‘We Don’t Need EHR Training’ - The Lake Wobegon Effect

In our extensive experience with provider practices and IT systems, we found one of the most common causes of failure and dissatisfaction with EHRs has to do with poor training and implementation.

Part of this is could be due to vendors who over-sell their product, stressing its plug-and-play characteristics, its built-in, out-of-the-box functionality, and its ease of use. It almost seems so intuitive that anyone could pick it up in an hour or so. As we say in the business, there is a lot of Kool-Aid getting mixed up and served here.

But part of this is due to what’s sometimes known as “the Lake Wobegon effect” (the belief by a particular group that all of its members are above average in parameters such as looks and intelligence).

After getting over the sticker shock of software licensing, hardware costs, and implementation fees, providers and practice managers are confronted with the time intervals involved in training and implementation. And since they sat through the near-perfect demos, scripted with perfect data and done by software vendors’ reps who could almost make the applications stand up and sing and dance, it’s no wonder that providers scoff at the notion that their staff would take many hours or even days to learn the new system.

Now comes the Lake Wobegon effect. Every provider and practice administrator thinks his or her staff is above average, so they frequently take the recommended training intervals and cut them way down. Sometimes by half or more. After all, the application is Windows-based, browser-based, point-and-click, drag-and-drop, has built-in bubble help screens, is intuitive and user-friendly, and all that good stuff. So how could it possibly take as long as everyone else says?

In fact we have seen practices that ask what the quickest (not necessarily the best) implementation interval and then cut that in half.

Here is the sad truth. The chances are even - 50/50, to be precise - that your staff is below average, and that it will actually take more - not less - time to train and implement and become fully facile and productive with a new EHR system.

Sometimes a practice or facility will choose an arbitrary date in the future - say June 30 of this year - to be fully up and running on a new EHR system. When you question where they are in the process of contracting with EHR vendors, you may find that they haven’t even started the process seriously, they have just seen a few demos. So not only have they not yet even selected a system and contracted with a vendor, they haven’t even received the training and implementation estimates from them.

Selecting an EHR vendor and system the right way takes a long time, several months at least, and after the selection is made, the implementation and training could take even longer. And since many providers waited all the way through most of 2009 and 2010 to determine the clarification of certification and meaningful use rules, the implementation schedules of many EHR vendors are very backed up with providers who are now jamming the queue.

And when it comes to training, don’t fall for the Lake Wobegon effect. Your staff is just as likely to be less skilled - and take longer than the norm - when it comes to training and implementation.

Take the time to do an EHR implementation properly. Full or partial failure can have a devastating impact on the practice.
 

Learn more about Marion K. Jenkins and our other contributing bloggers here.