The document discusses key factors for a successful EHR implementation. It emphasizes that the project should be user-driven, not IT-driven, with users rigorously documenting workflows and processes upfront. Users should control aspects like responsibilities, deadlines and interfaces, while IT focuses on computational logic, data, and infrastructure. Failure is common if EHR is used to automate poor existing processes rather than improve workflows. For the project to succeed, users, IT, and vendors must work together from the beginning with a detailed plan focused on usability and meaningful use for clinical staff.