4 Training Strategies for Physicians

Section 4.17 Implement

Section 4 Implement—Training Strategies for Physicians - 1

Training Strategies for Physicians

Training physicians to use electronic health records (EHR) and other health information technology (HIT) requires attention to personal preferences and issues associated with infrequent use.

Time needed: 8 hours
Suggested prior tools: 1.6 EHR and HIE Beliefs Assessment, 4.16 Training Plan

How to Use

The more engaged stakeholders are in the process of selection and implementation, the more likely you are to have well-positioned users ready to accept training and able to navigate reasonably intuitive systems on their own. Use the following tips for physician documentation training.

In general, physicians prefer minimum training and maximum personal coaching. While time consuming for trainers and other staff members, providing physicians with one-on-one support to learn to use the system pays huge dividends. Even if some classroom or online training is provided, one-on-one support in the early days of go-live is essential.

Train on actual screens and workflows. If temporary workflows have to be introduced because you are waiting for a system upgrade or interface, or because of another issue, it is very likely that the temporary workflow workaround will become permanent. It is a matter of how much change can be learned within a short period of time. It is better to delay implementation than to train and have to retrain shortly thereafter.

Use other physicians as coaches, if not also as trainers, if at all possible. Not only does this demonstrate that physicians can do this, but reduces potential embarrassment for those who feel they lack skills or abilities. There is also some peer pressure built in to this approach that encourages greater adoption.

Address new users who may just be out of training or who have never used an EHR.

· New providers are generally younger and will have more computer experience. Also, they may have been exposed to computerized physician order entry (CPOE) and other clinical automation where they trained. If physicians rotated through a Veterans Administration (VA) hospital, they will have used its EHR. However, they may believe that because they have used one system they will know how to use another. This may not be true and can be a source of frustration for them. It can also be a source of frustration if your system has less or different functionality.

· Users who are new to EHR and other HIT will require much more training, including basic computer skills. A good plan is to have a competency requirement for all users, no matter who they are. In addition, experienced users may find that your systems are very different than what they have previously used—with more or less functionality. This also can be a source of frustration for them, so you will need to set appropriate expectations.

Address special needs of infrequent users. Nursing homes may have a relatively stable group of physicians who admit residents, but there is a potential for a fairly significant amount of turnover in the admitting group, depending on the community. Whatever is applicable in your environment, there will always be the need to train and reinforce training that is forgotten by casual or new admitters. Because casual users use the system infrequently, they cannot be expected to remember all of the functions. Furthermore, they may rotate among a variety of facilities, each with different systems, and have an especially difficult time remembering how each works.

Create “cheat sheets” that walk users through the typical process they are expected to perform. This can be beneficial for all users – frequent and infrequent. Designate a staff member who can be ready to assist physicians at any time. It is not acceptable for them to not use the system, however, because of the risk of unintended consequences.

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