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The advantages of simulation training

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   By Heather Haugen, April 2012

H04_MU_Xerox-ACS_Haugen_90x119How to improve EMR adoption.

The phrase “meaningful use” has been repeated so many times in the past two years, with such intense focus and scrutiny, that we may have lost focus on its actual intended meaning.

The conversation today seems to center around healthcare providers implementing technology and accessing stimulus dollars. Driving adoption of the technology often isn’t even considered until after the go-live event. If the technology that promises to deliver the benefits is implemented but sitting unused, or used incorrectly, providers can’t expect to realize meaningful results. The next step toward achieving meaningful use – and where I believe the conversation belongs – is to ensure caregivers are using the technology consistently and accurately to achieve quality outcomes and improve patient care.

So our focus must move to how to improve adoption. How can we ensure the accurate use of the electronic medical records (EMR) systems by healthcare providers in all roles over the life of the application? It is time for us to drastically change our approach to training.

Consider the value of teaching caregivers to use EMRs through role-based simulators. Simulation provides an opportunity to practice in a real-life environment without real-life risks and consequences. Caregivers learn in their actual EMR application, which is critically important for learning workflow and gaining new knowledge about the system. They only learn tasks that are applicable to their role. For example, physicians learn to enter orders and write prescriptions, but don’t have to sit through training on functionality they will never use. It shortens the learning curve by ensuring caregivers are proficient in the use of the system, ultimately feeling confident enough with the technology to adopt and use it to provide care.

The success rate is significant – statistics show that providers who use simulation technology experience adoption rates of up to 70 percent higher compared to traditional training approaches, such as “train the trainer.” This ultimately means that caregivers are utilizing the EMR technology as intended and driving quality outcomes for patients.

Here is some practical information for any providers considering best practices for boosting adoption rates for EMRs:

  • Prioritize education: When organizations struggle with adoption of new technology, they often blame the user for resisting change. While it is true that user resistance can slow adoption, the user attitude is simply a barometer for how prepared the organization is for change and how they have chosen to educate caregivers. Resistance is often a symptom of lack of engagement by leadership and poor training.
  • Revolution training: It is time to question the traditional approach to training. We know from nearly nine decades of research about adult learning that the human brain is a poor storage device for information and data, unless that information is recalled and reinforced immediately by experiential activities. The one-time training event with an overloaded agenda is an almost certain waste if the user does not have the time to assimilate the information and relate it to concepts they already know.
  • Give caregivers time back for clinical care: Caregivers are busy people and are in the business of improving lives. One of the most frequently cited concerns about training programs is that they take time during business hours away from face-to-face patient time and revenue opportunities. Simulation training can be done anywhere and anytime at the convenience of the caregivers.
  • Make education relevant: EMR vendors, such as Allscripts, Cerner, Epic and McKesson, all customize their respective systems, so it doesn’t make sense to train caregivers on standard builds on systems. For education to be effective we must use the actual screens and workflows of an organization’s system – and simulation training can provide that, both for large hospitals or small physicians’ offices. It can also be customized to imitate different devices that caregivers may be using – desktops, laptops or tablets – as well as different roles that different caregivers may have, and the different sets of privileges that come with those roles.
  • Define proficiency: When designed correctly, simulators literally change how caregivers learn new technology. First, they are designed for each role using the application; generic simulators are ineffective. Additionally, individuals only learn the functions appropriate for their role. By defining the level of proficiency required for each role, we give the user a specific goal to achieve. One of the easiest ways to reduce the cycle time to proficiency is to define the proficiency level required for each job role. This becomes the metric for defining knowledge level in the application and drives adoption.
  • Develop sustainable processes: Adoption is never static; it is either improving or degrading in the organization. Drops in proficiency happen after upgrades or changes to the application. Leadership must invest in the people and processes required to sustain high levels of adoption over time. We must identify metrics as indicators of whether users are improving, maintaining or regressing in their adoption of technology. It takes relentless focus to achieve the levels of adoption needed to improve quality of care, patient safety and financial outcomes.

Driving adoption of EMR systems addresses the need to commit to something greater than a mandate. It brings the conversation around meaningful use to where it should be today: leveraging new technology to improve the quality of care.

About the author
Heather Haugen, Ph.D., is corporate vice president, The Breakaway Group, A Xerox Company.  For more on Xerox, click here.


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