staff to replicate real workflows under pressure.
Strategic Tips for Technical Dress Rehearsal Success
Begin planning 3–6 months in advance.
Use a standardized, scalable TDR framework tailored to organization size.
Include pre-visits, test script development, and command center planning.
Partner with experienced firms with proven methodologies and Epic expertise.
At CSI Companies, we’re proud to be recognized as Best in KLAS for Technical Services two years in a row. Our proven pre-go-live capabilities and TDR methodologies help healthcare organizations avoid the common pitfalls and achieve faster, safer, and more cost-effective go-lives.
Technical Dress Rehearsal is a Strategic Investment in Go-live Success
A robust Technical Dress Rehearsal isn’t just an IT milestone; it’s a strategic investment in your organization’s go-live success and long-term ROI. When done right, a TDR pays off with:
Faster provider ramp-up time
Fewer tickets, less overtime, and reduced downtime
Stronger clinician trust in Epic and in leadership
Financial continuity with fewer disruptions
Don’t settle for “good enough.” Demand a TDR that truly prepares your organization for go-live. Partner with experts who understand the clinical and financial stakes of an Epic go-live. Contact CSI Companies today for a go-live readiness assessment.