When end-users embrace an EHR platform and are able to use it effectively, these systems can fulfill the promise of better care through technology. However because of the complexity of EHR implementations, concerns about project timing and cost may supersede efforts to foster engagement with end-users. Clinicians work long hours and have challenging jobs, making it difficult for them to find time to engage with new initiatives. In some cases they may see changes as a distraction from their core responsibilities.
If your organization is still in the process of implementing an EHR platform or working to optimize your system, it can be very helpful to focus on engaging with clinicians and other end-users to get the most out of your new tools.
Here are four techniques to consider:
- Engage influential end-user stakeholder groups
- Emphasize patient care when communicating with certain end-users
- Increase transparency and build trust with two way communication
- Provide effective training that empowers end-users to use EHR
1. Engaging End-User Stakeholders
EHR project teams may find it helpful to initiate a dialogue with influential members of end-user departments, including laboratory, billing, pharmacy, diagnostics, and clinical teams. It often makes sense to start by identifying a key clinical leader who works regularly with many end-users and understands their perspective on the project such as the Chief Nursing Officer or Director of Pharmacy.
The support of these individuals can be highly influential; they are able to address end-user issues and directly advocate for the benefits of EHR. They may also help contextualize the patient care benefits of the system in a way that resonates with clinical staff, which can drive engagement in turn.
Project teams should also try to identify “champions” and “power users” amongst the end-user population. “Champions” are a subset of clinicians, often those with informatics experience, who are most likely to see the benefits of EHR early on. They serve a vital role in an implementation project through their vocal support for a project, acting as advocates to other clinicians.
“Power users” are those who are adept with new systems and often assist their colleagues when they are having difficulties with technology. They can likely be found in almost every department and play a vital role after EHR goes live by assisting colleagues and providing informal technical support. Fostering a dialogue with both of these groups of clinical stakeholders helps to build support for EHR.
2. Emphasizing Patient Care
Clinicians and pharmacists view almost every IT project through the lens of patient care. This priority guides nearly all the decisions they make, and they may be skeptical of anything that has the potential to distract them from their goals. Although other stakeholders may focus on long-term cost savings, greater efficiency, improved billing, better data exchange, or easier record keeping, these arguments are likely to be less compelling for clinicians. When working to build their engagement with a new EHR platform, it can be helpful to frame the benefits of the platform in terms of its ability to enhance the quality of care.
The use of EHR systems in coordination with computerized physician order entry (CPOE) has been shown to cut medication errors by as much as half. Many clinicians are concerned with making mistakes that may impact patients (such as adverse drug events), and these systems can help prevent them. Clinicians seek to improve patient care, and EHR is a powerful tool for accomplishing that goal; communicating that effectively is key.
The broader benefits of EHR and related health information systems (HIS) may appeal to clinicians as well. When an optimized platform is in place, sharing information between departments is faster and easier with EHR. Your team may be able to spend less time working on routine tasks, allowing them to focus their energy elsewhere.
One caveat: overemphasizing computer-based decision making can alienate physicians in particular. They may feel that medication choices or patient treatment options are being taken away from them. A more effective approach is to emphasize how these systems can act as a supplement to physician decision-making.
3. Increasing Transparency and Building Trust
When hospitals are able to build a culture of transparency they can make end-users feel like partners in the process of technological change and optimization. Project leaders should solicit and consider the diverse perspectives and concerns of end-users and let this inform their strategy. Frequent, two-way communication with end-users including emails, newsletters, and in-person briefings can help facilitate a feeling of ownership amongst end-users.
These means of creating transparency can help to build an environment of trust; it can also be helpful to try and set realistic expectations.It may be prudent to avoid overemphasizing the timesaving benefits of EHR, because these may not be realized immediately. Overly ambitious expectations can frustrate clinicians who find the system initially leads to slowed workflows; being honest with end-users about the timeline for evaluating the benefits of a system may yield better results.
By creating a sense of shared ownership of the system amongst its eventual users, open communication makes it more likely they will embrace EHR. One study on the subject demonstrated that buy-in among users was more important than system design in the overall success of an EHR project.
4. Providing Effective Training
Training can be instrumental in helping users become comfortable and efficient using an EHR platform. To be successful, these trainings should be tailored to the needs of an organization and thorough in their scope. Insufficient training can leave users unequipped to work with new software, and may create a need for increased ongoing tech support. By investing in training up front, organizations can empower end-users to leverage an EHR platform more effectively.
Holding only a handful of large training sessions may be ineffective. Ideally training will be more flexible, with sessions available at different times and across several weeks in order to give all end-users (especially clinicians) a convenient opportunity to attend. Making trainings as accessible as possible can go a long way towards maximizing their impact.
To make these trainings as valuable as possible, project teams should assess the capabilities of end-users throughout the organization before planning their curriculum. Training should be adapted to particular groups of users based on department and assessed technological skill level, and it shouldn’t end when the system goes live. Resources for ongoing assistance should be available to end-users who may want to revisit trainings later on.
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