The Path to Paperless

Training Is Key in an EMR Rollout

Audit training to ensure that skills are learned.

By Peter J. Polack, M.D., F.A.C.S.

For a project as big as electronic medical records (EMR) implementation, you need commitment from the authority figures in your practice and buy-in from the entire staff. It only takes one negative person in a key position to drag everybody else down.

A senior partner may need to intervene if the practice is aware that one of the physicians is working against the team, either by commission or omission. The practice administrator shouldn't be saddled with this no-win task. And patients should be informed that the new technology will benefit them, so that they may forgive any initial bugs in the system.

Training Leads to Success

The most common cause of a failed project is the people factor. This usually boils down to poor planning and training. A well-planned training process cannot be overemphasized. The transition to electronic charting is stressful enough for everybody, and dealing with live patients is the wrong time for employees to be learning the basics of the EMR system.

Key personnel should be designated as "super-users" who will train the rest of the staff and also be "go-to" people when there is a problem. By training others, these people will become expert in running the system.

Some cross-training will be necessary, as clinical personnel will need to be familiar with the practice management system (EPM). And some front office and billing staff may need to be familiar with some basics on the EMR side, particularly if the EMR system automatically sends the encounter coding to the billing side.

One practice tasked its clinical coordinator to train the medical assistants on the EMR system to meet the launch date set by the physicians. Weekly sessions were scheduled and the coordinator felt that everything seemed to be going well.

However, when the time finally came to go live with the EMR system, it was obvious that some of the employees really didn't have a clue how to navigate the software. There were also issues with people forgetting how to print documents, not following proper log-in protocols and not properly saving entered data.

How did this happen? The training process did not include a way to audit how well-trained each staff member was prior to the big day. Simply putting people through a training regimen does not ensure that they will "get it."

We used mini-digital recorders to document actual exams dictated by physicians. After medical assistants completed the training program, they were tested on the EMR system using these recordings. The supervisor then graded their performance. A handful of techs were required to repeat the training.

Don't Let Skills Turn Stale

A lengthy gap between training and the EMR system's "go-live" date can be a problem. Those who trained early may get rusty, so be aware.

There should be plenty of opportunities for practice, preferably during the workday. The alternative would be sessions after hours or on weekends. Doctors who don't have the time to practice during the workday can access the system from home using remote desktop services. Motivation may be the biggest challenge. Remind everyone that this team effort will take the practice to a new and higher level. OM

Next: The Importance of a Simulation Day