Following the Department of Health and Human Services and the Centers for Medicare and Medicaid Services release of finalized "meaningful use" requirements that providers must meet to quality for incentive payments, hospitals are becoming more anxious about successfully implementing an EMR. Here Judith Klickstein, senior vice president of information technology and CIO of three-hospital Cambridge (Mass.) Health Alliance, gives three tips on getting your hospital comfortable with an EMR.
1. Go with an established vendor. "There's no so thing as a perfect vendor or a perfect product," Ms. Klickstein said, but it helps to choose a company with a solid record of successful implementations and happy customers. After some research, Cambridge Health Alliance decided to start their implementation on the ambulatory side with Epic.
When choosing a vendor, Ms. Klickstein says, "You have to watch out for the skill of the people they're giving you and the complexity of the IT. You don't want to depend on somebody right out of college who doesn't know what they're doing. You want somebody who's been in the industry for a few years, who has a few battle scars."
2. Recognize different learning styles. In an ideal world, everyone in your hospital would learn information the same way, but in reality, you're going to be dealing with a variety of learning styles, from people who work best in big groups to people who need one-on-one support to people who can go off and learn the whole system by themselves. When Cambridge Health Alliance started to train its staff on using the EMR, it sent staff members to a site for two weeks, where "everyone sat at everyone's elbow" learning how to use the system. The staff members seemed to be learning while they were on site, but once they returned to the hospital, Ms. Klickstein says "it was like getting an unwanted divorce. They go through withdrawal."
Instead, the hospital system now offers various types of training, both on and off site. By offering standard classroom training and one-on-one training, as well as manuals and online exercises, your hospital can ensure that even slow learners can address their difficulties and achieve an in-depth knowledge of the system.
Ms. Klickstein also recommends checking in with new staff at the six-month mark and soliciting feedback about training. "We're sending clinical trainers to meet with them [then] because we've found it's an important transition point," she said. "It appears to be very, very helpful and appreciated."
3. Talk to your staff about their difficulties. When starting an implementation, it is essential to realize that you will run into problems. Ms. Klickstein reports a light at the end of the tunnel: "There's the trauma of go-live, and we found that within the first couple of months are always challenging because everyone's getting used to a new workflow. But after a few months, people usually say, 'I could never go back to using paper again', after six months they're fairly skilled and they want to start changing things and pushing buttons and getting system to be accommodating around their preferences."
Even so, before you reach the point when your physicians and nurses are comfortable with your EMR, you will experience difficulties. Many of the issues, Ms. Klickstein says, may arise because physicians and nurses can't do their jobs and use your EMR at the same time. The easiest way to tackle this problem is to simply listen to your staff. Solicit feedback. Ask questions. Start a committee tasked with finding solutions.
"In year six, our primary care group went off the deep end, partly because the nature of their practice is very different and very intense," Ms. Klickstein says. "We started a Primary Care Task Force, where we consulted a number of practicing clinicians and we used them to put together a hit list of changes that they thought would make the practice better. We've gone about addressing them, so it's a rapid cycle of change — listening to problems and fixing them."
Read more coverage on recent rulings on meaningful use and EMRs.
-CMS Eases Requirements for Final "Meaningful Use" Rules
-Secretary Sebelius Announces Final Rules on "Meaningful Use" of EHR
1. Go with an established vendor. "There's no so thing as a perfect vendor or a perfect product," Ms. Klickstein said, but it helps to choose a company with a solid record of successful implementations and happy customers. After some research, Cambridge Health Alliance decided to start their implementation on the ambulatory side with Epic.
When choosing a vendor, Ms. Klickstein says, "You have to watch out for the skill of the people they're giving you and the complexity of the IT. You don't want to depend on somebody right out of college who doesn't know what they're doing. You want somebody who's been in the industry for a few years, who has a few battle scars."
2. Recognize different learning styles. In an ideal world, everyone in your hospital would learn information the same way, but in reality, you're going to be dealing with a variety of learning styles, from people who work best in big groups to people who need one-on-one support to people who can go off and learn the whole system by themselves. When Cambridge Health Alliance started to train its staff on using the EMR, it sent staff members to a site for two weeks, where "everyone sat at everyone's elbow" learning how to use the system. The staff members seemed to be learning while they were on site, but once they returned to the hospital, Ms. Klickstein says "it was like getting an unwanted divorce. They go through withdrawal."
Instead, the hospital system now offers various types of training, both on and off site. By offering standard classroom training and one-on-one training, as well as manuals and online exercises, your hospital can ensure that even slow learners can address their difficulties and achieve an in-depth knowledge of the system.
Ms. Klickstein also recommends checking in with new staff at the six-month mark and soliciting feedback about training. "We're sending clinical trainers to meet with them [then] because we've found it's an important transition point," she said. "It appears to be very, very helpful and appreciated."
3. Talk to your staff about their difficulties. When starting an implementation, it is essential to realize that you will run into problems. Ms. Klickstein reports a light at the end of the tunnel: "There's the trauma of go-live, and we found that within the first couple of months are always challenging because everyone's getting used to a new workflow. But after a few months, people usually say, 'I could never go back to using paper again', after six months they're fairly skilled and they want to start changing things and pushing buttons and getting system to be accommodating around their preferences."
Even so, before you reach the point when your physicians and nurses are comfortable with your EMR, you will experience difficulties. Many of the issues, Ms. Klickstein says, may arise because physicians and nurses can't do their jobs and use your EMR at the same time. The easiest way to tackle this problem is to simply listen to your staff. Solicit feedback. Ask questions. Start a committee tasked with finding solutions.
"In year six, our primary care group went off the deep end, partly because the nature of their practice is very different and very intense," Ms. Klickstein says. "We started a Primary Care Task Force, where we consulted a number of practicing clinicians and we used them to put together a hit list of changes that they thought would make the practice better. We've gone about addressing them, so it's a rapid cycle of change — listening to problems and fixing them."
Read more coverage on recent rulings on meaningful use and EMRs.
-CMS Eases Requirements for Final "Meaningful Use" Rules
-Secretary Sebelius Announces Final Rules on "Meaningful Use" of EHR