Table 1: STAT-HI Checklist

Heading	Ref	Item	Source
Culture	1.1	Does the programme/project give sufficient attention to social factors, ethical considerations and practical workflow issues? (See principle 13 [14]).	[32-35, 37-39]
	1.2	Does the business case and programme/project plan critically evaluate the relevant supporting evidence (or its absence) from the literature? (Is the “treatment” evidence-based? [32])	[42]
	1.3	Is there an open and constructive relationship with suppliers? (Does the commercial contract make clear where functionality is constrained to a stated specification or what degree of flexibility there is for development or adaptation and how this is costed)?	[31]
	1.4	Is the default assumption that the implementation will be evaluated using STARE-HI (or a similar structured methodology) and that the evaluation will be published? (See principle 16 [14]).	[29]
	1.5	Is there an appropriate balance between standardization and respect for local autonomy? (See principle 13 [14]).	[32]
	1.6	Is there an environment in which those who feel the programme/project is starting to go wrong feel able to say so and then get a proper hearing? (See principle 2 [14]).	[30]
Governance and Risk	2.1	How clearly are the success criteria defined? How widely are they agreed? (Does the business case include funding to backfill clinicians for project governance and workflow design activities? Are the participating clinicians solely the enthusiasts, or have opponents been recruited to balance the discussions? See principles 5 and 18 in [14]).	[30, 37, 39]
	2.2	Has the programme been broken into manageable steps? (Have all stakeholders agreed that the stages are manageable? See principle 5 in [14]).	[30]
	2.3	Are there sufficient skills to deliver the full scope of the programme? (Has the business case and programme/project plan been independently peer reviewed by qualified health informatics practitioners? See principle 18 in [14]).	[30]
	2.4	Do the Senior Responsible Owner and programme/project manager have good relevant track records? (For instance, are they registered with UKCHIP [43] at level 3)?	[30]
	2.5	Does the risk management plan include assessment of how to address unforeseen consequences in workflow and emergent change following implementation? (Is the programme alert for new kinds of errors, negative emotions, disruption to well-established communication patterns? See principle 1 in [14]).	[37, 39]
	2.6	Is there a decision-making structure that will ensure strong and effective leadership of the IT-enabled business change? (Do eventual system users and operational managers own the changes? See principle 15 in [14]).	[31]
	2.7	Does the programme/project use an evolutionary approach with rapid learning cycles, recognizing that it is virtually impossible to fully understand and predict the behaviour of complex IT systems at the start of the project?	[30, 32, 37, 39]
	2.8	Beyond immediate technical success, how will wider benefits be secured?	[31]
Managing change	3.1	Does the programme have a complete understanding of its current business processes and how its stakeholders interact both with the business and between themselves and a clear understanding of what it wants the new business process to achieve?	[31, 37, 39]
	3.2	What incentives exist to drive performance? (Have clinicians agreed with the desired outcomes of the HI project, not seeing it as an end in itself that is being imposed upon them)?	[31] [44]
	3.3	Does the programme have a good appreciation of the likely impact of the business process change on service levels, productivity and different stakeholders?	[31, 37, 39]
	3.4	Does the technology exist to deliver the change? (Is a feasibility study or pilot required to offer proof of concept or proof of technology)?	[31]
Technology	4.1	Does the design and the implementation plan include not just system functionality but how it will affect actual clinical workflow? (Is there sufficient attention to ‘messy’ real-world practice rather than deceptively neat abstract models? [23-24])	[33-35, 37-39]
	4.2	Will system performance be rapid and reliable enough for clinical usage?	[36-39]