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Developing EHR Expertise to Increase Satisfaction and Productivity

Series One: Electronic Health Records

An EHR system is a complicated tool that requires sufficient training and practice to gain competency. Achieving EHR proficiency can reduce frustration, increase efficiency and mitigate the effects that EHR burdens have on physician burnout. Research indicates that physicians with adequate initial training are significantly more satisfied with their EHR system and that satisfaction remains consistent for more than five years following initial training.

The effects of poor initial training can last for years. However, the negative effects of poor initial training can be neutralized with appropriate follow-up training. Investing time in training can pay off in the long-term with time savings and frustration reduction.

Although administrators and vendors are primarily charged with providing appropriate training to users, clinicians can influence training options. To increase EHR expertise, clinicians can:

  • Take advantage of ongoing training opportunities, particularly if initial training was insufficient.
    • According to experts, the best practice is six hours of onboard training. This includes classroom training followed by at-the-elbow support.
      • Taking full advantage of initial training is essential, but if that opportunity has passed, ongoing training may be part of your organization’s EHR vendor agreement.
  • Request training that is tailored to your workflow and specialty from qualified trainers.
  • Request “at the elbow” training. Classroom training may not be sufficient to achieve proficiency.
  • Ask about regularly scheduled one-on-one personalization support. Vendors or consultants can set up a “personalization lab” in a clinician’s office or hospital. (A “lab” can be a mobile workstation in the hallway manned by an EHR specialist who can answer ad hoc questions while clinicians are between patients or on breaks.)
  • Find the “power users” in your organization and ask them if you can observe how they interact with the EHR in order to pick up strategies.
  • Request a personal EHR efficiency report.
    • Most EHRs can track how a user utilizes the system. For example, an analysis can show what you do most frequently during an office visit. You can then create templates for the issues that you consistently and repetitively document.
  • Obtain training on software upgrades to take advantage of new features.

Many organizations have implemented successful EHR proficiency training programs. The following articles describe methods for identifying needed proficiency improvements and providing meaningful EHR training.

Creating the EMR Advantage. The Arch Collaborative EMR Best Practices Study
This article discusses Arch Collaborative findings about EHR training.

Physician Burnout — EMR Shaming Has to STOP
This blog post describes ways an organization can identify clinicians who struggle with the EHR and match them with EHR super users.

Epic Deployment at Penn Medicine Continues Success with Training, Optimization
This article discusses Penn Medicine’s EHR continuing training and optimization program for clinicians.

8 Ways to Reduce Physician Frustration with the EHR
This article discusses Gould Medical Group’s EHR optimization training program for clinicians.

Advanced Proficiency EHR Training: Effect on Physicians' EHR Efficiency, EHR Satisfaction and Job Satisfaction
This article highlights Kaiser Permanente’s Pathway to Proficiency (P2P), an EHR proficiency training program, to illustrate ways in which EHR proficiency training improves job satisfaction and work-life balance.

Peer-Led EHR training Saves Physicians’ Scarcest Resource: Time
This article discusses Kaiser Permanente’s HealthConnect Essentials course. All training is conducted by physician EHR super users.