The beginning of a new year is often a time of reflection, planning, and organizing. This year, remember that achieving success with your range of healthcare information technologies—technologies that hold great promise for the future of healthcare—means keeping sight of an important factor: there are real human beings who need to learn not just how, but how best, to use each technology. A new approach to training is in order. And big reveal: it’s not just the EHR.
The widespread availability of a diverse range of healthcare information technologies is staggering and awesome. Never before have healthcare providers had such vast and, indeed, good tools and technologies at their disposal—tools that promise improvements to patient outcomes, financial impact, sharing of useful data, and provider satisfaction at work. At the same time, however, too many providers feel weighed down by ongoing administrative demands.
Technology training programs intend to help ease the transition to new solutions or software upgrades. That often means, however, that providers and clinicians must sit in a room to watch a trainer rely on grainy system screenshots to explain how to do an order, make a note, and review the labs. Unfortunately, these same programs miss the mark on how the systems work together to create a cohesive and efficient experience with all the technologies. Physicians leave the training room in a zombie-like state, retaining little material, but are promised “at-the-elbow support for two weeks after go-live.” It’s a small solace to the thousands of real human beings who are about to go back and care for more real human beings.
Any given healthcare facility can have hundreds of connected solutions they use to deliver patient care. PACS, messaging tools, outside data sources, cardiology/GI/critical care systems, documentation solutions, speech recognition, real-time decision support . . . the list goes on. I can’t count the number of times I’ve been involved go-lives and witnessed the pain of end-users who struggle to overcome the poor training, while also trying to relearn basic computer tasks as they single finger hunt and peck at the keyboard with a death grip on the mouse. All the while, they’re plodding along with festering bad habits acquired over the years of survival in the trenches of healthcare. I’ve also seen providers who never learned the computer and workflow skills slogging through the GUIs while the patient’s condition changes in real-time and the work/patient load piles up.
Watching users jump around the various menus, buttons, and windows of an amalgamation of healthcare technologies without the expertise and with a patchwork of poorly-learned, on-the-go habits is painful. Sadly, it demonstrates beyond a doubt a misfire of an organization’s training culture and programs and an indictment of our entire industry for failing to learn faster “how to train and support healthcare providers on health information technology platforms.” It’s not just the EHR, it’s not that providers uniformly refuse training (although they justifiably have a long history of prior past training insufficiencies), and it’s not just the constant administrative burden heaped upon them all leading to burnout.
Want to stop the insanity? Map all of your workflows, for better or worse. Make it your 2020 resolution to fully and completely understand how to perform each function most efficiently, and then train to that. Understand that each specialty will have a unique set of parameters—nurses need something different than surgeons, and emergency medicine needs something different than physical therapy. It’s a monumental task, but it’s doable. Then go with the flow. It’s all about the flow. All the technologies feed together. “How do I do an admission from end to end?” “How do I complete cardiac catheterization from beginning to end?” “How do I perform a cesarean section from the onset of labor to the delivery, closure, recovery room, and transfer to the floor?” As I write this piece, I’m on an airplane; imagine if my pilot was skilled at take-off but didn’t get great training for the landing. Or worse yet, they wonder, “What is this blinking red dohickey?”
Providers need to read x-rays; I’d advise learning the viewing tools as they may be integrated software separate from the EHR. Performing some cardiac procedures mandate expertise with the hemodynamic and vascular imaging technology that’s almost certainly not part of the EHR. Want to use voice recognition that is up to three times faster than typing and it automates numerous EHR and computer tasks? Get help with that too, or consider other alternatives, like working late at night to complete documentation or clicking from here to eternity. To reiterate: learn all the tools and learn them well.
It’s time to go beyond traditional training programs. Establish personalization labs and workshops where end-users can prep their views and tasks specific to their patients and specialty needs. Equally or perhaps more importantly, it reinforces their knowledge of workflow and the associated technology platforms with a trainer or better yet a similar specialty colleague alongside for teaching and guidance. Most importantly, TRAIN TO EXPERTISE on every element of the workflow because at the end of every healthcare task is a real person—a parent, neighbor, friend, or child.
Remember that providers who are efficient with technology tools are more satisfied with their work environment, take better care of their patients, and get home earlier to their own loved ones. It’s our responsibility to help make sure that everyone in an organization knows not only how, but how best, to use each technology in a cohesive fashion.
