Exhibits 1- 7

Exhibit 1

Exhibit 1.

Four study cohorts can be defined according to the adopter/user and HIS type.

Legend: *means only EMR or eDrug is adopted/used but not both; +/- means either EMR or eDrug is present for basic-adopters/users

Cohort	EMR	eDrug	EHR
A: Non-adopter/user
B: Basic-adopter/user*	+/-	+/-
C: Intermediate-adopter/user	√	√
D: Advanced-adopter/user	√	√	√

Exhibit 2

Exhibit 2.

Each cohort in 3a can be further divided into three care settings each with different HIS types

Setting	EMR	eDrug	EHR
Physician Office	√	√	√
Community Pharmacy		√	√
Acute/Tertiary/continuing care		√	√

Exhibit 3

Exhibit 3.

Each cohort in 3a can be further divided into three provider types each involved with different HIS types

Provider	EMR	eDrug	EHR
Physician	√	√	√
Pharmasist		√	√
Authorized health professional		√	√

Exhibit 4

Exhibit 4.

Different study design options available based on composition of the cohorts and time periods being examined. Legend: N is sample size; T is time period; subscripts 0 to 5 denote the sample sizes and time periods for each cohort; ∑ refers to the column, row and grand total sample sizes. For example, Cohort-A at Time-0 can be defined to include all three types of providers across all three settings who have not adopted/used EMR, eDrug and EHR at the baseline period.

Examples	Time-0	Time-1	Time-2	Time-3	Time-4	Total
Cohort-A	A(N1T0)	A(N2T1)	A(N3T2)	A(N4T3)	A(N5T4)	A(N1-5)
Cohort-B	B(N1T0)	B(N2T1)	B(N3T2)	B(N4T3)	B(N5T4)	B(N1-5)
Cohort-C	C(N1T0)	C(N2T1)	C(N3T2)	C(N4T3)	C(N5T4)	C(N1-5)
Cohort-D	D(N1T0)	D(N2T1)	D(N3T2)	D(N4T3)	D(N5T4)	D(N1-5)
Total	∑(N1T0)	∑(N2T1)	∑(N3T2)	∑(N4T3)	∑(N3T4)	∑(N1-5)

Exhibit 5

Exhibit 5.

Five kinds of studies to examine the information/system/service quality and use/satisfaction dimensions in the BE Framework. Legend: Cohorts-A, B, C, D are non-adopters/users with no HIS, basic-adopters/users with eDrug or EMR, intermediate-adopters/users with eDrug and EMR, and advanced-adopters/users with eDrug, EMR and EHR, respectively. Time-0 is the baseline period, Time-X is the next period, Time-Y the period after Time-X, and Time-Z after Time-Y, etc. Cohort-A with no HIS is excluded since these studies all require specific types of HIS being adopted/used.

Studies on BE Quality/use Dimensions	Cohort-A	Cohort-B	Cohort-C	Cohort-D
(1) Comparison: documented features vs. best practices		Time-0 to Time-X/Z	Time-X to Time-Y/Z	Time-X to Time-Y/Z
(2) Usability: ease of use, functionality and usefulness		Time-0 to Time-X/Z	Time-X to Time-Y/Z	Time-X to Time-Y/Z
(3) Qualitative case: survey, interview and observation on on percieved/actual use		Time-0 to Time-X/Z	Time-X to Time-Y/Z	Time-X to Time-Y/Z
(4) Quantitive case: system use log triangulated with qualitative case findings		Time-0 to Time-X/Z	Time-X to Time-Y/Z	Time-X to Time-Y/Z
Data quality audit: patient electronic records vs. manual chart		Time-0 to Time-X/Z	Time-X to Time-Y/Z	Time-X to Time-Y/Z

Exhibit 6

Exhibit 6.

