Here's a multiple-choice quiz with an answer that may surprise you:
What's the most expensive cost element when you implement new Electronic Medical Records?
a. EMR Software
b. Workstations and monitors
c. Training and Change Management
d. Customizing templates
If you answered "EMR software" - sorry, no cigar. While EMR / EHR software isn't cheap, it's a one-time expense.
If you chose "Workstations and monitors" you're still on the wrong track. Workstations and monitors with more than enough power for EMR cost under $1000.
If you answered "Training and Change Management," you may select the kewpie doll of your choice - you're absolutely right. This cost component is perennial and has no end!
Why is that true?
1. We've discovered that new staff usually needs to be trained not only on the EMR application, but also on basic computer skills like Windows, use of mouse, printing, creating folders, moving files, logging on and off, etc. If your staff is not comfortable with using computers with GUI (Graphical User Interface) for day to day operations, they will surely need training on that.
2. Implementation of Electronic Medical Records would involve use of devices like scanners, fax servers, etc. If the Clinic does not use such devices currently, staff will need to be trained on using these devices.
3. EMR software is a major application, thus most users will need to learn multiple new software functions. This takes time - learning a complex application requires lots of repetition until the new skills become second nature.
4. Initial training is often conducted in a tight time frame where the schedule is dictated by the EMR vendor and clinics find that they need additional training.
Here's another quiz question:
What is the leading cause of failure for new EMR implementations?
Studies show the failures are primarily related to inadequate training. Clients often want to know the quickest, most cost-effective way to train their staff on EMR software.
By avoiding the following 8 Cardinal Sins of EMR Training, you'll significantly slash your training costs, and improve your return on investment.
1. Big time gap between training and 'go live'
We've seen cases where the EMR vendor rushed ahead and trained staff on using EMR, even though the provider enrollment with various payers was far from complete. Big mistake! The training vendor went through the motions of training, collected a nice check, and went away. When the enrollment process was finally completed, 8-10 weeks later, and the clinic began using the EMR system - you guessed it, the provider and staff had forgotten how to use the application and were forced to purchase additional training days.
Here's our recommendation: insist on starting training after the setup process is complete, including all interfaces (lab interface, eRx, etc.).
2. Training everyone on everything
In a larger clinic (including multiple locations), clinic staff often play widely different roles, and therefore need to know very different parts of the EMR application. Training every staff member on every feature of the EMR won't optimize their skills on the parts that are most relevant to them. For example, only a few staff members will have access to the sensitive areas of the EMR (e.g., security administration).
Training plan must be based on roles. A better approach is to have the EMR vendor train a set of super-users ("Train the Trainer") who will have the responsibility to train and support the rest of the staff. They are the ‘go to' people when users have issues with using EMR (before someone makes a call to the Customer Support operations of the EMR vendor).
3. Assuming that training ends after implementation
Training doesn't end when the EMR system is up and running. Staff roles and responsibilities can change over time, and new employees will need training on the EMR software. Training never ends - but it's a lot cheaper to have one or more super-users on the staff who can train than others, than to bring back the training vendor each time. (See #2 above.)
4. Having the EMR vendor train staff in basic computer skills
Having the EMR vendor teach basic computer skills is a huge waste of money. If your staff members can't teach each other these simple skills, find an adult-education course, or hire a computer science student who'll do the job for a fraction of what the EMR vendor would charge. Plan to have the hardware installed well in advance, so that staff can be trained on basic skills before the EMR system arrives.
5. Assuming that training can be imparted remotely and effectively over Webex or other web conference media
Many EMR vendors offer remote training using remote Webex or GoToMeeting sessions over the Internet, without any on-site support during go-live. Remote training costs less but is never as effective as face-to-face training. Choose on-site setting, even if it means spending extra money. Also, insist on having an expert on-site during go-live.
6. Not insisting on formal training material or not using desktop recording software to record the training session
Insist that the vendor provide formal training materials that can be used to train new staff. Ideally, the training materials will be tailored to your practice requirements. If no formal training material is available, have your staff capture snapshots and create a training binder for future reference. Better still, use a desktop recording software to record the video and audio (if possible).
7. Assuming that the training provided by EMR vendor will encompass all elements that are relevant to your medical practice.
Most of the time, the EMR Vendor may adopt a ‘one size fits all' approach as far as EMR training is concerned. It is in your interest to work with the vendor in designing the training sessions customized to your specific requirements. You may find that some portions are not covered at all while some easy functionality hogs valuable training time.
8. Not validating the credentials of the trainer provided by the EMR vendor in the medical specialty of your Clinic.
We recommend confirming the trainer's credentials before he/she comes on-site. It's very important that the trainer understand the unique requirements of your medical specialty, so the trainer can offer relevant tips to help your staff optimize their use of the EMR system.
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We would like to keep revising this list for the benefit of our future readers. Hence if you believe that there are other training sins that you want included on this list, please do leave your comments. We will have an updated list available for free download soon.
Check out our downloadable spreadsheet on EMR Implementation Costs - an organized approach for getting a good EMR RFP or price quote and select the right-fit EMR Software for you Practice. Don't forget to contact us for a no-obligation 'Free' Selection consulting available to all bonafide buyers.