Laying a Foundation for EHR Satisfaction

One of the rationales for low EMR satisfaction that I hear most often is that older clinicians just don’t like or understand computer systems. As it turns out, nationwide Arch Collaborative data doesn’t support this — any connection between age and EMR satisfaction is tenuous at best. Many other factors have a much bigger effect on satisfaction. But this is good news. If EMR satisfaction isn’t about age, that “unsolvable problem” (it’s not like you can make a clinician younger) isn’t actually a problem.

However, one potential solution may still come from the roots of healthcare: medical schools.

I recently read about the Indiana University School of Medicine’s EMR training program for their students. This year, the first class to use an EMR in their education program has graduated.

Now obviously, there are a lot of different EMRs out there, and EMR-specific training is important for mastery. But even general familiarity with EMRs could really help new physicians come into hospitals and clinics with good overall experience. “By better preparing the physicians of tomorrow to practice in a modern, technology-driven environment, we are laying a foundation for them to succeed in a practice environment that is far different than the one many of us entered after medical school,” said Susan Skochelak, MD, VP of medical education at the AMA, in a recent article.

So how can organizations that follow in IU School of Medicine’s footsteps make this training most helpful? What do future providers need to succeed with an EMR?

Current Arch Collaborative research shows strong correlation between EMR satisfaction and three main factors:

1. Successful Initial and Follow-up EMR Training

The trick with initial training is to ensure that the training reflects the workflow of the clinician and how he or she delivers care. For example, a cardiologist and an ER doctor work in the EMR very differently. They also need to learn different tools (see below on personalization) and learn from clinicians in their specialty if the EMR is going to be an asset to care and not just a hassle.

Follow-up training (for example, 60 days later) can ensure that clinicians remember — and are using — what they learned. All of this makes clinicians more confident in their EMR use and happier with the EMR in general. And especially as the EMR is updated and new tools come online, physicians benefit from further follow-up training.

For medical students, early general EMR training could give them a leg up. Schools might also focus on effective ways that these future clinicians can get the most from their later training. Imagine the difference if clinicians started their practice seeking out, and even demanding, effective EMR training! Peers training peers is also key to successful EMR education, so medical students could benefit from learning how to engage their peers and drive their own education.

2. Personalization of the EMR

Few (if any) EMRs are designed just right for an individual provider — that’s why it’s so important for providers to set up and use personalization tools that support their own, specialty-specific workflow. And this applies to more than just data entry; many organizations have done a commendable job in making physicians efficient in data entry with templates. But Collaborative research shows that the tools that help clinicians get data out of the EMR make the biggest difference.

Early medical-school training on personalization tools would have to be a little more abstract, as each EMR has a different design and different tools for personalization. Students should be informed of the benefits of using personalization tools (especially for pulling data out) and taught to continually use the tools they have to tinker with and optimize their own EMR experience.

3. Teamwork and Collaboration between IT and Clinicians

Partnership between IT and clinicians is one of the most important ways to create a foundation for EMR success. The happiest organizations support their clinicians’ IT needs and work together to find solutions. This type of culture requires buy-in from both medical and IT personnel.

Medical students can be taught to bring to their organization an enthusiasm to share their feedback, willingness to participate in EMR training (first as students, then as teachers), and an understanding that they’ll find the most success when they don’t see physicians and IT as ‘us versus them.’

In addition, schools that offer a Master of Health Administration degree ought to include education around this need to cooperatively engage with physicians.

In a recent blog, I wrote about how EMRs can be leveraged to improve patient engagement; this should be included in the medical educating curriculum. Students should be trained not to turn their backs on patients as they document, but rather, to show patients how the EMR is being used to capture and assess their health, order their medications and other therapies, and access outside health records.

While IU School of Medicine was the first to start offering EMR education, they aren’t the last — seven other medical and health-profession schools are now using the same technology platform. I hope to see other schools follow suit. Changing healthcare is often a painfully slow process, but starting at the roots provides a great foundation for this change.

[This piece was written by Mike Davis, Arch Collaborative Lead Analyst at KLAS. For more information about KLAS, click here. To follow KLAS on Twitter, click here.]