Computer Consult: Staff, this is a computer

December 4, 2000

It takes a systematic plan to train staffers to use the computer. The first step is to reckon with their phobia.


Computer Consult

Staff, this is a computer

It takes a systematic plan to train staffers to use the computer. The first step is to reckon with their phobia.


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By Rosemarie Nelson


Learning to use a computer and learning to throw hand grenades are two different things. Only one of them can kill you.

However, you couldn't have convinced my mother of this difference when her employer asked her to exchange her typewriter for a keyboard and monitor several years ago. "I don't think I can learn this," she told me. "I'm going to look so stupid. I'll probably have to quit my job."

That's the kind of fear a box of silicon chips and wires can inspire in a computer illiterate. Though my mother is a receptionist, secretary, and transcriptionist at a small law office, she voiced the same concerns that I've encountered in dozens of physician practices in my work as a computer consultant.

In view of widespread computerphobia, you can't take a casual attitude toward training staff to use a new practice management or electronic medical record (EMR) system. Medical practices need a careful plan to shepherd people like my mother into the world of cursors, directories, databases, URLs, and attached files. To proceed without such a plan is to court disaster. You can perform a thorough market analysis to find the perfect office-information system, but if your staffers are daunted by the challenge of learning it, you've wasted a lot of time and money.

So send your staff to computer boot camp and have them learn the motto "The mouse is my friend." Encourage them to take baby steps toward computer competence. Here's a successful ice-breaking technique: Install an old PC—maybe the one that you're replacing with a newer, faster machine—in the office lunchroom and invite everyone to play computer solitaire. If nothing else, this will help them develop mousing skills.

Mousing may be second nature to you, but remember the first time you laid your hand on the mouse and awkwardly moved it around to direct the cursor's movement on the screen? And remember how tough it was to double-click at just the right speed so you could activate a function or an icon? It took my mother several sessions to get the hang of the double-click.

Once you've got employees into computer solitaire, it's time to introduce them to a more serious set of basic skills:

Computer hardware. How to turn the computer on and off. Understanding the difference between the hard drive, the floppy drive, and the CD-ROM drive.

Windows operating system. How to open, shrink, move, and close a window. How to work with a pull-down menu. How to open and close an application.

Word processing. How to create, save, and retrieve a document. How to cut and paste text. How to format text with boldfacing, spacing, etc.

The Internet. How to send e-mail, use a search engine, and bookmark a Web site.

Maybe you're asking yourself, "Do I have the time, patience, or expertise to teach these skills?" The likely answer is No. So hire out the training.

There's no shortage of teachers and courses. You can find computer classes at community colleges, computer stores such as CompUSA, and companies that specialize in computer training. The Yellow Pages are crawling with training companies, but if you need further help, visit the Web site of the Independent Computer Consultants Association based in St. Louis ( You can search the site for a trainer near you.

Expect to pay $300 to $1,000 per student, depending on the subject matter and the number of sessions or total hours. Make sure the program provides a PC workstation for each participant, and enough instructors so that every student receives individual attention. You can't just give staffers a manual and expect them to learn on their own.

Computer-training companies also can conduct classes at your office. It can be very comforting for staffers to learn to use the PC on their home turf, especially on the exact PC they'll be using daily. But be sure to schedule training when the office is closed—never while patients are present. You can't expect staff to learn the ABCs of computers while they're walking people to exam rooms, answering phones, and posting charges. Patient care and computer education are mutually distracting, and both will suffer in the process.

Whether you send your employees to a class or bring a trainer on site, do some homework beforehand. Make sure the teachers have the right credentials. One credential is certification from the software company, vouching that the person has mastered its programs. Microsoft, for example, offers eight different programs leading to certification as a Microsoft Certified Professional. One is a program for instructors called Microsoft Certified Trainer. Generic certification for computer instructors is awarded by the International Association of Information Technology Trainers ( and The Chauncey Group International (, a subsidiary of Educational Testing Service in Princeton, NJ.

Of course, credentials are no guarantee of effective teaching. So ask for references. Would former clients hire that trainer again?

Also preview the trainer's curriculum to ensure that it's on the appropriate level for your staff. A nervous novice doesn't belong in an advanced class.

The author is a computer consultant in Syracuse, NY.

Bits and Bytes

Edited by Robert Lowes

• These Web sites help you swallow the HIPAA-potamus. Like Y2K, the Health Insurance Portability and Accountability Act of 1996 is another big, fat, scary monster of a topic. This federal law requires—on pain of hefty fines and jail time—that physicians and other health care players keep patient information in electronic form safe and confidential. (More on this in next issue's cover story.)

So what does it take to obey HIPAA? Several Web sites simplify HIPAA things for the bewildered. One is the proverbial horse's mouth—a site maintained by the US Department of Health and Human Services ( ). Here you'll find a tentative timetable for publishing the final rules, HHS press releases, and answers to frequently asked questions. Likewise, the Healthcare Information and Management Systems Society ( has compiled a treasure trove of FAQs, articles, action plans, and links on a section of its Web site called HIPAASource.

• An online snapshot of your community's health. You're a new internist in Cape Girardeau, MO, and for the third time in the same day, you've diagnosed a patient with coronary heart disease. Is this a fluke or an indication your patients are eating too much fried chicken?

You can answer that question by visiting a free Web site called Community Health Status Indicators Project ( ), a project of HHS. Type in "Cape Girardeau County," and up pops a medical profile revealing that the county death rate from heart disease is 17 percent higher than it is for the entire nation.

Other data includes average life expectancy, the actual and expected number of infectious disease cases, the rate of premature births, and the rate of health insurance coverage. The Web site charts every county in the nation, and compares them not only with the rest of the country, but also with counties with roughly the same population and demographics.


Rosemarie Nelson. Computer Consult: Staff, this is a computer. Medical Economics 2000;23:27.