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These are payments made by an employer to a contractor which are not authorized by the contract. They are occasionally paid when a contractor has performed very much to the satisfaction of the employer but has shouldered some extra cost clearly not attributable to his own actions, such as exception- ally bad weather or some other misfortune outside his control. Only the employer can decide to make an ex-contractual payment, not the engineer or other person acting on his behalf; and the employer must himself have power to make the payment. Hence a private person or company may be able to make an ex-contractual payment; but a public. | Change Management Strategies for an EffeptiVe EMR Implementation Claire McCarthy MA Douglas Eastman PhD Contributing Editor David E. Garets FHIMSS HOSS Change Management Strategies for an Effective EMR Implementation Claire McCarthy MA Douglas Eastman PhD Contributing Editor David E. Garets FHIMSS H ÌĨ1SS HIMSS Mission To lead healthcare transformation through the effective use of health information technology. 2010 by the Healthcare Information and Management Systems Society. All rights reserved. No part of this publication may be reproduced adapted translated stored in a retrieval system or transmitted in any form or by any means electronic mechanical photocopying recording or otherwise without the prior written permission of the publisher. Printed in the U.S.A. 5 4 3 2 1 Requests for permission to reproduce any part of this work should be sent to Permissions Editor HIMSS 230 E. Ohio St. Suite 500 Chicago IL 60611-3270 cmclean@himss.org ISBN 978-0-9821070-6-5 The inclusion of an organization name product or service in this publication should not be construed as an endorsement of such organization product or service nor is the failure to include an organization name product or service to be construed as disapproval. For more information about HIMSS please visit .