Abstract

BackgroundTraining is a critical part of health information technology implementations, but little emphasis is placed on post-implementation training to support day-to-day activities. The goal of this study was to evaluate the impact of post-implementation training on key electronic health record activities.MethodsBased on feedback from providers and requests for technical support, we developed two classes designed to improve providers’ effectiveness with the electronic health record. Training took place at Kaiser Permanente, Mid-Atlantic States. The classes focused on managing patient-level information using problem lists and medication lists, as well as efficient documentation and chart review. Both classes used the blended learning method, integrating concrete scenarios, hands-on exercises and take-home materials to reinforce class concepts. To evaluate training effectiveness, we used a case–control study with a 1:4 match on pre-training performance. We measured the usage rate of two key electronic health record functions (problem list and medication list management) for six months before and after training. Change scores were compared using the Wilcoxon sign rank test.Results36 participants and 144 non-participants were included in the training evaluation. Training participants were more likely to manage both medication lists and problem lists after training. Class material is now being incorporated into an enterprise-wide multi-modal training program available to all providers at Kaiser Permanente in the Mid-Atlantic States.ConclusionsOngoing information technology training is well-received by healthcare providers, who expressed a clear preference for additional training. Training improved use of two important electronic health record features that are included as part of the Meaningful Use criteria.

Highlights

  • Training is a critical part of health information technology implementations, but little emphasis is placed on post-implementation training to support day-to-day activities

  • We developed two classes designed to train providers to be more effective when using the Electronic health record (EHR): one class focused on chart review and managing patient level data, and the other focused on accurate and efficient documentation and order entry

  • This study demonstrated that ongoing training may increase the use of medication lists and problem lists, the small sample size meant that some effects did not reach significance

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Summary

Introduction

Training is a critical part of health information technology implementations, but little emphasis is placed on post-implementation training to support day-to-day activities. The goal of this study was to evaluate the impact of post-implementation training on key electronic health record activities. Health Information Technology (HIT) has the potential to improve healthcare quality, increase patient safety, and reduce costs. Achieving that potential depends on healthcare providers being both willing and able to use the technology effectively. Despite the current high visibility of electronic health records (EHRs), many providers are unconvinced that EHRs will improve patient care and clinical outcomes [1,2,3,4]. Training is associated with improved use of advanced electronic health record features such as templates and order sets [8], and improved physician satisfaction with HIT systems [9,10]

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