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EHR implementation rising, but hurdles for healthcare providers remain

Brian Eastwood | May 7, 2013
Thanks to government incentives, more healthcare organizations in the United States are implementing Electronic Health Record systems than ever before. But EHR implementation isn't the same as EHR adoption, which requires significant investment in planning, training and personnel.

Von Baker, practice director for healthcare services at TEKsystems, says healthcare organizations need to realize that the change management and "clinical transformation" that accompanies EHR use must be part of the project lifecycle from the planning stages. Business processes are going to change, she says, and EHR users need to know how this will change what they do today compared to what they will do tomorrow.

Bringing users into the process at the outset has significant training advantages as well, Baker says. The sooner that workflows and business processes are incorporated into training, and into memos or announcements about what the EHR system will look like, the sooner that information is disseminated to end users, she says. This also makes it more likely that practical scenarios, such as different use cases for orthopedics versus pediatrics, make their way into curriculum development.

When this happens, organizations can avoid the "why" questions that so often dominate classroom-style EHR training sessions and instead focus on exercises that engage clinicians in how EHR technology is used, Baker says. It also allows for assessment, an often-overlooked aspect of training that helps users gauge what they know and trainers understand what they need to work on, she adds.

Relationship Among EHR Vendors, Users Evolving

Many EHR vendors offer templates for lesson plans. Others conduct onsite training sessions. These can be a good start, says Allen Kriete, vice president of healthcare services for TEKsystems, but organizations need a plan for when the vendor leaves.

In addition to assessing clinical workflow and IT architecture, this needs to involve a holistic look at competency gaps from both a technical and functional perspective, Kriete says. Doing so will put EHR training and curriculum in the context of change management, ROI and efficiency gains-all of which will have a long-term impact on clinicians and, it is hoped, let them focus less on technology and more on patient care.

This doesn't mean healthcare organizations should establish a "set it and forget it" relationship with their EHR vendors. Far from it. As CompTIA found, providers need numerous things from their vendors: Deployment and training help, regular system updates, remote system monitoring and a "consistent point of contact...familiar with the healthcare provider's needs."

This amounts to a "managed IT services relationship," CompTIA says. It's not something that EHR vendors should pitch right away, though, as "Few healthcare providers at small or group practices are familiar with the concept of managed services."

Even if such a relationship is established, though, healthcare organizations will need to add staff as EHR adoption expands. CompTIA notes that many healthcare workers handle EHR maintenance and troubleshooting themselves, as they manage credentials, install patches, back up data and manage system preferences.

On a small scale, this makes economic sense, CompTIA concludes; eventually, though, "time a physician spends IT troubleshooting an IT issue is time away from seeing patients."


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