A key strategy for successfully rolling out an electronic health record at a group practice is providing custom training for users with different technology skills and personalities, the CEO of a practice with 235 physicians says.
Guthrie Clinic in Sayre, Pa., divided doctors into 11 groups for training purposes, says Joseph Scopelliti, M.D. president and CEO. For example, he jokes, some were labeled as “tech-savvy but grumpy” while others were “easy-going but uniformed.” Then the practice developed 11 targeted training programs to meet doctors’ specific needs.
Practices that want to implement EHRs on a short timeframe to qualify for maximum Medicare and Medicaid incentives under the American Recovery and Reinvestment Act must devote significant internal resources to training rather than relying heavily on their EHR vendor, Scopelliti says. “We took our vendor’s training playbook and expanded it tenfold,” he says.
The CEO warned practice managers to avoid training doctors too early in the process. Guthrie provided 12 hours of training four days before go-live at each site, plus another four hours of training the day the system went live.
Guthrie conducted a mock go-live event after hours at each of its 25 clinics using individuals posing as patients with certain conditions. During these tests, no trainers were on hand to offer advice, he notes. “That helped us identify gaps in our training,” he adds.
Scopelliti made his comments Sept. 17 at Health Data Management’s Health IT Stimulus Summit in Boston. His other advice included:
* Don’t use 100% of a records system’s functionality on day one. For example, Guthrie has yet to implement a patient portal because that would have slowed the rollout.
* Spell out expectations for minimum use of EHRs as well as best practices. Guthrie created an “etiquette document” that, for example, stated all notes should be completed within 48 hours of a visit, but the best practice is to complete notes before the patient leaves.
* When implementing an EHR at multiple sites, phase in the rollout by grouping practices with similar needs. For example, Guthrie spent 11 months rolling out electronic records at primary care practices with similar workflows. Then it moved to specialists who had complex and varied workflows. Finally, it rolled out the system to procedure-based specialists.
* Build a detailed communication plan before the EHR rollout. Guthrie held a kickoff event to explain the “why” behind the project. It produced a weekly newsletter with updates as well as a weekly “tips and tricks” e-mail. Plus it held Web seminars.