HIMSS: Training key EHR implementation concern, study finds

Sixty-four percent of healthcare professionals believe that achieving full end-user adoption of an electronic health record (EHR) system is a roadblock to successful implementation, finds a joint survey conducted by TEKsystems Healthcare Services and HIMSS Analytics.

The survey was designed to provide insights into the status of EHR implementations, the challenges healthcare organizations face, and areas for improvement. TEKsystems and HIMSS Analytics surveyed 300 single and multi-hospital organizations and health professionals throughout the United States.

“Achieving meaningful use and truly improving the quality of patient care can only happen if end users fully adopt a new EHR system in an acceptable timeframe,” says Allen Kriete, TEKsystems vice president of healthcare services. "Organizations expect their people to adapt quickly, yet many do not plan for end user training until late in the effort."

Developing a training strategy up front training would allow for key competencies and performance indicators to be identified, he adds. "As organizations transition from implementation to day-to-day operations, any deficiencies in the ability to meet the targets can be pinpointed to either a specific user group, department, or globally as indicated by analytics and aligning remediation accordingly. Developing an effective adoption strategy is a critical step that needs to be detailed earlier in the process and carried throughout the life of the initiative. That includes finding the appropriate resources necessary for building, integrating, and conducting the training.”

Other survey findings:

According to more than three-quarters of healthcare professionals, results of poor EHR training implementation include rework (85%), lack of applicability to real-world scenarios (84%), low levels of user adoption (84%), long learning curves (82%) and inability to leverage the system for meaningful use (77%). 

• 66% of respondents cite the challenge of finding the right workers with the right skills for the implementation.

• More than half struggle with finding the right people to build a training program (57%) or lead the classroom discussions (53%).

“The importance of effective training cannot be overlooked. To avoid these outcomes, organizations must proactively build a customized training program that is led by educators with clinical and technical EHR experience. The training cannot simply be ‘off-the-shelf.’ It should align with the overall organizational goals, workflows, technical requirements, and end-user job roles” Kriete says. “One method for ensuring a training program is effective and builds confidence within an organization is to engage end users, those using the system on a day-to-day basis, in the development of the curriculum.”  

Von Baker, TEKsystems healthcare practice director, says: “In addition to leveraging end users in this process, efforts should be taken to combine synchronous and asynchronous learning methods to foster a learning environment that meets the needs of the adult learner and their hectic schedules and a learning environment that is not bound by space or time."

• Overall, less than half of clinical end-user stakeholders are deemed completely engaged in the program; even the trainers for the new system are not fully engaged, with only 59% reporting their trainers are completely engaged in the process. 

“This study shows the majority of executives and decision-makers are engaged in the implementation process, but unfortunately, this is not the case with end users. Giving end users the opportunity to provide feedback during the development of and during the training boosts their sense of ownership and increases their confidence in the system post-implementation,” Baker says. 

• More than 50% of healthcare organizations anticipate end users will need more than 6 months to adapt to the new system. 

“The work does not stop once the implementation is complete," Baker says. "Providing post go-live support is critical to ensure the end users fully adopt the system. Best practice is to create performance support tools for end users to have ready access to how-to reference guides when the needs arise-self service. The right blend of performance support tools depends on the organizations culture, internal drivers (varied workflows, varied specialties, and geographically dispersed facilities, and available technology. Underestimating the amount and degree of post go-live support can cause a decrease in productivity and performance and increase end-user frustration."

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