Training providers: beyond the basics of electronic health records

Abstract

BackgroundTraining is a critical part of health information technology implementations, but little emphasis is placed on post-implementation training to support day-to-day activities. The goal of this study was to evaluate the impact of post-implementation training on key electronic health record activities.MethodsBased on feedback from providers and requests for technical support, we developed two classes designed to improve providers’ effectiveness with the electronic health record. Training took place at Kaiser Permanente, Mid-Atlantic States. The classes focused on managing patient-level information using problem lists and medication lists, as well as efficient documentation and chart review. Both classes used the blended learning method, integrating concrete scenarios, hands-on exercises and take-home materials to reinforce class concepts. To evaluate training effectiveness, we used a case–control study with a 1:4 match on pre-training performance. We measured the usage rate of two key electronic health record functions (problem list and medication list management) for six months before and after training. Change scores were compared using the Wilcoxon sign rank test.Results36 participants and 144 non-participants were included in the training evaluation. Training participants were more likely to manage both medication lists and problem lists after training. Class material is now being incorporated into an enterprise-wide multi-modal training program available to all providers at Kaiser Permanente in the Mid-Atlantic States.ConclusionsOngoing information technology training is well-received by healthcare providers, who expressed a clear preference for additional training. Training improved use of two important electronic health record features that are included as part of the Meaningful Use criteria.

Successful Physician Training Program for Large Scale EMR Implementation

“…Physician training is an essential element of EMR actualization; however, there are few concrete recommendations in the literature regarding the development of such a program [3,6,[8][9][10][11][12][13]. At Stanford Children's Health, an EMR training program for physicians was developed and implemented prior to a large scale EMR implementation which was considered successful based upon learner evaluation data and feedback from departmental and institutional leadership.…”

“…Physician training is an essential element of EMR actualization; however, there are few concrete recommendations in the literature regarding the development of such a program [3,6,[8][9][10][11][12][13]…”

“…Rockswold et al, found that 43% of clinician users rated initial training as "less than adequate, " 94.6% of respondents thought their ability to use the EMR could be improved, and the authors called for the closer study of both training content and delivery [8]. A review of the literature reveals general training strategies for all employees [9], recommendations for nursing populations [10], post-implementation training [11], training within the broader context of a successful EMR implementation [3,6,12,13], and training as a barrier to EMR adoption [14,15]. To our knowledge, this is the first manuscript to describe the focused development and implementation of a successful physician training program in preparation for a large scale EMR implementation.…”

Effect of implementation of a coded problem list entry subsystem

“…Post-implementation training is essential and is a critical part of health information technology implementation [27]. We observed no dedicated training courses for the CPLES and arranged several promotional meetings and invited physicians through emails and text messages; attendance was not mandatory.…”

Information and Communication Technology to Facilitate Learning for Students in the Health Professions: Current Uses, Gaps and Future Directions

“…However, despite the potential benefits of EMRs, healthcare providers have been slow to incorporate this technology into clinical practice (Buntin et al, 2011;Ludwick & Doucette, 2009). Lack of technological skills among clinicians is often cited as a barrier to its use (Boonstra & Broekhuis, 2010;Bredfeldt, Awad, Joseph, & Snyder, 2013). Additionally, few health professional programs provide didactic training on EMRs in the curriculum (Borycki, Griffith, Reid, Kushniruk, & Kuo, 2013;Flood, Gasiewicz, & Delpier, 2010), which further perpetuates the "competency gap".…”