This last step is based on the evaluation of what has been learned from the training and daily use of the system. It confirms the continuous evaluation of applications, objectives and needs and existing requirements in the electronic medical record implementation to further improve the workflow.
There are different issues that can strengthen the evaluation, we mention a few:

• What are the similarities between the needs and objectives in the evaluation and improvement of efficiency?
  
• Does the workflow process require re-evaluation?
  
• Does the training need additions that help improve efficiency?
  
• Had we done a good training on the theoretical and practical side to help doctors make correct medical decisions?
  
• Had we done a good training on the theoretical and practical side to help doctors make correct medical decisions?
  
• The roles and responsibilities of personnel they require changes to raise the quality of performance?
  
• Is technology in different services suitable?
  
• How one can rely on this technology?
  
• Is this technology fast and efficient to medical confidentiality work and great pressure?
  

There is another evaluation of the implementation of the electronic medical record that will contribute the training of the practice and its evolution. Often what happens in the implementation phase is different from what was planned, hence the practice needs to be reviewed regularly to ensure proper operation and meet patients and staff.