One of the most common complaints we hear from physicians regarding their use of EHRs is inadequate and insufficient training. This is either early in the process during implementation, or later, once the EHR is implemented and clinicians or staff have to learn more advanced features — or have to solve problems that they have encountered. Frequently there are simple solutions; however, you may need an internal champion who is an expert user of your EHR. Or you may require advanced training for new features or customizations.
A number of years ago, while working on a primary care IT strategy, I had the opportunity to lead a project to develop local peer support networks or physician user groups (PUGs). The principle behind the groups was to find a way to bring together clinicians with a wide range of skill sets ranging from none to highly skillful in relation to EHR use and health IT. However, as with many of these types of strategies, programs such as this are difficult to sustain over the long term. User groups can be facilitated through geographically co-located communities of practice or by bringing together disparate individuals with similar interests, EHRs, and specialties through online communication media.
The following summarizes lessons learned after 20 months of facilitating and supporting physician engagement through the Physician User Group strategy (2005 and 2007). Many of these learning points remain applicable in 2012, further supported by social media and mobile communication tools. It is important to note that the creation of these groups entailed both face-to-face meetings and online communication, leveraging local relationships and strengthening mechanisms to facilitate collaboration:
- There are multiple levels of engagement of clinicians. Physician User Groups are an entry-level engagement strategy to facilitate communication, build trust and credibility, and provide feedback into health IT projects to ensure relevance of the projects to end users and to facilitate and organize thinking within a community.
- Time is one of the scarcest commodities that we have in the healthcare system today. Physicians work in a highly time pressured environment.
- It is not necessary to reach every clinician face to face. A very effective communication system exists among physicians in a community and the message will be disseminated informally and via email.
- It is important to initially understand the needs of the local group and allow concerns, issues, and desires to be openly discussed and documented. From the physician’s perspective: “What is in it for me and my local community?”
- The context then needs to be established in order to define what is doable and what is not and to seek involvement of clinicians in those areas.
- Once the group is established, the majority of communication takes place electronically.
- Leaders do not all need to be tech savvy. Strong clinical leaders who are respected by their colleagues and are seen as “more like me” are highly effective group leaders.
- Leveraging existing groups, e.g. departments of family medicine, and medical staff groups, is a very effective way to build your clinician member base quickly.
- One of the roles of groups is to facilitate communication among physicians in a peer-to-peer communications network.
- Leaders must have an easy mechanism to generate communications and distribute those communications to their members.
- Wherever possible in communication with physicians one should not use acronyms, as this creates confusion.
- The importance of accountability. It takes approximately two “cycles” to get buy-in and support from your members. It is necessary to prove to the members that you are responding to their needs and feedback, and that this is being integrated into the solutions and processes that are being developed.
- If face-to-face meetings are possible, they should be scheduled approximately every six months; it takes about one year to effectively establish a user group.
- Meetings among group leaders are a critical part of sharing the lessons learned and providing timely and useful information and feedback to the IT resources and sponsors plus executive team members.
- Groups will evolve and change over time based on environment and needs.
- User groups enable physicians to organize themselves and structure their thinking within communities. Whether related to connectivity, information such as DI, Labs, Medications, or EHRs, a standardized approach and fewer variables is easier to manage and more effective in achieving adoption and improved clinical outcomes.
- Many EHR vendors offer user groups and online discussion forums for their customers.
If you belong to a user group, do you find time to participate? Does the group provide assistance in terms of using your EHR? Share your comments or thoughts below.