Successful Physician Training Program for Large Scale EMR Implementation

Abstract

SummaryEnd-user training is an essential element of electronic medical record (EMR) implementation and frequently suffers from minimal institutional investment. In addition, discussion of successful EMR training programs for physicians is limited in the literature. The authors describe a successful physician-training program at Stanford Children's Health as part of a large scale EMR implementation. Evaluations of classroom training, obtained at the conclusion of each class, revealed high physician satisfaction with the program. Free-text comments from learners focused on duration and timing of training, the learning environment, quality of the instructors, and specificity of training to their role or department. Based upon participant feedback and institutional experience, best practice recommendations, including physician engagement, curricular design, and assessment of proficiency and recognition, are suggested for future provider EMR training programs. The authors strongly recommend the creation of coursework to group providers by common workflow. BackgroundDeliberate and comprehensive end-user training is essential for the implementation, actualization, and end-user satisfaction with an organization's chosen electronic medical record (EMR) [1][2][3][4][5][6][7]. Given the variety of roles and specialized workflows performed by medical staff, physicians comprise a unique group of end-users for whom distinct recommendations are essential. However, there are few guidelines in the literature addressing the development and implementation of an EMR training program for physicians. Rockswold et al, found that 43% of clinician users rated initial training as "less than adequate, " 94.6% of respondents thought their ability to use the EMR could be improved, and the authors called for the closer study of both training content and delivery [8]. A review of the literature reveals general training strategies for all employees [9], recommendations for nursing populations [10], post-implementation training [11], training within the broader context of a successful EMR implementation [3,6,12,13], and training as a barrier to EMR adoption [14,15]. To our knowledge, this is the first manuscript to describe the focused development and implementation of a successful physician training program in preparation for a large scale EMR implementation. Case ReportThis case report outlines a training program developed at Stanford Children's Health (SCH). SCH includes Lucile Packard Children's Hospital (LPCH), the major teaching hospital for pediatric and obstetric care for Stanford University, as well as about 100 network physicians in a medical foundation. As of 2014, LPCH has 311 beds, approximately 1,250 faculty and advanced practice providers (APPs), and approximately 1,000 rotating fellows and residents. The EMR implementation at SCH was a transition from one commercially available EMR system to another. The legacy system included computerized physician order entry (CPOE) and online clinical documentation in the inpatient setting w...

Impact of Longitudinal Electronic Health Record Training for Residents Preparing for Practice in Patient-Centered Medical Homes

“…9,10 Because EHR training content is generally not embedded in medical education curricula, training has primarily been delivered in limited, discreet sessions, and often taught as a standard Human Resources onboarding component rather than a professional competency. 11 Moreover, assessing the impact of EHR training for future physicians is still in its infancy. Reports on EHR learners in both undergraduate medical education (UME) and graduate medical education (GME) state the tremendous value of being a competent EHR user, not only for measuring performance for the Accreditation Council for Graduate Medical Education competencies such as systems-based practice and practice-based learning but also to promote lifelong learning as future physicians enter practice.…”

Implementing a Large-scale Electronic Health Record System in the Primary Healthcare Centres in Saudi Arabia

“…Initially, training in large-scale projects should be designed and delivered by a training team that comprises a training manager, training coordinator, instructional designers, a physician lead and super-users (Pantaleoni et al, 2015). It has been recommended that training and support should be provided in early phases (pre-implementation phase) of EHRS implementation (Fullerton et al, 2006;Ghazisaeidi et al, 2014;Ludwick & Doucette, 2009b).…”

“…It has been recommended that training and support should be provided in early phases (pre-implementation phase) of EHRS implementation (Fullerton et al, 2006;Ghazisaeidi et al, 2014;Ludwick & Doucette, 2009b). However, others have suggested training sessions should commence no more than eight weeks prior the go-live phase (Pantaleoni et al, 2015), as training at such an early stage may be forgotten by the trainees. It has also been recommended that ongoing training and technical support should be provided to the EHRS end-user (Adler, 2007;Ash et al, 2012;Pantaleoni et al, 2015).…”

“…However, others have suggested training sessions should commence no more than eight weeks prior the go-live phase (Pantaleoni et al, 2015), as training at such an early stage may be forgotten by the trainees. It has also been recommended that ongoing training and technical support should be provided to the EHRS end-user (Adler, 2007;Ash et al, 2012;Pantaleoni et al, 2015).…”

“…Members of a super-user team are usually organisation personnel who have already received education and training to guide the change process, provide instruction, communicate and continuously support other stakeholders (Keshavjee et al, 2006;Pantaleoni et al, 2015;Simon et al, 2013). Any healthcare practitioner can be a superuser, including physicians, nurses, or pharmacists (Simon et al, 2013).…”