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T R A I N I N G C O N S I D E R A T I O N S F O R

H E A L T H I N F O R M A T I O N T E C H N O L O G Y

11639 E. Wethersfield Road, Scottsdale, AZ 85259 USA

www.michaelsandassoc.com Toll-free: 877-614-8440

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Executive Summary

The business of healthcare is experiencing change of a magnitude that has

never before been seen. The implementation of health information technology

(HIT) is burgeoning within health care organizations across the United States.

After selecting and preparing computerized medical record software, training

health care workers to use the new technology remains a critical need.

Relatively new to technology, the health care industry must strive to create

training that can be delivered with minimal impact on staffing, the flexibility to

meet the needs of multiple disciplines, and the effectiveness to decrease the

impact on revenue that is commonly seen after the implementation of an

electronic medical record (EMR) system.

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The New World of Health Information Technology

In light of recent ARRA legislation, healthcare organizations are scrambling to comply with government mandates and implement health information

technology. HIT includes such things as:

Computerized physician order entry.

Computerized documentation of patient biometric information.

Electronic delivery of diagnostic test results.

Computerized documentation of physician, nursing and allied health

patient care plans and notes.

Evidence-based guidance.

The scope of HIT requires that all health care workers must be trained to use the

computer system.

Although many resources are focused on defining such things as meaningful use

of health information technology, levels of adoption, and software selection, little

attention has been focused on the training and support of the health care workers

who ultimately use health information technology on a daily basis.

Resources Devoted to the Implementation of HIT

Software Purchase

•>$10,000 per Prescriber

Software Implementation

•1.5 X purchase costs

•Technical configuration

•Additional staff

•Decreased productivity & revenue loss

Training

•No published cost measures exist

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The Current State of the Industry

Health care as an industry is a latecomer to the computer age, and many nurses and physicians are novice computer users. They are now faced with

the challenges of learning basic computer operation and the introduction of computer technology into the daily work of patient care. These challenges

precipitate changes in workflow and data entry processes that can impact the delivery of patient care.

Components of Effective Training

It is essential that health care staff are properly trained and prepared to use health information technology, and health care organizations must create

effective and flexible training through a variety of delivery methods such as online courses, instructor-led training and hands-on practice. Training must

also focus on the key concepts and processes, and it should be chunked into flexible learning modules that can be reused to meet the needs of the

many different roles involved in the delivery of patient care.

Example of Chunking Training into Modules for Flexibility and Reusability

Training Modules Learner Roles

Physician Nurse Social Worker Nursing Assistant

How to enter vital signs X X

How to view vital signs X X

How to enter an order X X

How to view an order X X

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Because EMR software is constantly changing—with upgrades and new functionality—training must keep up

with the change. Learning modules must be designed so they can be quickly and easily updated to reflect

changes in software or processes and can be utilized for ongoing employee training long after the initial

implementation training.

Implementation of effective, successful HIT training requires several components:

A development team with an in-depth knowledge of the processes and practices associated with the

delivery of patient care and a detailed understanding of computer technology and the possibilities and

limitations of an EMR system

Expertise in and application of adult learning theory and instructional design principles

A focus on the end users—the targets of change—and their concerns and needs

A dedication to creating conditions for success during this time of extreme organizational change

There are few experts within the health care industry who possess this combination of skills to design

effective training.

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The Clinical Specialist

Historically, training within health care has focused on the validation and advancement of clinical skills—a task most often performed by clinical

experts such as registered nurses trained as clinical nurse specialists. Although clinical nurse specialists are experts in the processes and practices of

the delivery of health care, the training of computer technology is typically not within the scope of expertise for these professionals.

The Information Technology Solution

A new breed of health care professionals has arisen in response to the growing need for HIT implementation expertise. These professionals include

nursing informaticists, medical informaticists, and other licensed health care professionals who focus on the integration of technology with the delivery

of health care. The design and delivery of HIT training is often delegated to the informaticist, who possesses an in-depth knowledge of patient care

delivery processes as well as an understanding of health information technology. Missing from the equation, however, is the expertise in adult

learning, instructional design, and change management.

The Software Vendor Solution

In response to the lack of effective training solutions, many vendors of electronic medical records systems offer prefabricated or customized training to

a health care organization. Although a software vendor is an expert in the functionality and processes associated with their particular EMR system, the

vendor is often unfamiliar with the unique culture and processes of each health care organization. Oftentimes the result is training that teaches health

care staff how the software works, but not how to use the software in their daily work.

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The Instructional Design Solution

Infrequently seen in health care but utilized by many other industries, the instructional designer is trained to tap the knowledge of subject matter

experts in order to design and deliver effective training. Instructional designers for an initiative as large and complex as EMR implementation typically

work in a team to provide consultation services and training solutions. They can collaborate closely with subject matter experts in all areas to perform

tasks such as:

Clarify organizational goals and objectives.

Identify the target training population: their characteristics, current

processes, and needs.

Analyze the level of performance to be attained as a result of the training.

Determine strategies for transferring learned skills into the workplace.

Identify learning objectives for the training program.

Design and develop a flexible, comprehensive training program that meets the

needs of learners, is instructionally sound, creates conditions for success, and

meets the business needs of the health care organization.

Implement the training solution along with complementary communications to

prepare learners for success.

Evaluate the success of the training program.

The Instructional Designer’s Role

Clinical Nurse Specialist: Patient care processes

and training

Software Vendor: Software function

and training

Instructional Designer: Utilizes subject matter experts in all three areas to design effective and efficient training based on adult learning

theory and instructional design principles

Clinical Informaticist:

Software function and patient care

processes

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Benefits of an Instructional Design Solution

The delivery of training to patient care staff is a large expense for an organization,

triggering increased payroll costs during the training and implementation period. Although

hiring instructional designers to manage the training is also an investment, it is often

more economical than using the internal resources because:

The internal resources are usually fully booked with work. Stretching internal

resources can be detrimental to morale, but hiring additional permanent

employees can be expensive and time consuming. Instructional design

consultants are fully engaged in the learning project and feel the urgency of

deadlines.

Successful instructional design consultants have proven track records, protocols,

methodologies, and efficiencies that reduce development time and money.

Instructional designers are skilled at learning new technologies and business

processes and can quickly assimilate into the organization’s environment. This

acceleration provides an excellent return on investment.

Consultants schedule their work around the subject matter experts’

commitments, maximizing their time and reducing their time away from their

other priorities.

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Conclusion

A critical component in the successful implementation of health

information technology is training. However, very limited attention

and resources have been dedicated toward helping novice users in

the industry gain the necessary skills to be successful with the

technology. HIT process, practice, integration and

functionality experts have historically been tasked with creating

training, but they lack the essential expertise to create

instructionally sound, effective solutions. By completing the

existing team of experts with experienced instructional design

consultants, health care organizations can achieve optimal ROI

and deliver EMR system training that meets the needs of the staff

and the business objectives of the organization.

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H E A L T H I N F O R M A T I O N T E C H N O L O G Y

At Michaels & Associates, we provide consultation services and custom training development for a variety of businesses including the healthcare

industry. We help our clients build an environment for individuals where learning matters and profoundly impacts every person, business and

community. To learn more about how Michaels & Associates can help your organization build effective EMR training, contact us.

Michaels & Associates — where applied learning and your business goals meet.

info@michaelsandassoc.com www.michaelsandassoc.com toll-free: 877-614-8440