Question 1

You are not a staffing firm — what are you instead?

Accepted Answer

Threshold FDE does not fill roles or place headcount. When a staffing firm succeeds, you have people in seats. When Threshold FDE succeeds, the technology is live, the frontline is using it, adoption is measured against the Rules of Engagement, and a named owner inside your organization is running it without us. The distinction matters operationally. Staffing solves a capacity problem. Threshold FDE solves a deployment problem — which is a different problem entirely. The work is: map the real workflow, close the readiness list, align the named internal owners, sequence the go-live, and stay through stabilization. That work does not get done by adding headcount; it gets done by a multidisciplinary operator team with accountability for outcomes. Every engagement has a named FDE operator on the Rules of Engagement. The handoff at the close of an engagement is not from us to your staff — it is from us to a named accountable owner inside your organization who was identified in week one.

Question 2

What does 'forward-deployed' actually look like in our environment?

Accepted Answer

Forward-deployed means we are physically present during the work that matters. Tier two — the Full Forward-Deployed Engagement — opens with a named FDE operator on-site in week one, embedded in your operating cadence: clinical, operational, technical, revenue-cycle, data, and change-leadership disciplines running as one team. In the workflows, not peripheral to them. The named operator sits at the table where readiness decisions are made, where go-live criteria are signed, and where adoption is read verbatim against cell six of the Rules of Engagement. They are not running a parallel program from a remote desk; they are working the same problem the named client-side owner is working, in the same place the named client-side owner is. This is different from a remote review cadence, a weekly status meeting, or a written progress note. Forward-deployed means the operator carries accountability for named outcomes against named cells, on-site, through go-live and into stabilization. The Tier one Deployment Readiness Sprint opens with a remote engagement lead because the work is diagnostic; Tier two embeds because the work is deployment.

Question 3

Do you coordinate with the EHR vendor — or replace them? Do you work with our internal IT and informatics teams?

Accepted Answer

We coordinate, not replace. Threshold FDE is not in the EHR implementation business — Epic, Oracle Health, Meditech, Athenahealth are already sold and being deployed by your existing vendor. We do not compete with that engagement and we do not resell the EHR's services arm. We sit alongside it. We also sit alongside your internal IT, your informaticists, your CMIO, and your clinical-operations leadership. The named FDE operator is not there to displace anyone in your organization; the operator is there to bring the disciplines — integration sequencing, frontline behavior review, multi-vendor coordination, adoption measurement — that the Rules of Engagement say are required for the deployment to land. The named client-side owner is involved throughout; nobody on the engagement is asked to disappear. Multi-vendor coordination across the EHR vendor, the platform vendor, the integration partners, and your internal IT runs on the same week, not in a series of handoffs. The readiness list is dual-named — a named FDE operator and a named client-side owner on every requirement. Nothing moves without both names on it.

Question 4

Are you a strategy consulting firm that delivers recommendations?

Accepted Answer

We do not deliver a document and leave. A strategy deck is a recommendation without an owner. Threshold FDE's work is accountable at the operator level — every readiness requirement has a named owner, every go-live criterion is signed before the first change goes in, and every adoption metric is owned by a named leader inside the organization. The discipline behind this is the Rules of Engagement. It is six cells — problem, solution, readiness, owners, go-live criteria, adoption measures — written with the client at the opening of every engagement. They are not a document we hand off at the close. They are the document everyone points to when the work gets hard. If you need a strategy recommendation — a vendor assessment, a sequencing analysis, a build-vs-buy analysis — we can help frame that thinking early in an engagement, but Threshold FDE's core scope is deployment. We are operators, not analysts. We are in the environment, not producing insight about it from the outside.

Question 5

How soon does an FDE operator show up on-site?

Accepted Answer

It depends on the tier. The three engagement shapes match three points in a rollout, and the operating cadence is different at each one. Tier one — the Deployment Readiness Sprint — runs on a remote engagement lead opening in week one, because the work is diagnostic: walk the readiness site-by-site, build the readiness list with dual-named owners, sign the go-live criteria before any change goes in. That sprint is fixed-scope and runs ~3 weeks. Tier two — the Full Forward-Deployed Engagement — embeds an FDE operator on-site in week one. The operator is named, accountable, and physically present during Workflow Mapping & Floor Readiness (the first four weeks of the engagement), running the readiness list cell by cell against the Rules of Engagement, coordinating across the EHR vendor, your internal IT, and the integration partners — and they stay through go-live and into stabilization. The horizon for Tier two is ~6–9 months. Tier three — the Stabilization & Adoption Retainer — keeps the operator on after Tier two closes, on a rolling quarterly cadence, catching adoption drift and integration regression against cell six of the Rules of Engagement. The cadence matches where you are. If you tell us which tier matches, we will name the same operator, the same date, and the same named client-side owner for the opening of the engagement.

