Despite HIMSS being cancelled because of the coronavirus, we at KLAS feel that it is important to get our data out to providers. In this post and its corresponding presentation, I want to talk about one particular way that provider organizations can optimize their EHR experience.
An Overview of the Arch Collaborative
In an effort to help both patients and doctors benefit from the EHR, KLAS started what is known as the Arch Collaborative. Through the Arch Collaborative, KLAS has surveyed over 215 organizations and over 45,000 providers to ask about their EHR experiences and to dig deeper into what makes EHR users successful. Through this initiative, KLAS has been able to establish a benchmark so that organizations can take the survey, measure their clinicians’ EHR satisfaction, and compare the results with those of their peers.
This comparison is valuable because we have found that even if two organizations are using the same EHR, they may be having completely different experiences. When we saw these results, we wanted to find out where the variation came from; did it come from the EHR use, from the organization itself, or from particular specialties? In the end, we found that most of the variation is because of the users themselves.
Why does this matter? We have seen that in 73 percent of organizations, two physicians in the same specialty who are using the same EHR have polar opposite opinions about how the EHR enables them to deliver high-quality care. One physician will say that the EHR is the worst thing to ever happen to the medical industry, and the other will say that they can’t practice medicine without it. We have also seen a lot of emotions from users as they have talked about their EHRs. Many feel frustrated, uncomfortable, or hopeless when it comes to using the EHR. But many organizations also have very successful EHR users, and one of the key components of having successful users is a focus on training.
The Value of EHR Education
In the Arch Collaborative survey, when participants identify themselves as highly successful users, we ask what their key to success is. In a recent report, about 20 percent of providers said that EHR education is a key differentiator, and that response was the most common answer aside from personalization at 32 percent. With nurses, EHR education is by far the most cited reason for why someone is a successful EHR user. When we looked at the distribution of satisfaction as it related to training, we saw that, of the people who received better training, 83 percent agreed that the EHR enables them to deliver high-quality care and only 17 percent did not. On the flip side, of the people who felt like they had poor training, 64 percent were unsatisfied with their EHR. So what does “good training” actually look like?
One of the most common things we hear from organization leaders is, “I know that training is important and that it will make a difference, but I can’t get my clinicians to agree to training because they don’t want any more.” However, when we asked about training on the Arch Collaborative survey, the results showed that 61 percent of providers said they would like more EHR education. When we looked at those providers who didn’t want more training, 19 percent said that they weren’t confident that participating in training would be a high-quality experience.
Because of that response, we determined that the quality of the EHR educator is instrumental. It is important for trainers to have a clinical background so that they can relate with those they are helping and know what it is like to walk in their shoes. Similarly, the trainers must be engaging and empathetic toward the clinicians. Having a peer instruct classes and provide at-the-elbow support really builds a foundation for the clinicians and jump-starts their progress.
The Length of Training
In addition to who the trainers are, the length of the training plays a huge impact on clinicians’ EHR satisfaction. Organizations that offer four hours of training or less see a significantly lower EHR satisfaction than those that offer five hours or more. Obviously, that is a big time commitment, but the good news is that the training doesn’t have to be consecutive; even if the five or more hours of training are spread out over three months, that still leads to a lot of user success. We have seen many organizations break up their training so that they offer two hours during a provider’s first week, then two more hours a month later, and then a couple more sessions afterward to follow up.
Breaking up the training allows a few things to happen. First, the providers don’t feel overwhelmed with all of the information up front. Second, providers know what is expected of them. And third, the time between training sessions allows the providers to become familiar with the EHR, the workflows, and the pain points. It really makes a difference for the providers to use the EHR in a real work environment so that they can provide additional tips or to ask for further personalization when they are ready.
Providing follow-up training looks a little different from providing initial training. For the full details, check out this post’s HIMSS presentation.
The Devil Is in the Detail
When we compared the 10 least satisfied organizations to the 10 most satisfied organizations, we saw similar training approaches. Both sides of the spectrum were using online training, at-the-elbow training, departmental meetings, and other similar methods. The similar approaches despite the vast difference in scores told us that the type of training an organization implements isn’t the important thing; it’s having trainers who have a clinical background, who are compassionate, and who lift up the clinicians around them to help them rise up to their fullest potential. It’s teaching the content in a way that establishes a partnership between the trainers and the trainees.
Even though the details may seem small and inconsequential, they matter, and we at KLAS hope to help organizations be mindful of those details so that they can not only have successful and satisfied EHR users but also contribute to revolutionizing healthcare.
Connor Bice is a Report Analyst with KLAS Research. To follow KLAS on Twitter, click here.