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It took about six months to train the physicians
and staff for EHR implementation at ophthalmologist Peter Polack's practice in Ocala, Fla.
It also took about a year of planning and preparation prior to training.
"A lot of people were asking why it was taking us so long," says
Polack, who was writing about the process in an ophthalmology magazine at the
time. "It's because that was our intention."
In total, all 11 physicians and 50 clinical staff
members at the five-site practice learned to master the EHR. The success, he
says, is due to the fact that they took their time with the process and formed
a solid training plan. "If you don't have the right plan in place, if you
don't have everybody involved, if you don't have buy-in from the stakeholders
in the project, then you're going to fail," says Polack. "It's not
like any other thing that you're going to do, so don't treat it that way."
Practices like Polack's that successfully
implement EHRs know that adequate preparation and proper training is key.
Here's how to launch a successful EHR transition at your practice.
- Get a head start
Proper preparation for EHR training begins as
soon as you identify which system you will be using at your practice, says
orthopedic surgeon Eric Fishman, president and CEO of speech recognition
software distributor 1450, Inc., and managing member of EHR Scope, LLC, which
provides health IT consulting services to physicians. Immediately tell all
staff members what system you will be using and when you plan to implement it,
says Fishman, who is based in Palm
Beach Gardens, Fla.
Then, direct them to the EHR vendor's website to watch available videos and
demos and learn more about the system. "There's a lot to be learned and
it's impossible to learn all of it in a short period of time for most
employees," he says. "Getting a head start is beneficial."
It's also a good idea at the start of the process
to identify which staff members will play key roles in the planning and
training process, says Polack. One is a "physician champion" who will
motivate the other physicians. "If all the other doctors are supportive of
this one doctor, then that creates a trickle-down effect as far as the attitude
of the whole practice," he says.
Also, identify a staff member on the clinical
side to "oversee" the training process. This individual should
"work in concert with someone on the technical side of things — unless you
have someone on the clinical side that has very good technical skills,"
says Polack.
- Form a strategy
You also must determine what type of training to
provide your physicians and staff. Depending on your vendor and your practice's
budget, there will be various options available — from intensive one-on-one
training with a vendor trainer to training that is solely Web-based. Of course,
the more one-on-one vendor training your practice uses, the pricier the process
gets.
Adina Friedman, medical marketing director for
CTS Medical Software Selection Guides, a Rockville, Md.-based company that
provides advice, reviews, and ratings of software, including EHRs, suggests
looking for a mix between in-person training and Web-based training.
A smart option is to identify one staff member
(or a few staff members if your practice is larger or if it is a multi-site
practice) to receive vendor training, says Polack. Once this staff member —
often known as the "super user" — is trained, he can assist with
training the rest of the staff, and he can answer any simple questions that
arise.
Prior to training staff members, it's crucial
that the super user has a firm understanding of the EHR, says Fishman. As the
super user learns to use it, he may realize that the system needs to be
modified to fit your practice's needs. The super user can then arrange for the
necessary modifications to be made early on in the process. That way, staff
members "only have to learn [the EHR] once, in the way that it will
actually be implemented," says Fishman.
The super user doesn't necessarily need to be a
physician or administrator, but he should be a motivated tech-savvy employee
who has some management experience, says Friedman.
- Assess needs
Prior to training employees on the EHR, you must
test their basic computer skills, says Polack, noting that abilities tend to
vary widely among staff. At his practice, for instance, some of the older
employees were unfamiliar with using a mouse and drop-down menus. "These
are things that a lot of us that use computers know — and almost feel like we
know intuitively — but you can't take those things for granted," he says.
Some of the "crucial" skills to measure
are an employee's comfort level with using Windows, using a mouse, printing,
scanning, and logging on and off a computer, says Suzanne Houck, president and
CEO of Houck & Associates, a healthcare consulting firm in Boulder, Colo.
If employees need a skills boost, the super user or another tech-savvy employee
should conduct basic training, she says. "It becomes very expensive if
you're trying to get people up to speed and blend that in with your EHR
training."
Before training on the system begins, also assess
the current high-volume work flow areas at your practice, says Houck. She
suggests putting a flip chart in a staff area and writing down key work flow
items, such as making referrals, ordering labs, and rooming patients. Then, ask
staff to write down their responsibilities related to each item. Next, decide
how, when, and who will complete these tasks in the EHR. "Planning upfront
is really crucial in terms of mapping processes and deciding if you want to
change them and optimize them," says Houck. Of course, a work flow assessment
will also help you decide which staff members will be trained on what tasks.
- Learn and explore
The actual training method you use will vary, of
course, depending on the technique and type of trainer your practice has
chosen. Regardless, staff members need to be trained on each of the modules of
the EHR that match up to their responsibilities, says Houck. They also need
some time to play and test the system on their own, then return to the module
to reinforce what they are learning. At Polack's practice, for instance, he
placed computers in a spare room so that staff could be trained there, and
later during downtime, explore the system on their own.
Even if an employee will not be frequently using
the EHR, there are some core things everyone needs to learn, says Houck, such
as how to log on and log off the system. They also need to understand where the
EHR and the practice-management system interface with each other, says
Friedman. "Everyone has to have the big picture view and then it has to
split off into function."
The duration of the training process will vary
depending on your EHR and your practice, says Houck. "There are some
really easy systems that people can learn in a day, and then there's some that
take weeks, literally." When determining how much time to allocate to
training, Houck recommends asking a practice similar to yours that has already
implemented an EHR.
- Test and assess
Just prior to your go-live date, the super user,
or whoever has trained each employee, should assess trained employees' new
skills, says Polack. That way you know who is ready for implementation and who
needs a training refresher.
Then, top off training with a full-staff practice
session as close to the go-live date as possible. At Polack's practice, all
employees came into work the weekend before the system went live for a
"simulation Saturday." Those who would not be frequently using the
EHR posed as new and established patients, while those who would be using it
more heavily moved the "patients" through mock visits using the system.
It's a great way to "identify any problems with work flow and any
technical glitches," says Polack. "You're always going to uncover
something and that's the time to discover it — not on your go-live date."
source from physicians practice
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