Today I got the following message (actually on Facebook) from a previous colleague of mine. When I worked with her she was an RN, but she just finished her education to become an APN and found a job at a local well known medical provider. Here’e her message to me after starting the job (specific names removed):
Help! I need to learn [Jabba the Hutt EMR’s] charting system;-( No bueno… Mucho hard!! I like [previous job’s] EMR so much better!!
Excuse the spanglish and almost text message style feel to the message. In fact, I wouldn’t be surprised if she sent me that Facebook message from her phone. Yes, our methods of communicating are changing.
I was pretty taken a back by her message actually. Not because I haven’t heard complaints about this Jabba the Hutt EMR system (Definition of Jabba the Hutt EMR Vendors: Good in their day, but have gotten so big and bulky that they’re barely functional) before. I actually had heard similar stories, but I just didn’t expect it from her. She was always very good at computers and doing what she needed to do with the EMR when I worked with her. Plus, she’d already used a couple different EMR in her career.
I will discount part of her reaction as the knee jerk response to a new job, a new company, APN instead of RN and a new EMR software. That’s a pretty steep learning curve for anyone.
The challenge this comment provides however is how do clinics train new doctors on their EMR. In my opinion, the real problem for my friend isn’t like the EMR software, but is instead the training that she received on the EMR software. Properly trained, I’m sure she’d like using the EMR software a lot more than she just expressed.
Training new staff on the EMR is a challenge and vitally important. I was in charge of training the new staff at my previous work. I trained everyone from medical records staff to Lab Tech’s to MA’s to RN’s to APN’s to PA’s to MD’s and DO’s. I trained general medicine providers, dietitians, GYN’s, dermatologists, and a few other specialists. That’s a wide variety of people to train, but overall we did a pretty good job with most. Outside of our initial implementation where the whole staff was trained, I probably trained 50 different people. Let’s just say that people definitely learn at different paces.
About 2 minutes into the training I could tell you how good (or bad) the training was going to go. I could train a provider on our EMR system in about 45 minutes to an hour to the point that they’d feel comfortable doing their job. Certainly there were some intricacies to looking up various codes and charges, but generally they knew what they were doing after an hour. The worst case scenarios usually ended up needing about 2 hours of training where I had a little more time to let them flounder through the charting process themselves on our test install so that they could really learn in a low pressure environment.
In our case, we had a contract with an outside company where they were always swapping out providers. Luckily our nursing staff was very consistent and could assist the new providers as various questions popped up.
To be honest, I think this system of training worked pretty well. One of the keys to our success was that we had a well defined process for using the EMR. So, a technical person like myself could easily train a clinical provider. Plus, I was deliberate in only showing them the easiest route to chart (at first) even though there was almost always 3-4 ways to do something. I learned this lesson the hard way. Far too many people get confused when you train them on 3 ways to do the same thing.
My favorite story about training a doctor though was when a doctor was ill and so a replacement doctor was provided from the company we partnered with. Turns out the new doctor they sent was pretty tech savvy and confident (not to be confused with arrogant). We looked at the clock and realized him and I would only have 5-10 minutes to train him on the EMR system. This was far from ideal, but you make the most of whatever situations come. So, I cranked through the most important features and processes. Then, I wished him good luck! He had a great day with no issues. Of course, as I said above, we had a nursing staff that could assist him as needed as well.
Moral to the Story: As a clinic it’s important to have a way to train new staff on your EMR.
Training staff for your initial implementation is important, but it’s critical to have a solution to the learner’s often-asked question: “Where do I go for help after training?” Dropping the ball here will cause heartache and system mis-use.
[…] note: If you don’t read my other site EMR and EHR, go check out this post I just did about EMR training. I think you’ll really enjoy it. While you’re at it, go and like the EMR and HIPAA […]
Good point Tony. As I said in the post, the nurses ended up being a great source of where to turn for new EMR users since most of the nursing staff had been there since the beginning. Plus, the nurses knew who to turn to after that. So, they would come track me (or whoever was appropriate) down for the provider. It worked quite well.
Sounds like you had a great training program, John. Did you do any eLearning? How do you communicate changes and optimization training?
Tony,
Thanks. I think it went pretty well.
Our EMR vendor provided some e-learning, but I found it pretty useless. The problem was that they showed every feature under the sun. For example, they had this great scheduling search feature. In this instance, we only did same day scheduling. So, having our users learn about this search feature would have just confused them. So, we didn’t do that much eLearning.
Changes and optimization are interesting. I think I posted about this before, but I’m too lazy to go find it right now.
Changes I would pour over and identify anything that would effect our clinic. Then, I’d review those with the staff so 1. they’d be aware of the changes and 2. make any decisions that needed to be made based on the changes (ie. are we going to use this feature or not). The initial review part was the hard part. Since you had to know what would and wouldn’t effect the clinic. We’d also table certain new features to implement later since we could turn them off after the upgrade and then roll them out on our time frame.
Optimization was an ongoing thing. For example, someone would say that we hated how XYZ was working. So, we’d sit down and talk about all the options (usually after getting feedback from the EMR vendor). Half or more of the time those discussions led to feature requests for our EMR vendor. The rest would lead to some change to our process and use of the EMR.