Question 6

Who owns the playbooks and the readiness list you leave behind?

Accepted Answer

Yours. The artefacts produced inside your environment during the engagement — the readiness list, the Rules of Engagement, the integration sequencing document, the playbooks written against your workflows — transfer to your organization at the close of the engagement. They live in your environment. The named client-side owner signs for them at the transition. The operating model that runs those artefacts is ours. We do not transfer the way Threshold FDE runs a deployment across environments; we transfer what was produced inside yours. If another team picks up the work after we exit, the readiness list and the Rules of Engagement are how they pick it up. This is also why every requirement on the readiness list is dual-named. By the time the engagement closes, the named FDE operator and the named client-side owner have read, signed, and re-baselined the same document together. There is no ambiguity at the transition. The artefacts are yours; the discipline is what you buy from us.

Question 7

What happens at the end of an engagement — do you keep showing up?

Accepted Answer

The named FDE operator exits when the named internal owner is running the program — not at go-live, not at a calendar date. At the end of engagement, ownership transfers formally. The exit criterion is operational: adoption is measured, the workflow is stable, and the internal owner can sustain it. That is what "done" means. What transfers at the transition: the readiness list, the Rules of Engagement, the integration sequencing document, the playbooks produced inside your environment. The named client-side owner signs for them. By the close of stabilization, the named FDE operator and the named client-side owner have read, signed, and re-baselined the same document together, so there is no ambiguity at handoff. If you want continuation without the on-site cadence, Tier three — the Stabilization & Adoption Retainer — keeps the named FDE operator on a rolling quarterly rhythm after Tier two closes, catching adoption drift and integration regression against cell six of the Rules of Engagement. If continuation without an operator on the named client-side owner's rhythm is what fits, the tier is offered at the close. If not, the transition lands clean.

Question 8

How do you handle confidentiality, PHI, and our existing BAA posture?

Accepted Answer

The engagement is scoped under the client's existing agreements. Threshold FDE is not introducing a new PHI-handling product into the environment; we work inside the BAA posture your organization already holds. The named client-side owner governs what leaves the environment; the named FDE operator governs what gets produced inside it. What enters: the named FDE operator and the named engagement lead, named on cell four of the Rules of Engagement before they step into the environment. What governs their access: the same controls your clinical, operational, and IT teams already operate under. There is no separate environment, no parallel data store, no client data resident outside the BAA envelope. If a piece of work falls outside that envelope — e.g., a discovery exercise that needs a data export to a Threshold FDE-controlled environment — we scope and contract for that work before it begins. Threshold FDE's first call names the no-fit on the data-handling side just as it does on the engagement-tier side. The Rules of Engagement are written under your existing posture, not around it.

Question 9

Who owns downtime-procedure writing during an EHR cutover — and where do you fit in?

Accepted Answer

Ownership is joint, not single. The named FDE operator, the named client-side owner, your IT team, and your clinical informatics team write the downtime procedure together at week zero — paper order sets, manual handoff logs, the named clinical owner on the page — because no one of those four carries the full picture alone. IT names the network and integration paths that fail first; clinical informatics names what the floor has to keep running when the system is down; the embedded deployment partner names where the integration will break under failover; the named client-side owner carries the call when the procedure actually runs. It is read against the floor before cell five is signed. The procedure is not signed at a calendar date; it is signed when the named FDE operator and the named client-side owner have walked it against the floor with IT and clinical informatics present, and the four names are on the same page. We rehearse the procedure against the floor — a tabletop against the actual clinical workflow, not a slide deck of it — until cell five (go-live criteria) is signed against a run we have already executed, not against one we expect to. The vocabulary for this lives in /glossary under the downtime procedure entry — the joint accountability shape, the rehearsal-against-the-floor discipline, and the cell-five signing are defined there as their own terms. We name them so the procedure your organization runs during a cutover is the procedure the floor already rehearsed — not the one that looked correct on paper three weeks before.

Questions Threshold FDE gets in every first conversation.

Common objections, answered directly.

Send us the two-paragraph problem.
We will reply with the Rules of Engagement.