5 important areas of EHR training during implementation

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Having gone through the requirements gathering, budgeting, and selection process, the time has come to focus on implementation. A crucial element of which is the EHR training for all users. However, training is not simply just a matter of conveying information to users; it must be conducted in a manner that takes into account an organization’s needs and strategic goals, the competency level and learning styles of trainees, as well as any other practical considerations that assist or present barriers to training.

In sum, implementation and post-implementation training should be part of an organization’s overall technology strategy since an EHR’s value to a healthcare practice depends largely on its user’s ability to make the most of the technology. Even when armed with the most sophisticated EHR, an organization that is unable to train its EHR users effectively is wasting valuable technology resources by not giving users the skills to optimally use the EHR.

The following provides a discussion of the benefits of effective EHR training and five key areas of focus for EHR training.

What is EHR training?

EHR training refers to the structured education and instruction provided to healthcare staff on how to use an Electronic Health Record (EHR) system. This training encompasses everything from system navigation, data input, and understanding features, to ensuring staff can incorporate EHR into their daily workflows. EHR training often involves hands-on exercises, tutorials, and ongoing education as updates and new features are added to the system.

Training is designed to meet the specific needs of users like clinicians, nurses and administrative staff, enabling them to efficiently perform tasks within the EHR system. This approach ensures all users are proficient in the functionalities relevant to their role.

What is EHR certification?

EHR certification refers to the certification process through which an EHR system is tested and validated to meet specific criteria established by regulatory bodies, such as the Office of the National Coordinator for Health Information Technology (ONC). Certified EHR systems ensure that healthcare organizations are using systems that meet national standards for security, interoperability, and functionality.

For healthcare providers, working with a certified EHR system is crucial for ensuring compliance with governmental regulations and for qualifying for incentive programs, such as those provided by the Centers for Medicare & Medicaid Services (CMS). Training on certified systems ensures that users can maximize the system’s capabilities while meeting legal and operational standards.

Why is EHR system training important?

Training staff for EHR is beneficial beyond simply acquiring technical competency on an EHR system. For example, research indicates that training can positively influence providers’ willingness to use EHRs effectively, and their understanding of how the system can be leveraged to improve clinical practice through the use of advanced features. Lastly, with better training, providers are more likely to be satisfied with healthcare information technology.

However, proper training is often treated as an afterthought to implementation planners, and typically organizations disregard EHR training to their own detriment. As noted in the journal, Applied Clinical Information, user training is often not treated as essential to the implementation process and thus frequently suffers from minimal institutional investment.

Other research on this topic indicates the result of this institutional neglect is that clinical users often rate their organization’s training as lacking. According to survey data taken from clinical EHR users, 43% of clinician users rated their initial EHR training as “less than adequate,” while 94.6% of respondents thought their ability to use the EMR could be improved. With the perils of neglecting training in mind, what can be done to improve EHR training?

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How much does EHR training cost?

The cost of EHR training can vary significantly depending on the size of the healthcare organization, the complexity of the EHR system and the level of customization required for different departments. Costs typically include:

  • Initial training fees: Many EHR vendors offer initial training packages as part of the system implementation cost. This can range from $1,000 to $10,000 or more, depending on the system and the number of users.
  • On-site training: On-site training with an EHR specialist can be more costly, as it requires resources like manuals, handouts and staff time to be considered.
  • Ongoing training costs: As systems evolve, additional training may be required. This could include periodic refresher courses, updates on new features, or training for new staff. These costs can add up over time, with some vendors charging a flat fee for ongoing support or hourly rates for custom training sessions.

It's important to note that inadequate training can lead to decreased efficiency and errors, which may incur even greater costs in the long term; organizations should budget for comprehensive EHR systems training to maximize their return on investment.

Having addressed some common questions about EHR training, let's explore the main areas of focus:

1. Create an EHR training timeline based on goals

As a preliminary note, EHR training is an ongoing process that should extend beyond the initial implementation phase. Therefore, one should not assume that the training timeline should end on the go-live date. As systems update new features may be added requiring users to be trained on these updates.

Further, as will be discussed below, training should be designed to give users the skills to improve their EHR competency beyond just basic skills, rather the goal should be to provide continuing enrichment opportunities for users to make the most out of their organization’s EHR. As such, healthcare organizations should establish a training timeline with milestones that are tied to goals involving users and how they should be using the EHR.  

For example, when creating a training timeline, for which you will set short and long-term goals for training completion; a short-term goal would be to have all users learn to log in to the system (and ensure access) by week one, whereas a long-term goal would be to train all patient care coordinators to input a new patient by week four. Plan to have multiple training sessions and set aside time in your schedule for training. By allowing dedicated time for training, you will achieve greater concentration from the staff.

