Pre-training tactics trending in EHR implementation process


It’s no secret that health records are evolving — morphing from paper to pixel alongside other products of the parchment lineage.

With a steadily transforming platform, industry allies are in a state of constant innovation and movement to keep in stride with the technologies they promote. As momentum needs to carry throughout the entirety of the EHR implementation process, more and more companies are aiming to up their acceleration early, via comprehensive pre-training regimens, so their products may travel farther in less time. Chad Cagnolatti, of healthcare IT consulting firm Impact Advisors, spoke to PhysBizTech of this emerging emphasis in the industry of getting to physicians and their practices even before the EHR training modules do.

“It’s really new tactic that we’re seeing; shifting opportunities sooner than training for docs and other staff members,” Cagnolatti said. “We don’t want training, which actually comes right prior to go-live on an EHR, to be the first experience for the majority of physicians. So what we’re seeing are opportunities and tactics as part of the implementation of the EHR for the physicians to become familiar with, and get to see and touch, and actually get to practice on the EHR well before training comes.”

Although the prefix implies a lack of structure, pre-training methods are built with a particular scaffolding, where practice executives, contributing medical staffers from all levels of training, and hospital organizations must come together to establish a common ground.

“What we find very helpful and valuable [with small-to-medium sized practices] is if we focus the training on the support staff in those practices,” Cagnolatti noted. “So if we can get a front-office MA or if we can get an NP who works alongside those clinic physicians to also come to and be a part of training, it really helps those physicians in smaller practices once we’re live.”

This method of bringing all practice contributors and industry allies together at once before actual EHR training, Cagnolatti added, allows for those involved in a practice and care community to find a “bridge” or similar vein, as well as get their preliminary questions in order.

“A tactic that we see as helpful to physicians is to talk specifically about a list of training steps to emphasize with them; we call them bridging steps,” he said. “If I’m a physician in a clinic, how do I cue up my patient for some pre-admission testing? How do I get my patient scheduled in the hospital for an elective surgery? How do I send my patient to a draw station of their choice for some outpatient labs? How do I get my patient from the clinic today, if they’re sitting in front of me, to some sort of care menu which is on the hospital side or the inpatient side.”

When prompted about how many bridges should be erected in the process, Cagnolatti said step amounts vary.

“It’s not cut and dry; there’s normally a good few dozen that we would focus on but it is practice-by-practice” he noted.

And the pregame for EHR training definitely shouldn’t stop at just one goal-setting discussion — according to Cagnolatti, talks and movement in governance must remain as constant before EHR implementation as it does during and after.

“We’re seeing internally an increase on the emphasis of physician participation in governance. We have steering committees, we have decision-making bodies, we have physician advisory groups that are a part of the project. We have physicians look to the organization of the practice and try to get a balanced membership to sit in on those governance bodies. We get those physicians to weigh-in on questions about software scope and strategy. The benefit that we realize from that is that they have more of a feeling of ownership; they’re making the decisions, they’re not just having something done to them.”

Physicians shouldn’t be the only healthcare members participating in these ambulatory councils or governance boards — there are places for nurses, medical assistants and executives to become involved as well, Cagnolatti concluded.

“Processing patient flow throughout a clinic using the EHR is not just about a physician, it’s about everyone who supports that linear flow of the patient’s experience knowing their part and knowing each other’s parts as well. A collaborative model in designing workflow steps is essential.”