Migrating to a new EHR? Training considerations for a successful go-live

Despite widespread market adoption of Electronic Health Record (EHR) systems, provider frustration with the technology has been well documented.

Many healthcare organizations have struggled to maximize return on investment in their EHR, prompting some hospitals and practices to switch vendors in the hopes of finding a better fit. Evolving technology needs among providers, ever changing reimbursement requirements, and consolidation in the EHR vendor space contribute to platform transition trends.

As healthcare entities take on the arduous task of migrating to a new EHR, end-user training is one of the most important factors in ensuring that the new technology is embraced by clinicians and other team members tasked with using it. Engaging training resources early in the EHR migration project helps healthcare organizations bolster end-user adoption and supports effective—and realistic—EHR budget and timeline management.

Here are three key training areas to keep in mind as your organization traverses the path to greener EHR pastures.


First and foremost, organizations heading into EHR migrations should consider staffing needs. Evaluate what the required roles entail and when it is appropriate to bring resources on-site. Timeline planning can be tricky and it is sometimes advantageous to bring training resources in later in the process than one might initially anticipate. Principal Trainers (PTs), for example, can spend almost a year securing Epic module certifications and getting end-user training materials ready only to learn they must redo them when workflows are further augmented as the organization gets closer to go-live. Those timeline frustrations may result in organizations losing PT talent during the transition between initial training and EHR build finalization.

Involve human resources (HR) in the migration support recruiting process early on. Set clear expectations regarding what the organization is looking for. Include thorough job descriptions and expected engagement timeline details. Help HR resources learn about the new technology and what the various migration support roles entail to recruit high-quality candidates.

Another consideration is the role of the training team during the discovery phase of the project. Bringing them in early is appropriate when documenting workflows and testing build. Make sure you address informatics needs in staffing. Informaticists play a key role in making sure end-users are heard throughout the build phase and during EHR implementation. This can have a huge impact on tech adoption after go-live. Also look at Project Manager (PM) needs. Some vendors recommend focused PM coverage, but this is an area where PM resources can likely manage multiple areas for efficiency.


Training is probably the costliest component of an EHR implementation. It is not uncommon for training expenses to exceed vendor budget recommendations by 20 to 50 percent. Many healthcare organizations find they need to overhaul classrooms or offer training in multiple locations. Establishing that infrastructure can be an expensive endeavor before you even get to hiring staff. Healthcare entities need enough money in the budget to support the training delivery, including temporary classroom trainers, near the end of the EHR build. Addressing these needs at the last minute can eat up a significant portion of the budget.

When setting your budget, consider the additional training-related costs your organization may incur. This is where having outside expertise comes in handy. Consultants well-versed in the complexities of an EHR migration can help you anticipate unique budgetary considerations ahead of schedule, when you first sign with your new technology vendor. Understanding these variables leads to more realistic budget planning. Build contingencies into the budget beyond the standard two-percent buffer.


When deciding on an EHR migration timeline for your organization, take into consideration things that affect end-users. If you are working in a popular vacation destination, for example, summer may not be an ideal time for a go-live in light of seasonal spikes in patient volumes. Extreme winter weather may make it difficult for trainers and end-users to get to training sites. Also consider other priorities that may pull the training team out of their role to support other areas. Expect to lose training resources and end-users from time to time, and plan ahead to avoid headaches related to last-minute resource shifts.

Many organizations struggle to get EHR build done in time for training. Further system optimization is also common after EHR go-live. While this is not ideal from a training perspective, awareness of the potential hurdles the project may encounter can lead to more feasible timeline planning.

Every site seeks to tackle migrations in as short a time as possible, but surprise timeline delays can have a big impact on budget. Engage Instructional Designers/Principal Trainers early on and look at your timeline together to identify areas of overlap between EHR testing and training. These periods can be a huge detriment to training success, leading to unnecessary stress and retraining. These headaches can be prevented by separating build and training efforts by one to two weeks.

Preparing for Your EHR Migration

Healthcare organizations should partner with training resources from the very beginning of EHR migration planning to best serve end-user adoption. When trainers are pulled in at the end of a migration, things can quickly escalate to panic mode. Inexperienced trainers that offer end-users a lackluster training experience net weak traction with EHR utilization and poor return on investment for the healthcare organization implementing the technology.

By engaging EHR trainers early on, organizations can better understand training timeline nuances. It also helps give impacted end-users a voice during the EHR implementation process. Implementation teams should spend time with end-users over the first six months of the migration project to learn existing workflows. That information is shared with the project team who then mimics processes within the new EHR. Workflows that are well documented allow trainers to say to end-users, “This is how you used to do this, and here’s how you’ll do it now.” Painting that clear picture for clinicians and staff promotes greater end-user embracement of new technologies.

About the Author
Chris Cooley currently acts as Training Program Director at Pivot Point Consulting. During her tenure, Chris has worked on 15 EHR implementations, acting in a leadership capacity on 10 of those projects. With a combined knowledge of adult learning principles, technical writing, project management, and the healthcare industry, Chris is known for her creative approach to effectively implementing healthcare solutions that serve the entire organization.

The views, opinions and positions expressed within these guest posts are those of the author alone and do not represent those of Becker's Hospital Review/Becker's Healthcare. The accuracy, completeness and validity of any statements made within this article are not guaranteed. We accept no liability for any errors, omissions or representations. The copyright of this content belongs to the author and any liability with regards to infringement of intellectual property rights remains with them.

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