2. Assess training needs and user’s skill levels

Assess your clinicians' current skill level and comfort with computers, especially for those moving from paper charts. Determine if your staff are computer literate or need more training. If your budget permits, provide basic computer training for clinicians less familiar with technology. Over time, even reluctant users can become proficient with an EHR system if given the chance to develop their skills under a supportive training plan.

With information about users' skill levels and needs, training should focus only on what each department or clinician needs. Training the entire staff on every aspect of the new EHR system wastes time and resources. If a physical therapist needs to document initial evaluations and a physical therapist assistant only needs to write daily notes, then only include the therapist in evaluation documentation training to save time.

Too often, practices make the mistake of training staff in areas that they won’t need to use in the foreseeable future. By focusing training on the “need to know” areas, there will be less confusion and greater attention paid to the training session. The U.S. Department of Health and Human Services advises using duty-specific training for general staff and creating more specific training modules for EHR specialists.

3. EHR training team

A training team should be a representative sample of your practice with all stakeholders involved. For example, administrative staff, clinical staff, and any other parties that can bring insight to the team regarding training needs and effective methods of assisting users learn. Among this team super users (or peer experts) should be designated to offer on-the-ground information to users and to provide further formal and informal training if needed.  

As such, it is important to designate an individual in each department that has a more comprehensive understanding of the system. This person will likely have a good practical understanding of tech and will be provided additional training. This way, your clinical staff members will have someone to reach out to in their respective departments. Identify leaders in your practice who will be called upon to mentor and train inexperienced staff.

4. Use real-time and hands-on EHR training

Allow staff to follow along with training in real-time. Each staff member should be seated with a computer to follow along with the instructing super user. Provide each clinician a “cheat sheet” or reference page as well. All instructions should be written out for later reference. By providing all instructions on a written reference page, clinicians will be able to follow along and “do” instead of “watch.” By inputting data and selecting patient records along with the instructor, they will better remember their training. Watching is too passive. Encourage action.

When it comes to EHR training; utilize the resources that your EHR system provides. Training does not stop with one, two, or even ten training sessions. Select a good EHR vendor and they will make themselves available to your users for further reference and questions even after implementation.

5. Choosing the right curriculum

Curriculum selection is simply a matter of looking at organizational goals regarding EHR use and addressing areas in which users are deficient that could prevent EHR-related goals from being attained.

Information gathering occupies an important part of curriculum design. For example, researchers at Kaiser Permanente, Mid-Atlantic States (KPMAS) conducted a study of EHR effectiveness training. The researchers indicated that the foundation of targeted EHR training is based on using several sources of information on which to design course content, these sources include:

  • Widespread support questions
  • Operational efficiency training content from the healthcare community
  • Recently added EHR enhancements
  • Survey data from expert users

Much like the discussion above, regarding targeted training, a training curriculum should be built on areas of need based on information collected from the sources mentioned above. With information collected from the listed sources, a training curriculum can be designed that addresses key areas in which users are deficient.

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Challenges in EHR training

While EHR systems offer immense potential to improve healthcare delivery, training staff to use these systems is not without its challenges. Here are some of the most common obstacles:

  • Resistance to change: Some staff may resist adopting new technology due to comfort with old systems or fear of technology.
  • Diverse skill levels: Training must account for staff members with varying levels of computer literacy. Tailoring the training to different levels of technological proficiency can be time-consuming but is crucial.
  • Time constraints: Healthcare providers are often pressed for time, making it difficult to schedule adequate training sessions without disrupting daily operations.
  • Ongoing updates: EHR systems are constantly updated, meaning training cannot be a one-time event. Continuous education is necessary to keep staff up to date with system enhancements.

By recognizing and addressing these challenges early in the implementation process, healthcare organizations can improve the overall effectiveness of their EHR software training programs.

EHR training checklist

When designing an EHR training program ensure that you include each step listed below in your plan:

  • Assemble a training team using key stakeholders 
  • Assess the amount of support the vendor will provide for training during implementation and after
  • Collect data regarding training needs 
  • Establish training goals
  • Create a training plan 
  • Create a training timeline
  • Identify superusers
  • Identify the training methods such as the method of delivery and style of instruction   
  • Establish training schedules, location and staffing
  • Refine and adjust the training program based on feedback 
  • Establish post-implementation training objectives

Conclusion

Without proper training, the EHR system will not be used to its fullest capacity. By making training an ongoing process, users can optimize their EHR use, making the most of its features and become more engaged in a practice’s mission, thus avoiding setbacks and errors, reducing employee frustration and decreasing employee turnover.

Originally written by: Amy Vant

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Jeff Green

About the author…

Jeff Green, MPH, JD works as a freelance writer and consultant in the Healthcare information Technology Space.

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Jeff Green

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