Somewhere around month six or nine, someone on your team resigned. A scheduler, maybe a clinical lead. Someone who sat through the go-live training, understood the reasoning behind how things were configured, and carried that context in their head every day.

Their replacement learned from someone else in the office who knew the area of the system they’d be working in. That person had already built a few workarounds of their own. Workarounds that made sense at the time but were never written down, never validated against the original configuration, and never reviewed by anyone who remembered why the system was set up the way it was.

A few months after that, three people were using the same feature three different ways. None of it was documented.

I’ve spent 30 years on the vendor side building, implementing, and optimizing post-acute EHR platforms. This pattern shows up in nearly every organization I work with. Not because the go-live training was bad. Usually it was good. Structured sessions, dedicated super-users, real documentation, protected time for clinical staff. The problem is what happens next.