My concept for building a successful physician EHR satisfaction program is similar to building a house. Once a strong foundation represented by a complete and constantly evolving EHR system, along with its associated technologies, is in place, it’s time to consider the structure that will take shape. This structure consists of three pillars, the first of which is training.
A complete EHR training program consists of a minimum of three key components:
- Onboarding Training: Training of users new to the organization
- Ongoing Training: Maintenance training done at least once a year to keep users up to date on EHR, workflow and policy changes
- Field Support: Just-in-time training for when issues arise at the point of care
Onboarding training should be customized as much as possible to the needs of the individual EHR user in both content and duration. It should assess their prior knowledge of both the EHR and of the organization. Then, train to the learner’s knowledge gaps. Most organizations are shifting to virtual training environments that can adapt as the learner moves through the session. The closer organizations stay to the Epic Foundation build, the better they will be able to take advantage of Epic-provided virtual training courses. This adaptation can also be made by a skilled trainer in-person, but is difficult in large group sessions. While large sessions may be efficient for the training team, they tend to be inefficient for advanced learners. Onboarding should address both the standard functionality of the EHR that is appropriate for the learner and the workflows, content and locations unique to the organization.
Ongoing training should be both time and need-based. Time-based training should keep the end-user up to date with EHR changes and upgrades, workflow changes and changes to organizational or governmental policies.This type of training can be accomplished through various means such as tip sheets, virtual training, newsletters, departmental or other regular meetings and scheduled personal sessions. The modality chosen should fit the magnitude of the change. Need-based training can be both on-demand or identified through observation or analytics. This type of training is typically done one-on-one via a trainer or superuser, via a link to training on a user dashboard or sent directly to the individual. It is estimated that each provider should get about four hours of ongoing training annually via a combination of these methods to maximize their efficiency with the EHR.
Provider Field Support
Field support is critical to any training program. Providers are busy, and when a training issue arises, it is often in a time-critical clinical setting and far too complicated for the typical help desk. To this end, I recommend routing all provider help desk calls that are not password resets directly to a dedicated provider field support team. The field support team can be made up of provider superusers or dedicated trainers knowledgeable in both clinical workflows and provider EHR content. The field support team can also round with providers to observe workflows and train on the fly. This team should attend regularly scheduled physician meetings to deliver brief training sessions or observe and answer questions. The recommended ratio of this team to providers is between an optimal 1:100 to a minimum of 1:250, as found in research by myself and by the KLAS Arch Collaborative.
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About the Author
Dr. Brian Patty joined Medix Technology as Chief Medical Informatics Officer in 2020. As one of the nation’s first CMIOs, he brings more than 40 years of medical and clinical informatics experience to the team. Dr. Patty partners with our clients at all stages of their Epic journey, from implementation to optimization. His areas of expertise include improving clinical workflows, simplifying EHR processes to improve end user satisfaction, reducing burnout and costly turnover, and maximizing technological investments.