Once the initial patient engagement strategy is implemented, it is time to plan for next steps. Optimizing patient engagement technologies requires building on initial successes and depends on the growth in adoption by providers and patients. There are many technologies which can be added to many patient engagement technologies (i.e., add-ons), such as additional features in a patient portal. After the go-live, it is important to monitor the systems, upgrades and patches in order to minimize downtime and maximize success. Many aspects of workflow and usability can be enhanced as well. Finally, the change management and governance process overlays every aspect of the technology.