One of the most important things that a practice can do is provide for adequate staff training on a new EHR system. Here are four steps for success.
Selecting and implementing an EHR is not a sprint - it just won't happen overnight. If your practice understands that concept, it will be better prepared to set realistic goals and timelines for getting staff up to speed on its new system. One area that typically receives short shrift is staff training and education on new technology systems.
Practice management consultant Elizabeth Woodcock said it is frustrating to her when she is asked to assist with an EHR implementation involving a system she knows is good, but the physician "hates it." "And part of it is because of that initial implementation," she said. Rather than work to undo staff resistance to a new system, it is far better to build in adequate time for staff training to nurture a positive outlook. Here are four ways to start that process:
1. Dedicate time for training.
One of the most important things a practice can do is to commit dedicated time for training, separate from patient care. It's impractical to think that physicians and staff can keep up a busy schedule while learning a new system on the fly. Not only will it slow down work flow, but it can add to staff frustration and even resistance to the new system. Tom Giannulli, chief medical information officer for Kareo, an EHR vendor, said the best way to start is slowly.
"Dedicate time to learn the EHR system and practice your daily routines as part of your training. Do not make the mistake of trying to learn the system when you are seeing patients or when you can be easily distracted," he said. "Like any other tool, the more skilled you are with the tool, the more value you can receive from its use."
2. Designate a super user.
Most practices do not have onsite tech support, and even if they are part of a large integrated health system that has an in-house IT department, asking for help usually entails waiting. That's why it's vital to identify a staff member who is either experienced with EHR systems or has the desire to learn.
Saroj Misra, an osteopathic physician based in Warren, Mich., acknowledges that continuous EHR training can drain away time from patient care, but he recommends committing a few hours each week for a single physician or staff member to learn the EHR. "Now that's a pretty significant time commitment. But then that person becomes a liaison or a de facto liaison to the EHR vendor … and also a person who can educate and provide ongoing education for the physicians and the office staff," he said.
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3. Retrain on a recurring basis.
Misra said the number one misstep in the path to EHR adoption is inadequate training. During implementation, the EHR vendor will send a technician to the practice to conduct initial training. However, because of limited time and financial pressures, Misra said the vendor usually underestimates the time needed to do a good job.
Another problem, according to Misra, is not arranging for additional training on a recurring basis. He said the difference between a "power user" and a physician who just wants to get through her day using the EHR is that the former is always learning new functionality.
The solution is to train first and then train again. Find out what your EHR system can do, and then over time, find out what you want it to do, said Misra. "[Physicians] get their head so down in the trenches doing the work, that they never bother to ask, 'What more can my EHR do? What more should my EHR do? And who do I relay that information to?'"
4. Develop customized training.
Osteopathic physician Marissa Rogers is program director for a Michigan-based residency program that has 46 providers, which is part of an even larger, multi-state health system. She said that because she had previous experience implementing an EHR in private practice, she was nominated to be the physician lead on her current EHR system.
One thing that has helped her clinic quite a bit, said Rogers, is the biennial chart audit done by the health system to find areas where providers are missing patient documentation. The health system gives providers positive and negative feedback on the results of the audit; it has developed online provider education designed around audit deficiencies. "As they audit physicians, they figure out where the common problems are," she said. "And do a little [online] education … they just input a little PowerPoint presentation with a quiz at the end."
Erica Spreyis associate editor at Medical Economics. She may be reached at firstname.lastname@example.org.