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3 EHR training best practices for clinician satisfaction

By providing specialty-specific EHR training, using e-learning modules, and encouraging ongoing EHR education, healthcare organizations can help promote clinician satisfaction.

While federal incentives successfully promoted health IT adoption to drive patient-centered care, EHR use has had an unintended consequence: clinician burnout. Following EHR training best practices can help improve clinician satisfaction with health IT and curb burnout across all clinical specialties, according to KLAS.

Tailoring EHR training to meet the diverse needs of clinicians, using e-learning modules and providing ongoing education are key strategies to drive clinician EHR satisfaction.

Specialty-specific EHR training

Providers who strongly agree they received specialty-specific EHR training are almost 25 times more likely to report clinician satisfaction with EHR functionality, according to a 2022 "KLAS Arch Collaborative" report.

However, current EHR training models typically do not take into consideration specialty-specific workflow and documentation needs.

A 2021 study outlines a stratified model for EHR training that aims to provide a more customizable approach. The model has four levels: basic computer training, general EHR training, workflow-specific training, and one-on-one training and retraining.

The researchers noted that breaking EHR education into distinct levels allows a stratified approach to compensate for prior EHR experience and proficiency. For instance, if a clinician is new to an organization but has used the EHR system previously, they could receive a "refresher" course on general EHR training.

Level one of the EHR training model covers basic computer training to ensure competency with basic computer skills. The authors noted that organizations can easily deliver this information asynchronously through online training modules.

The second level of the model, general EHR training, uses a "one-to-many instructional model." EHR trainers typically conduct these sessions in the classroom, providing explanations of basic features and functionality. Additionally, trainers demonstrate the fundamentals of EHR navigation, documentation and order entry.

This level of training provides an opportunity to emphasize standardized EHR use, as well as ways clinicians customize the EHR, the authors said.

Level three of the model incorporates specialty-specific workflows and best practices. During this training level, small groups of clinicians complete simulation-based sessions led by clinical informaticians, using specialty-appropriate patient charts within a simulation EHR environment.

"This model allows for instant debriefing as well as formative and summative feedback and coaching and promotes retention of concepts learned during the session," the authors wrote.

Lastly, level four of the model focuses on one-on-one EHR education. Typically, organizations should reserve these sessions for providers who need additional support using the EHR, the researchers said.

Healthcare organizations should provide level four training on-demand or schedule sessions to interrupt care provision minimally, they added.

E-learning modules

Healthcare organizations are increasingly turning to self-directed e-learning as a cost-effective EHR training method to supplement traditional instructor-led training, according to a 2023 KLAS report.

While previous KLAS research found that in-person training was much more effective than virtual training, data collected in recent years has found that e-learning can have an equally significant effect on the clinician experience.

KLAS defines "e-learning" as self-directed electronic learning. "Virtual training" refers to the combination of e-learning and instructor-led virtual training.

A benefit of e-learning is scalability, the authors noted. Frequent updates to the EHR can stretch healthcare organizations' training funds thin. However, e-learning modules can be modified at any time, allowing providers to access the most up-to-date resources. E-learning can also reduce costs associated with classroom-based training due to its web-based nature.

While clinicians still report the highest satisfaction with in-person EHR training, the report found that it is only slightly ahead of e-learning.

Additionally, over the last few years, clinician satisfaction with virtual EHR training has increased. The share of clinicians who would recommend e-learning courses to a colleague has increased from 67% in 2021 to 83% in 2023.

KLAS data revealed that increased adoption of virtual training can significantly improve the clinician experience. However, the quality of training is critical to maximizing the positive impact of virtual education. Clinicians who reported virtual EHR education was helpful and effective were less likely to report burnout.

Ongoing EHR education

Ongoing EHR training can help promote end-user proficiency in the EHR and mitigate clinician burnout, according to KLAS.

Additionally, ongoing EHR training can help improve the clinician experience and prevent physicians from leaving healthcare organizations. Among physicians who decided to leave their health system, KLAS found that two-thirds expressed a strong willingness to engage with their organization through more EHR training.

A study published in JAMIA outlines a program called reBoot Camp at the Mayo Clinic. Physician leaders in informatics created the program to enhance ongoing EHR education. Mayo Clinic offered the program from April 2018 through June 2020. There were 37 two-day and 43 one-day sessions, with 673 unique participants.

Peer instructors helped ensure that session material would transfer to clinical settings. Other educational programs, discussions with colleagues at health IT learning collaborations and user-group meetings informed the reBoot Camp curriculum.

Initially, the program included modules led by senior instructors with specific expertise. Instructors used agendas, name tags and real-time learner feedback to ensure comprehension. Co-instructors circulated to troubleshoot and give participants one-on-one attention.

The instructors presented each module as a three-step information exchange: didactic lectures, detailed dialogue and active learning laboratories.

"Active learning included personalization in the live-production environment and walkthroughs of workflows and techniques in the training environment," the study authors explained.

Researchers used surveys to study baseline, immediate and long-term perceptions of program satisfaction and self-assessed skills with the EHR. Confidence in skills increased by 13.5 points for general EHR use, and survey results showed that this confidence level stayed the same after six months.

Mayo Clinic incentivized participation with continuing medical education (CME) and quality improvement Maintenance of Certification credits within the participants' specialty medical boards.

"Giving CME credit to participants is a small incentive for completing the training and an avenue to justify the time away from clinical duties to participate," the study authors wrote.

While intensive sessions for ongoing EHR training can improve confidence in EHR skills, the study authors noted that finding the time to participate in the reBoot camps remains a critical barrier for some providers, and ongoing studies are needed to find solutions.

However, ongoing training does not need to be extensive for it to bring value to clinicians. Based on survey responses from clinicians, KLAS suggests healthcare organizations format ongoing EHR training sessions as 15- to 60-minute sessions totaling three to five hours per year.

Put simply, an EHR system is only as valuable as the quality of end-user training. Specialty-specific EHR training, e-learning modules and ongoing education initiatives can be instrumental in driving clinician satisfaction and optimizing EHR use.

By using these EHR training best practices, healthcare organizations can empower clinicians to navigate EHR systems with ease, ultimately improving care delivery and organizational outcomes.

Hannah Nelson has been covering news related to health information technology and health data interoperability since 2020.

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