The Impact of Inadequate Training on Use of EHRs

Over the last two years, thousands of clinicians have submitted satisfaction ratings through AmericanEHR for over 150 different EHR products. EHR users regularly share additional comments regarding their EHR experiences. Lack of adequate training is a consistent theme that many clinicians report as having a negative impact on their ability to effectively use their EHRs.

The following selected comments describe user experiences with respect to training:

  • We are repeating a training session after one year of use to enhance our ability to use the system more effectively and properly. We understand that we have not had adequate training to use the system to its potential. We anticipate our satisfaction should markedly improve once we have a better understanding of processes.
  • We have had glitches with personnel. Some of your staff will not stay with your practice for a long time. What happens is the following: If the system is not easy to pick up, then you are investing a lot of training time in non-contract employees who just might not show up to work one day.  It is hard to understand that in tough economic times staff just leave your practice… but they do. Having to train new people on a system can be a significant cost.
  • When this system was promoted and demonstrated to us, certain things we were looking for (i.e. billing capabilities, PQRI reporting, etc) were portrayed as being very easy to use but have indeed not been so. There was relatively little on-hands training provided to the staff without an extra cost and we felt somewhat unprepared once we went live. We have done a lot of learning by trial and error and have improved our use and abilities but we still have not begun many things that we want to do with the EHR.
  • We spent many days training initially and have ongoing training, which is burdensome but worth it.
  • EHR Companies need to understand the practice management part of the entire system takes less training than the EHR portion. The EHR portion takes training before, training during, and LOTS of training and assistance after: 1month, 3 months, 6 months, and 1 year. Then periodically, maybe every year.
  • I have a different perspective since I helped in the design and implementation as compared to other physicians. I also spend more time on the EHR compared to other physicians as the acting CMIO. Overall, the initial use was probably much harder for your average user as compared to myself since I did receive more training than others.
  • I think if we had more training (which my colleagues refused to buy), we would have had a better implementation.
  • I’m still implementing the system and I have yet to fully evaluate its capabilities. I do think when when I am fully implemented it will be a good system capable of easy applications. I just have to learn how to do it. It is difficult to run a solo practice and try to learn an EHR at the same time. I need 2 weeks of intense training.
  • It has improved safety and ease of communication. However, my work days are substantially longer due to the cut and paste nature of this system. My training time was 2 hours of an on-line module — an absolute joke in view of the complexity and idiosyncrasies of the system.
  • Labor intensive on the front end. Training and proper set up are the most important aspect. Don’t skimp on the training. When set up properly, very efficient and easy to use, but set up takes a great deal of time. Not an “out-of-the-box” product.
  • Our main problem is implementation — not enough training to bring fully on line, even years later.

What is clear from these comments is that training (or lack thereof) has an impact on the practice and ability to effectively use an EHR in the short term — and for many years post implementation. There is a need for initial training in order to use basic system capabilities as well as intermittent refresher and advanced training to learn the more complex functions within an EHR.

As practices transition to Stage 2 of Meaningful Use and more advanced skills are required to manage complex tasks such as medical reconciliation, the need for training will not diminish.

How much ongoing training is sufficient? What strategies have you implemented to keep your clinicians and staff adequately trained (e.g. super users, remote training, practice learning sessions, etc.)? Share your experiences below.


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