Helping doctors adapt to EMRs

Much ink has been spilled discussing why physicians are resistant to adopting EMRs.

The thing is, it’s really no mystery.  Researchers have arrived at what seem like sensible answers to the question, including a) problems changing their work habits, b) fear of the unknown and c) struggles with kludgy interfaces.

So, why not take these problems on directly? While we can’t get inside clinicians’ heads and tell them how to think, we can address their issues concretely.

If the anecdotes I hear are accurate, many are pushed into EMR use and forced to do all the adapting, rather than getting the help they need.

So how can we help?

Obviously, physicians and other clinical staffers need access to accessible, intelligent training — ideally, both Web-based and live — as well as easy-to-use documentation that’s written in very simple language.

But that’s not all. While many institutions breeze by this step, IT departments (or consultants) should do everything they can to customize the EMR experience for individual clinicians. (If your EMR is too rigid to allow for this, that’s another story, but let’s pray you have one with some flexibility built in.)

It’s also important to pinpoint what other frustrations clinicians may have. For example, some doctors who type poorly are immensely frustrated by using EMRs, something keyboard-savvy techs might never consider.  A good old-fashioned typing course might work wonders in those cases.

In the rush to deal with the complex technical issues involved in EMR integration, it’s easy to blow by the needs of individual users.  It’s even easier to throw some fragmentary training at clinicians and assume they have a bad attitude if it doesn’t “take.”

The truth is, though, that nobody can afford to be short-sighted about getting users connected to EMRs.  Let’s hope everyone bears this in mind as the main wave of rollouts begins.

About the author

Anne Zieger

Anne Zieger

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

8 Comments

  • Answers (a) & (b) to not follow any evidence at all. Just take a scan at all of the new medical technologies that have been developed and deployed over the past 20 years or so. Virtually everyone of them caused some change in practice habits and workflow. They were certainly full of “the unknown” in many cases.

    My 2 cents.

  • These three things are the symptoms not the disease. The real problem is the technology. While doctors easily take up new technology to use they will not, actually can not, manage that technology. An EMR requires technology management, even for limited Internet browser based EMRs. This management requires both tech level skills and business skills. ie. Tech level so when the wireless can’t connect the doctor can get it to connect and /or manage staff or tech company to solve the problem. Its easier to just say get the chart than learn the business and tech skills needed for an EMR.

  • We have a broad range of clinicians in our primary care clinics. Some are so adverse to change that they require bizarre and specific configurations (like disabling the CapsLock key) and long training timelines, while others pick up new software and processes with ease…we’re talking about a nearly 10x difference in training and support utilization between these two extremes and that’s a LOT.

    We’re already on a very popular/older EMR that just doesn’t cut it for our direct practice model. So in our case, we had to find an EMR that was both flexible and customizable and now have spent months customizing it so that the software is utterly intuitive, easy to use, FAST to use and are making the transition as painless as possible. We have tech support, software support, training support…so MichaelM’s point is really on target.

    Without those support mechanisms, there is no possible way a “real” EMR deployment is possible – the landscape is simply too broad, which then overwhelms the typical clinician who is schooled in medicine, not tech.

    In a group practice, IMO, it is the lowest common denominator that drives the training and support, not the “average” clinician…

    Mike

  • “– the landscape is simply too broad, which then overwhelms the typical clinician who is schooled in medicine, not tech.”

    Exactly Mike. The landscape is too broad for a single application to cover it all and still be usable. If applications are purpose specific then they would be much easier to use. However, that is where the demand for semantic interoperability rears its ugly head. Without a common information model being adapted the quality of information goes down significantly.

  • Some companies do offer the above and beyond when it comes to training medical/clinical staff. The agency I work for offers online interactive flash trainings that show our doctors and clincal staff their workflows and not just the functionality, a two day live training specific to each departments workflow and all departments get a manual specific to what they do and we cut out all extra information that would just bog down our staff. We then teach supervisors and admin staff the management fuctionality so that our medical and clinical staff don’t need to deal with this either. We even have a EHR Helpdesk function they can call 24/7 and get one of the trainers to help them through whatever questions/issues they are having (we have a few residential and crisis programs running here that need that support 24/7 support). Even with all this support (a) & (b) are a problem here but I wouldn’t make that a blanket statement that ALL medical/clinical staff are like this…many of them take to it like fish to water.
    Now (c) on the other hand I think will always be a problem since the electronic and paper world don’t match up perfectly and this is a large paradigm shift. I think we’ve got a ways to go before (c) is less of a problem.

  • CEOMike is right about the challenge of EMR adoption is often as much about learning the tech (ie. wireless disconnects) as it is about the actual use of the EMR.

    I do think the one size fits all model is going to fail. The Big EMR company of the future is going to be a collection of the very best area specific EMR software out there.

  • “I do think the one size fits all model is going to fail. The Big EMR company of the future is going to be a collection of the very best area specific EMR software out there.”

    100% agreement as long as they use a common information model for semantic interoperability.

  • Brilliant post Katherine. Its a touchy topic this… On one end you have many doctors disliking EMR’s and on the other , you have EMR firms putting the blame on personal traits of Doctors.

    You have shown the empathy that most EMR firms require to ” Understand, Fix and Get Across”

    Then one size fit all approach will not work…

    Common information models are definitely required, as they are what allow a number of benefits of digitization to be realized. But that cant be used as an excuse to create systems too complicated to use… The complexity inside must be elegantly represented outside, via smarter interfaces, great training, effective support and more a listening ear for feedback…

    The idea behind the information should never be to replace the doctor, but to use it to assist him in making a better decision..

Click here to post a comment
   

Categories