To plan and implement training, you will:
Identify staff roles. Specify what tasks each must know how to do in the EHR. Many organizations use training designed for trainees’ particular workflow or “role-based training.” Note that roles may change once EHR is implemented. Refer to Reexamine Workflow to help identify what training each role needs.
Assess staff computer skill levels. Give basic computer training to those needing more skill. Before you consider paying a vendor for this type of training, see if other staff members can help or consider a local class.
Go over the vendor’s training plan to see what will be covered. Vendors’ training is usually technical and focused on how to use the EHR. You will likely find gaps you may want covered, such as working toward achieving Meaningful Use.
Review common training topics. Consider additions needed for your site as your EHR use evolves.
Common EHR Training Topics
Getting started (e.g., opening EHR, logging in)
Entering basic patient information (e.g., name, date of birth)
Locating/retrieving medical information or reports, reading/reviewing notes
Entering diagnoses (e.g., primary, secondary, “rule out diagnoses”)
Creating, submitting orders
Documenting (e.g., immunizations, patient education, health and personal history)
Generating and tracking consults, referrals
Clinical decision support
Standardizing data entries (e.g., scripted statements)
Differentiating between suggested vs. required fields
Protecting privacy and security
Attaining meaningful use
Making workflow changes
Improving patient communication
Getting help with EHR use
See a list of training courses provided by the Indian Health Service to get an idea of the types of training that your site may need.
In many cases, vendor-provided training happens early in implementation. But training needs go on indefinitely, so it is a good idea to provide in-house training resources and capabilities as well.
Vendor-provided training. Ideally, trainers begin to interact and build relationships with clinicians and other staff well before go-live (up to 12 months before).
Ongoing training support may be more difficult to obtain in rural settings, which increases the importance of vendors’ initial training. Note that some vendors offer remote training in addition to in-person training.
In-house training. A train-the-trainer approach is commonly used for in-house training. Super Users are often trained by vendors and then tasked with training other staff. You may also have other training resources at your disposal, such as educators who are responsible for orienting new staff and helping staff maintain their credentials and skills.
Considerations for effective training include:
How the EHR fits in to specific roles and workflows. Some experts suggest that when trainers focus on what trainees need to know for their job, they can eliminate distracting “nice to know” content. Others suggest that training different user groups together can foster team spirit and support−for example, they would group users with related jobs in the workflow or users with similar jobs who work in different departments.
Scheduling and duration. Initial training should occur very close to go-live so knowledge is fresh and trainees are motivated learners. Hold sessions at times and locations that reduce distractions. Also, a series of shorter sessions may be easier on learners than one or two marathon sessions.
Breaking up lecture sessions. Use strategies like discussion, group problem-solving, written exercises, Q&A with experts, and hands-on activities during the training. These approaches keep a group engaged and serve people with different learning styles.
Potential online training. Perhaps some parts of training can be completed electronically, or trainees can do “homework” online to get familiar with EHRs before class.
Adapting to trainees’ learning speeds. Find ways to allow fast learners to move ahead and to provide slower learners with more time master the curriculum. This reduces boredom on the former and pressure on the latter.
Communication that flows both ways. Allow for questions and feedback from trainees, and use both to improve future training.
Training approaches include:
Super user training. Trains key users in advance so they are ready to train colleagues and help as needed.
Role-based training. Offers training designed according to staff roles.
Process-based training. Enables trainees to discuss and learn new workflows and changes in procedures and policies.
Reality-based training. Permits trainees to learn by entering existing patient records into the EHR (e.g., abstracts of history, problem lists, medications) or using information from simulated patient encounters.
Practice before go-live. Enables trainees to walk through scenarios repeatedly so they begin to feel natural. Rehearse important workflows such as patient intake, ordering common tests or procedures (e.g., medications, imaging, blood work, referrals), and end-of-visit scenarios.
See training resources from HealthIT.gov to answer the FAQ “How Should I Train My Staff?”
Read an article on designing an effective training from the American Health Information Management Association.
See an issue brief on Training Strategies: EHR Deployment Techniques from the California Healthcare Foundation.
The plan should describe:
Because adopting health IT is a lengthy process and the technology is rapidly evolving, safety net providers need to find ways to continue learning on this topic. It is important for organizations to motivate staff to obtain additional professional education and acquire certifications that will help keep everyone abreast of new developments.
Consider these free online courses for staff:
What You Need to Know
How to Build an EHR Workforce