Viewpoint: What teams should consider when training to use an EHR

Julie Spitzer -

Emergency department physician Lee Milligan, MD, who also serves as the vice president and chief medical information officer at Medford, Ore.-based Asante, became a credentialed trainer to help his organization transition from paper records to the Epic EHR, and now, he is sharing the lessons he's learned on training physician-peers to use the new technology in an op-ed for

To become an Epic credentialed trainer, Dr. Milligan spent nearly six months taking classes, exercising project management skills, sharpening emotional intelligence and acting as an intermediary between end-users and IT staff.

"Some days my role was simply to be the Rosetta Stone to both sides. Other days, it was more nuanced and required a deeper conversation to uncover the root of the issue. Some days it was about knowing what was possible. Most days it was about clarifying reality and knowing what’s not possible," Dr. Milligan writes.

Here are five tips Dr. Milligan picked up along the way to the Epic go-live at Asante.

1. Clinical and operational workflow. "Understanding the actual boots-on-the-ground workflow of your audience is the single most critical factor in the training process," he writes.

Dr. Milligan encourages trainers to match the EHR build and capabilities to caregivers' workflows. He adds it is especially important to ensure the required operational workflow be accomplished in the test environment so all glitches can be accounted for immediately.

2. Learning styles. All EHR vendors will encourage trainers to identify and assess the learning styles of their trainees.  Dr. Milligan believes that with the EHR, it's best to learn by doing.

"It's similar to learning to ride a bike. We can watch the bike, we can read about the bike and we can hear the bike riding along. But at the end of the day, we won't know how to ride a bike until or unless we actually get on the bike and start pedaling. We'll probably fall down a few times, but eventually we’ll get the hang of it. It’s the same with the EHR. Get your people on the bike and guide them to pedal and balance. When they fall off, help them back on," he writes.

3. Pedagogy. Dr. Milligan urges trainers to establish a partnership-type relationship with their end-users. The teacher and student should engage in dialogue such that they solve problems together and both learn from one another.

4. Personal connection. Trainers should make themselves as available as possible to the end-users to address any IT issues, urgent or not. Whether the trainer is able to address issues immediately, or point to someone on the IT team that could, being available to end-users throughout the transition is crucial.

5. Celebrate wins. Dr. Milligan recommends generative short term wins so end-users are happier and more motivated after each accomplishment.

"Remember that [physicians] have spent their entire career setting goals and accomplishing them. That’s how they arrived to their current state as a respected member of the medical community," he writes. "As they make progress, point it out clearly and often. It builds confidence and gives them something to fall back on when further challenges present themselves."

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