As health systems navigate the long-term effects of the pandemic, one of the most difficult challenges has been to provide ongoing training and support as droves of workers transitioned to remote or hybrid models.
For many organizations, it has meant rethinking their entire approach. “We used to do live training for everything. In a post-Covid world where there are a lot of restrictions, we’ve had to develop new ways to reach people,” said Ryan Seratt, Director of Training and Development, 314e Corporation. During a recent panel discussion, he spoke with Jes Cornelius (CIO, Sutter Health), Mike Restuccia (SVP & CIO, Penn Medicine), and Karen Marhefka (Deputy CIO, RWJBarnabas Health) about the hurdles they’ve faced in developing new training strategies, and how they’ve worked to overcome them.
The consensus? “It has been a big lift for all of us from multiple perspectives,” said Restuccia. “You have to make sure you have the right technology in place, and not just onsite, but for employees who are working from home or other locations.” And with many health systems in the midst of major implementations or upgrades — and dealing with an ever-changing ecosystem — it puts even more pressure on IT teams to provide clinicians with much-needed support.
“Training isn’t a one-time event; it’s a journey,” said Restuccia. At Penn Medicine, all training is conducted virtually at this point, which marks a significant shift from its pre-Covid policies. Like many organizations, “We had this belief that having training onsite and in-person was the only way.” Now, however, they’re finding that “remote training is much more efficient, and it allows us to be nimble in how we provide education.”
The one area in which it falls short, however, is the lack of “shoulder-to-shoulder training” that has been a key component in Penn Medicine’s implementation strategy. Prior to the pandemic, representatives from the EHR Transformation team would visit sites following a go-live to gain feedback on how the system is working and answer any questions that arose.
“Having that shoulder-to-shoulder support really elevated our satisfaction scores,” noted Restuccia, whose team has participated in KLAS’ Arch Collaborative to identify areas of improvement and measure progress in usability and adoption. “We were able to make a big leap forward.” And although visits have been limited in the past two years, he is confident Penn Medicine will be able to ramp up again soon.
In the meantime, the organization’s Information Services Advisory Committee (ISAC) helps with the one-off questions that weren’t addressed through training, either by responding or coordinating a response. According to Restuccia, ISAC manages around 300 inquiries per month, in some cases preventing users from making potentially detrimental decisions. “It has been a hidden gem for us,” he added.
Sutter has developed a similar approach to Penn Medicine’s transformation team, dispatching optimization training teams to round with clinicians for 30 days following go-live, then on a monthly basis after that. In addition to answering questions, they also offer suggestions based on data. For example, “they might say, ‘we can show you how to do this with fewer clicks,’” Cornelius added. “We’re very proactive in our approach, and we’ve found that to be really effective.”
At RWJBarnabas, deploying super users is a vital part of the process that should be sustained long after the rollout. “We tend to cut ourselves short with support,” said Marhefka, who also serves as VP of IT for RWJBarnabas Health Medical Group. “My advice? Don’t fall into that trap. It needs to be ongoing; and actually, it should be more robust post-go-live.”
Partnering with operations
Another component that can’t be overlooked is collaboration. To that end, RWJBarnabas created a Tower Council that holds weekly, three-hour meetings with representation from all key stakeholders, including the core vendor.
“We don’t do anything without partnering with our operations colleagues. We’re completely tied at the hip,” noted Marhefka, who coordinates closely with the CEO and COO of the Medical Group, as well as collages on the acute care side. As a result, they’re able to “stay in lockstep” from a training standpoint.
What’s just as important, she noted, is having participation from vendors at council meetings. “That has helped tremendously with providing clarity and transparency.”
Cornelius agreed wholeheartedly, adding that her frequent meetings with the CNO, COO and CMO – along with vendor leadership – have made a positive impact; not just in ensuring everyone’s on the same page, but also providing an opportunity to see things from a different lens. “That’s how we’ve been successful.”
“Our success is their success”
What has also contributed to that success — and will be paramount moving forward — is that, at Sutter, vendors are treated as partners.
“They’re in it with us,” she said. “Our success is their success, and vice versa.” It’s a philosophy that comes in handy, particularly when unforeseen challenges arise. For example, a change made to iPads caused 10 of Sutter’s practices to go completely offline. And while it may not seem like a catastrophe, considering the organization that has around 5,000 clinics, “it was a huge impact to those 10 practices,” Cornelius added. “Those are the little things we’re trying to figure out how to get ahead of. Sometimes in the technology world, vendors can forget that we support patients. We need them to be mindful of that.”
One way to do that is by engaging in meaningful conversations, which she and her team are able to do during regular sit-downs. “We talk with them and say, ‘this is our strategy. This is where we’re going. How can you contribute? Do you have suggestions?’ It’s a bidirectional conversation, and it has to be done at the right level,” meaning with the CEO or an individual who reports directly to the CEO, for example.
Seratt has found this to be case. “The two things that are really key are strong partnerships with vendors and project discipline — making sure everything is planned out,” he said. “We all do a good job handling the launches; it’s the surprises that really affect us. And so, the more teamwork and partnerships you have, the better those activities go.”
Three levels of training
By remaining in lockstep with vendor partners, leaders can more successfully anticipate the level of education that’s needed, noted Seratt, who recommended a three-column approach to training. The first is determining which changes are discoverable, such as new options on a dropdown menu. In this case, “things might be in a different order, but I can navigate through it based on knowledge I already have,” he said. That type of activity doesn’t require training.
The second refers to changes that are easily noticeable, and necessitate limited training, if any. “We want them to be aware that there’s going to be a change, and that they know how to adapt to it,” Seratt said, noting that video is an ideal platform for training in this situation.
Finally, the third category alludes to cases in which new skills or processes must be learned, ideally through some type of training delivery in which people can interact with an instructor. Alternatively, “it could take place through e-learning followed by a Q&A session.”
By establishing these categories, organizations can more effectively navigate the training process. “With so much information coming in, you have to be able to separate the rocks from the diamonds, and focus on the diamonds,” he said.
It’s no easy task, especially considering the workloads IT teams have had to shoulder, even before Covid. But without proper and consistent training, organizations can’t move forward with digital transformation, according to Cornelius. “The biggest challenge is meeting people where they need to be met,” she said. “Stay diligent. Don’t lose heart, and don’t treat your people as opponents. We are all working toward the same end goal.”
To view the archive of this webinar — Strategies for Providing Application Training & Support to Maintain User Satisfaction & Productivity (Sponsored by 314e Corporation) — please click here.