Five kinds of studies to evaluate the care quality and productivity dimensions in the BE Framework. Legend: Cohorts-A, B, C, D refer to non-adopters/users with no HIS, basic-adopters/users with eDrug or EMR, intermediate-adopters/users with eDrug and EMR, and advanced-adopters/users with eDrug, EMR and EHR, respectively. Time-0 is the baseline period, Time-X is the next period, Time-Y the period after Time-X, and Time-Z after Time-Y, etc.

Studies on BE Benefits Dimensions	Cohort-A	Cohort-B	Cohort-C	Cohort-D
(1) Efficiency: Call-to-pharmacy; special authority request adjudication	Time-0 to Time-X/Y	Time-0 to Time-X/Y	Time-X to Time-Y/Z	Time-X to Time-Y/Z
(2) Coordination: review/reconciliation of medication management	Time-0 to Time-X/Y	Time-0 to Time-X/Y	Time-X to Time-Y/Z	Time-X to Time-Y/Z
(3) Patient safety: adverse drug event and medical error prevention and detection	Time-0 to Time-X/Y	Time-0 to Time-X/Y	Time-X to Time-Y/Z	Time-X to Time-Y/Z
(4) Effectiveness: special authority compliance; disease management	Time-0 to Time-X/Y	Time-0 to Time-X/Y	Time-X to Time-Y/Z	Time-X to Time-Y/Z

Exhibit 7

Exhibit 7.

Two examples of time series delayed controlled matching cohorts. First is the two matching Pharmacy cohorts where baseline measures are taken at Time-0 with the original PharmaNet. Then Pharmacy1 deploys the new eDrug in Time-1 while Pharmacy2 continues with PharmaNet. Then Pharmacy2 deploys new eDrug in Time-2 while Pharmacy1 continues to use eDrug. Then Pharmacy1 deploys a new EMR while Pharmacy2 continues to use eDrug. Another example is the matching Physician cohorts for deployment of EMR, eDrug and EHR.

Examples	Time-0	Time-1	Time-2	Time-3	Time-4
Pharmacy 1	Original PharmaNet	New eDrug	eDrug	eDrug + New EHR	eDrug + EHR
Pharmacy 2	Original PharmaNet	Original PharmaNet	New eDrug	eDrug	eDrug + New EHR
Physician 1	Exsisting EMR	EMR + New eDrug	EMR + eDrug + New EHR	EMR + eDrug + EHR	EMR + eDrug + EHR
Physician 2	No HIS	New EMR	EMR + New eDrug	EMR + eDrug + New EHR	EMR + eDrug + EHR

Reactive Analysis

Reactive Analysis of an Information System, from the IT Interaction Model by Silver et al. [xx]

• Was the information system's design objective to IMPROVE the organization incrementally or to TRANSFORM it?
• What are the information system's FEATURES? What does it do?
• How does the information system FIT the firm's EXTERNAL ENVIRONMENT?
• How does the system FIT the firm's STRATEGY?
• How does the system FIT the firm's BUSINESS PROCESSES?
• How does the system FIT the organizational STRUCTURE and CULTURE?
• Can the organization's existing IT INFRASTRUCTURE support the system? Does the information system leverage the infrastructure? Does it extend it?
• How and how effectively was the system IMPLEMENTED?
• Who USES the system and how do they USE it? As intended?
• What are the CONSEQUENCES of the system for PERFORMANCE, PEOPLE, and FUTURE FLEXIBILITY? Did the system accomplish its objectives?

Guiding Questions

Guiding Questions from Kotter's Organizational Change Model [xx]

• Has the sense of urgency for change been established within the organization?
• Has a guiding coalition been created within the organization?
• Has the vision and strategy been developed within the organization?
• Has the vision and strategy been communicated throughout the organization?
• What is the mechanism to empower broad-based action for change throughout the organization?
• What are the short-term wins for the organization that can be generated from this change?
• What are the efforts to consolidate gains and produce more change within the organization?
• How are the new approaches being anchored within the organizational culture?