Streamlined Training Reporting During an EHR Implementation

It is well understood that a comprehensive and engaging training program is a key element of any successful EHR implementation. To maintain the high standard of patient safety and revenue integrity during and after an EHR transition, healthcare organizations typically require their staff to attend training on modules relevant for their job function and pass test(s) on use of the system before being granted security access.

During a perfect EHR implementation, the organization would have a crystal clear idea on which of its staff needs what training, what the progress of the training is and when it is appropriate to assign the corresponding security access to that staff member.

However, we typically see access related incidents being reported during a go-live – sometimes it can be the top issue during the first week. This item can directly be linked back to unattended training (e.g. user was not reminded or unclear on which class to go to) or incorrect security access set up. It delays patient care at go-live and it is very much avoidable.

We recognize that, with constant staffing changes and shifting understanding of the training needs, one can never get to the 100%. But how can we get ourselves to, say, 99.9%?

Apart from maintaining active engagement with executives, operational leaders, and all stakeholders throughout the transformation journey, dedicated reporting effort on training related activities is a powerful approach for the organization to transparently understand the progress of the education efforts, and more importantly, the gap that is yet to be closed. It also guides the security access assignment prior to go-live.

An ideal scenario for this reporting effort is as follows:

• The training requirement as well as the training completion information are documented and updated in near real-time
• The training completion information is compared against the requirement – leadership would understand the completion % and also have a list of users that are not yet trained as a target group to work with
• Finally, security access is granted based on the completed training

Here are some tips we have for you if you plan to invest in this reporting effort:

Formally define and communicate out the two components that serve as the “source of truth” (ideally, they should be recorded in one system, but typically they are not).

• Training requirement database (e.g. User Bob is required to complete Class A and B)
• Training completion database (e.g. User Bob passed Class A exam and registered for Class B)

Formally define and communicate out the following aspects of each source-of-truth database mentioned above.

• Owner/day-to-day steward of the database
• Information update process (e.g. when a user changes job, principal trainer will need to submit update to the owner of the database; when a user is terminated, operational manager will notify the owner of the database)
• Data integrity maintenance process (e.g. all training activities should be recorded in training completion database, including the paper based attendance and exams)

Formally define and communicate out the responsibility and expectations of related parties, e.g. Owners of the database, trainers, security access team.

• Make the training report actionable by articulating action items, associated issue owners and resolution process, e.g. missing class registration, failed assessment
• Start training reporting to operational leadership as early as appropriate to encourage completion of training
• Articulate training class/track’s implication for security access by developing a Training Class/Track and Security Access Crosswalk (e.g. Completing Class A, B, C indicates granting Access Type 1; completing Class A, C, D indicates granting Access Type 2)

Mechanics of the report.

• If the source-of-truth databases are separate, define a unique key/ID for each user for cross-mapping purposes. Always maintain accuracy and completeness of that ID. As a minimum, IDs should be available for mapping across training requirement database, training completion database, HR/ERP database and EHR user list
• Make sure class names are consistent cross databases
• Pay special attention and call out users who have multiple security access profiles to minimize any confusion. If manual review is needed, validate information (e.g. completed training, planned profiles) for these users proactively prior to cutover. You can start with areas where cross-functional users typically present, e.g. OR, smaller community hospital locations.
• When designing the database structure, make sure it’s easily reportable. This is specifically important for organizations that are heavily reliant on Excel to maintain data.

Managing EHR training is not an easy job. We hope these tips make your life easier and empower a data-driven training management program.