In theory, EHR users will respond well to some EHR platforms and less so to others, depending on how well its interface works. However, new research has suggested something different – that their response is related more to how comfortable they are with the training they’ve gotten on that specific EHR.
According to research appearing in the journal Applied Clinical Informatics, multiple previous studies have indicated that user satisfaction with EHRs is wildly inconsistent. In theory, people who use a given EHR would have more or less the same experience with it, but so far no current EHR seems to be able to generate a consistent positive reaction.
And this is where the researchers come in. To get a detailed look at EHR user experiences, they conducted an analysis of research conducted by the Arch Collaborative, a KLAS Research organization which collects research responses from 72,000 clinicians at 156 provider organizations.
When they crunched the resulting data, they found that the greatest predictor of user experience was not which EHR the provider used, nor what percent of an organization’s operating budget was dedicated to IT spending. Instead, they found that ratings were related to how the users rated the quality of the EHR-specific training they’d received.
For example, they noted, there were 475 instances in which two physicians in the same specialty using the same EHR in the same organization had strikingly different views of the platform. When asked whether the EHR supported delivering high-quality healthcare, one physician “strongly agreed” and the other “strongly disagreed.”
The researchers concluded that in more than 89% of these cases, the physician who strongly agreed that the EHR could help deliver quality care had reported having better training, more training or dedicated more effort in setting up EHR personalization. Meanwhile, the study also found that physicians who reported getting poor training on their EHR were more than 3.5 times more likely to report that it didn’t enable them to deliver quality care.
Given the importance of training, the authors say, it would be a good idea to look closely at both the quantity and quality of training user get on their specific EHR system. This is particularly important given that the participants in the survey showed significant jumps in overall satisfaction with their EHR experience for every additional hour of initial education they’d gotten. Specifically, when users got less than 4 hours of training, their average net EHR experience score was 6, while for users with 10 to 16 hours, the average net score was 27.5.
Another way to help physicians feel comfortable with their EHR experience is personalization, researchers concluded. They note that one of the most consistent observations they’ve seen across the Arch Collaborative organizations is how powerful EHR personalization can be for users. At the same time, they found that too few organizations had bothered to take this step.
Going forward, EHRs are likely to keep increasing in complexity, as features like decision support are integrated into its functionality. To cope with these changes, physicians will need to be trained on these functions as well, including updates on the limits of these functions.
My guideline was, “No matter who you train, you’ve trained the wrong person.” Additionally, “The person you train will only remember, at best, 80% of what you told them. If that person trains their successor, that newbie will only know 64% of what was originally taught.”