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Healthcare Transformation Through Education

Eliminate fear in EHR adoption with simulation training

Despite impressive progress in electronic health record (EHR) implementations in recent years, many healthcare organizations still struggle to realize the full value of this technology. To achieve improved clinical outcomes on a large and sustainable scale, a shift in both the mindset and behaviors toward EHR implementation is necessary.  

Among the benefits of EHRs are increased access to patient data, improved quality of care and shared information across the continuum of care. Armed with a complete record of a patient's medical history, providers can save time and develop more effective care plans. For patients, access to personal medical information empowers proactive engagement in wellness and treatment options.

In an effort to improve care, reduce costs and receive Meaningful Use incentives, healthcare leaders in hospitals, clinics and medical practices are pushing hard to implement increasingly complex EHR technology. EHR implementations jumped to more than 40% from 12% between 2009 and 2012. However, they often encounter obstacles to adoption.

A fundamental obstacle to EHR adoption is resistance to change, which is generally fueled by fear. Providers fear the unknowns of how change will impact their ability to provide patient care. Will it take longer? Will it cost more? Will it really improve care? Could it result in worse care? These fears, and others, fuel a resistance that can be difficult to overcome.

On the consumer side, resistance toward EHRs is primarily due to security concerns. According to Xerox's 2013 EHR survey, only 32% of Americans favor digital health records. Nearly 83% of respondents expressed concern that their health information would be stolen or misused. Add in the survey finding that only 29% of physicians have actually talked to their patients about the benefits of EHRs, and it's no wonder that EHR adoption is moving slower than expected.

Knowledge is Key
What kind of help can overcome resistance and pave the way for using EHR technology to deliver improved patient care? Walls of resistance are built when you throw new technology at providers with little or no training. On the other hand, providers adopt technology quickly when they believe there is value in it. With patients, communicating the value of EHRs and reassuring them around privacy and security issues will be critical in gaining their support for this technology. If knowledge is one of the best antidotes for fear, then perhaps it is time to look at innovative learning solutions that help providers and patients understand how and why EHRs can be used to improve care.

Healthcare organizations should begin by ensuring they have a strong plan for communication and engagement with all end users, from clinical leaders all the way to patients. Next, they must ensure that clinicians can quickly and effectively learn to use the EHR to provide care.

Allowing healthcare professionals to practice EHR activities specific to their jobs in a real-life environment without real-life risks and consequences is very effective - think flight simulators for healthcare. Providers can practice using their actual EHR application to perform common tasks such as entering orders, documenting exams or administering medications. Courses must be short and targeted, allowing clinicians to quickly become proficient in important workflow tasks without sitting through hours of training in functionalities they may never need or use. Achieving proficiency in role-based tasks shortens the learning curve and ultimately boosts providers' confidence in using EHR systems.

Best Practices
Healthcare organizations that lead change with an effective and sustainable plan for helping providers use an EHR encounter less resistance. Clinician leaders seeking to reduce EHR resistance and boost adoption rates should consider these best practices:

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  • Prioritize education. When an organization struggles to adopt new technology, it often blames users for resisting change. While it is true that user resistance can slow adoption, user attitude is simply an indicator of how prepared the organization is for change and how it has chosen to educate end users. Resistance is often a symptom of lack of engagement by leadership and poor training; thus, it is important for leadership to establish a culture of adoption and provide effective education.
  • Revolutionize training. Leadership should consider simulators or alternative hands-on education approaches. Nearly nine decades of research in adult learning has shown that the human brain is a poor storage device for information, unless that information is recalled and reinforced immediately by experiential activities.
  • Make learning relevant. EHR vendors customize their systems, making it ineffective to train caregivers on standardized systems. Leadership must recognize that care providers should be trained using the actual screens and workflows of their organization's system. Simulation training provides this, regardless of organizational size or complexity. Education should also be customized to imitate different devices that caregivers may use - desktops, laptops or tablets - as well as reflect various caregiver roles and access privileges.
  • Define proficiency. It is helpful for leadership to work with an EHR vendor to determine the optimal level of proficiency for each clinician group. Well-designed role- and task-based simulators can help educators define appropriate proficiency levels and goals.
  • Develop sustainable processes. Adoption is never static - EHR usage is either improving or degrading within an organization. Drops in proficiency tend to occur following upgrades or changes to an EHR application. Leadership must invest in the people and processes required to sustain high levels of adoption over time. Metrics must be identified as indicators of whether users are improving, maintaining or declining in their adoption of the system.

Healthcare leaders must challenge caregivers to approach care differently, while giving them the education and support required to achieve successful technology adoption. In the long run, education programs that truly address the needs, concerns and learning styles of caregivers can accelerate adoption and, over time, reap the care-quality benefits that EHR technology can provide.

Heather Haugen is managing director for The Breakaway Group, A Xerox Company.

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