Best Practices for EHR Implementation Training

Implementing an Electronic Health Record (EHR) involves diligent planning across multiple phases, from pre-work to post-live. One of the key phases in the EHR implementation process is training. At a high level, the training phase will encompass training all end users on the system, hands-on system practice and personalization. The best practices outlined here include applications from many healthcare delivery organizations across the United States with varying size, scope and complexity.

Here are the nine key areas to keep in mind.

Training Approach and Roles and Responsibility: Offer a variety of workflow-based/role-based training modalities with hands-on practice and with considerable support. Similarly, the training team will perform a variety of key roles, from curriculum development to training environment maintenance; therefore, it is necessary to define clear delineation of roles and responsibilities.

Training Timeline: Training delivery should begin five to six months prior to go-live, beginning with the publishing of the training schedule. In general, Super Users are trained first, as they will support future end-user training.

Identifying Trainers and Proficiency Requirements: Not all trainers are created equal. Leverage existing trainers, as they might be ideal candidates. Look for experts at neighboring organizations who may have also recently implemented an EHR. Trainers are also required to demonstrate proficiency for teaching the system, so consider a train-the-trainer (TTT) program where graduates must pass a content exam and complete a peer training assessment.

Training Content and Curriculum: Work with the Training Manager, CMIO, leadership stakeholders, and physician leadership to determine training tracks and curriculum. It is also important to update and communicate existing policies and procedures prior to go-live, so they reflect and support new system workflow. Facilitate pilot training classes with build analysts and operational leaders to validate curriculum content, training structure, and appropriate system access.

Physician Training: Work with the training manager to ensure there is a physician training strategy in place. Utilize physician champions as trainers based upon their knowledge of and enthusiasm for the system. Consider specialty physician training that ensures the content is reflective of their specific needs and encourages faster adoption of the system. Be prepared to address resistance to in-class training and work to determine how to address these physicians and their individual concerns. The timing of physician training also differs from the recommended end-user training timeline. Consider training physicians within two to four weeks prior to go-live.

No Training, No Access: Require training and end-user competency for system access and establish a policy for end users who do not meet the requirements.

Training Management and Tracking: It is critical to establish a system for managing, scheduling and tracking end-user training status. Very early on, it is important to:

• Identify the learning management system (LMS) that will be used to schedule end-user training.
• Determine the number of end users who need training.
• Develop a process to manage current and future end users who need training.

Training Sessions: A successful training session is well-organized. Here are some logistical considerations to keep in mind.

• Ideal classroom size is eight to 16 end users, led by a training and supported by a Super User.
• Accommodate various schedules, including first, second, third and weekend shifts. Some training may be offered 24 hours a day, seven days a week, or at a minimum of 7 a.m. to midnight.
• Utilize a centralized training location.
• Treat physician training much like the organization’s credentialing process. Work with the Medication Education Department to certify the training curriculum
• Fill classes with like providers of the same specialty (e.g., ED providers).

Backfill Coverage for Training Participants: Start backfill-coverage planning a year prior to go-live to account for shift scheduling. Ensure Champions and Super Users are relieved of operational duties to attend training, support training and complete go-live support shifts.

The goal of an EHR implementation training program is to ensure all end users complete the prescribed training and reach the required competency level prior to being granted system access. However, one size does not fit all. It is important to develop a training program based upon the unique needs of the client and scope of the EHR implementation.