3 steps to EHR training for new staff members

A practical look at information technology issues and usage

By — Posted April 30, 2012.

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Physician practices generally have a detailed training map that is laid out for all its doctors and staff as they implement an electronic health record system. But practices can’t lose the map once the system is up and running.

At some point, new physicians and employees will join the practice, and they will need the same level of system training everyone else received. “Organizations that are successful & have been careful not to shortchange their new employees,” said Jerrilyn Cowper, solutions manager for CTG Health Solutions, a health care technology consulting firm.

Small organizations don’t have the luxury — or the need — for full-time trainers like large organizations have. Therefore, the job will fall to either practice managers or “super users” within the practice. Super users — employees who generally have more extensive training than others and get others excited about the new system — are generally identified at the implementation stage.

Though that covers who will train the new physician or employee, it doesn’t address how the training will take place. Strategies usually involve three key stages.

Learning the basics. This is the period of time, generally within the first day on the job, when new employees learn what the system looks like, where they go to accomplish certain tasks and what kind of functionality the system has to offer, said Rishi Agrawal, MD, MPH, a pediatric hospitalist at La Rabida Children’s Hospital in Chicago.

Raquel Garcia de Acosta, office manager for Morris Sussex Family Practice in Lake Hopatcong, N.J., said one thing to emphasize in the first few days is an understanding of what tasks are accomplished on the EHR and what tasks are not.

Shortly after the Morris Sussex Family Practice adopted its first EHR, a medical student arrived for an externship. Garcia de Acosta said that experience helped the practice learn what strategies would work best the next time a new doctor or staff member joined the practice. For example, she said training should emphasize early on the practice’s style of performing tasks, such as documentation of visits and writing clinical notes. Not only will new staff be given sample physician notes, but they also should be trained on how to maneuver through the system and find certain data sets before they ever step into an exam room.

“I don’t think there’s anything more frustrating than wanting to talk to a patient who has come in to view their labs and you don’t have their labs available because you don’t know how to access them,” Garcia de Costa said. “Rather than having that happen in the room, I would definitely want to make sure my practitioner — whether it be a medical assistant, nurse practitioner or physician — was really comfortable with the software before they go in and start using it.”

Two-way shadowing during patient encounters. CTG’s Cowper said she recommends that a new employee follow someone else for at least a day. That helps the person get a feel of how the EHR fits within the practice workflow.

After shadowing, Cowper said the roles should be reversed. The trainer should look for potential problems and point out shortcuts and tips the new employee may find helpful. How much time is spent on each step should be determined on a case-by-case basis.

Flying solo. Garcia de Acosta believes most new clinicians should be prepared to go it alone on the system after no more than a week of training. But organizations should make sure they have adequate support.

It’s important to have as many super users as possible surrounding the new employee once they go solo, Dr. Agrawal said.

Training requires a lot of time, not just on the new employees’ part, but on the trainers’ part, as well. One thing practices need to consider is how the training period will impact the trainers’ ability to get their own jobs done while they focus on the new employee.

“It’s hard for small practices to absorb that workload,” Cowper said.

If the trainer is an administrative staff member, some practices rely on temps to fill in. If they are from the clinical staff, it might make sense to bring in a contract nurse, or a locum tenens for a week or so, depending on how the training will affect productivity. The decision may come down to reduced revenue due to loss of productivity versus the price of temporary help.

Intense training generally takes less than a week, Cowper said. Many vendors also offer online resources such as webinars that address specific problems or real-time technical support.

Whatever curriculum the practice uses, Cowper advises that it be kept current. There are always updates to software. The training material needs to be updated regularly to reflect the latest versions of the software and the newest functionalities.

A practice that invests the proper time and resources into training new employees will be stronger because of the effort.

“Training & is truly the vein of success for any organization when implementing a new EHR,” Cowper said.

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