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Practice Wise 9/30/12

September 30, 2012 News 1 Comment

Stuck in the Mud!

There is a great nationally coordinated race that raises funds for St. Jude’s called the Warrior Dash. It’s a combo 5K fun run and obstacle course that literally ends in a mud pit.

My husband and his coworkers signed up to do the race last month. Not wanting to be left out, I joined their team. I heard from friends and one of my consultants that it was more “fun” than “run.” Lots of teams wear really fun costumes that I was sure meant they weren’t really running, but loping along a nice wooded trail.

I’m in reasonable shape, power walk three miles, and do yoga, so of course I thought I’d be fine. However, I didn’t actually look at the event website to see what this activity entailed. I didn’t train for it properly. Boy, did I pay for it! The first half mile of the run was up a very steep incline, the first of many steep inclines. Then there was the rope wall to climb, the swimming obstacles, and so on. I shouldn’t have been surprised that it was much harder than I anticipated.

I see this happen all the time with our clients when they take on an EHR implementation. Doctors in particular have a tendency to short shift their training. I wish I had a dollar for every time I’ve heard, “I’m not changing how I practice or chart. I will make it work.” I always have to bite my tongue (and if you know me, that’s a tall order) because I want to ask these physicians if they figured out medical school and made it work as they went along instead of studying!

There is good reason for a project schedule with an implementation plan and required training. The people who do this work for a living know what a tremendous task it is to learn a new EHR. Learning anything new and committing it to habit takes time.

I get it. Doctors spend their lives in the top 10%, applying for medical school, residency match, and fellowships and jobs. They train, study, and work really hard to make these goals. So I marvel at those who spend tens of thousands of dollars on new software and think they can just figure it out with little or no training.

You’re busy trying to practice, and patient care is the goal. However, if you have this new tool to chart your patient encounters, you owe it to your patients, your staff, and yourself to invest your time in training.

Take the plunge and maintain your sanity:

  • Do sign up for all training offered by your vendor, show up and participate.
  • Don’t blow off the trainer and tell them that you don’t need to know what they are trying to teach you. True, you know how to practice medicine. However, you don’t know how to use your software. Accept it, learn it, and become proficient. You won’t regret it.
  • Do invest in the most training offered. Your vendor should know how much you’ll need to be successful (that’s the goal!) based on your specialty, the complexity of the software, staffing demographics, etc.
  • Don’t skimp on training and implementation support. If the vendor offers onsite training and go-live support, take it. The money you save in not having the vendor come on site will be lost in productivity.
  • Do pay attention to timelines. They are set for a reason. Get your training done or postpone your go-live if you can’t get it done. This is not just about how proficient you are — your inefficiencies negatively affect your staff and patients.
  • Don’t set unrealistic expectations for yourself. It’s not unusual for providers to do fine ‘not knowing’ during go-live week and then get very frustrated in the following weeks because they have not mastered the software yet. It takes time.
  • Do plan on taking the better part of a year to master the software, for your staff to master the software, for all your customizations and workflows to become fluid, all your interfaces etc. to be setup and adopted by all.
  • Don’t blame the software and everyone around you when you fail to master the software if you don’t do the necessary training. Nobody can learn this for you.

I plan on tackling the mud run again next year. This time, I know what I’m getting into. I plan to train appropriately for it (e.g., running hills and getting over my fear of the big, scary rope climbing things).

Do yourself a favor. Train hard for your EHR implementation. And if you’re already on an EHR and struggling, there’s no shame in going back for training. Just do it.


Final push to the end, last obstacle before the mud pit, not that you can tell by my clothes!

Julie McGovern is CEO of Practice Wise, LLC.

Comments 1
  • I am the computer equivalent of a really fast marathon runner. I have computer and informatics related degrees. I write my own programs in multiple programming languages and I’m the go-to person among my colleagues for assistance with any and all programs. Typically, I can learn a new program on my own in a few hours using help manuals, software related books and Google.

    In terms of our hospital’s EHR, I wrote a 100+ page “help manual” for my colleagues on tips and tricks that the vendor’s trainer said included things that even she didn’t know.

    Despite all of this and despite using our hospital’s EHR for over 2 years, I’m still VERY inefficient in using it, often make mistakes in CPOE and frequently receive alerts that tell me that I didn’t finish placing an order when I thought I’d done so.

    I really have a hard time believing that there are not serious flaws in the EHR software that my hospital uses! And it’s one of the major commercial vendors in the US and not some rinky dink fly-by-night EHR software company.

    Even for the less sophisticated users, I would take issue with several of your statements:

    “The people who do this work for a living know what a tremendous task it is to learn a new EHR….So I marvel at those who spend tens of thousands of dollars on new software and think they can just figure it out with little or no training….Do plan on taking the better part of a year to master the software…”

    I assume that the people who do this for a living know what a tremendous task this is because the existing EHR software is rather poorly designed and they have to deal with it day in and day out.

    It’s rather amazing that software that is open source or cost tens to hundreds of dollars seems to be better designed than EHR software that cost tens of thousands to millions of dollars. My hospital has invested many, many millions in this particular EHR over the past 12 years and will be investing another ~15 million over the next year or so. (This is an example of throwing good money after bad.) Our EHR software is so horrible that I would consider it to be pre-alpha level if it were released by Microsoft or Mozilla. Of course, a major difference is that flaws in Microsoft or Mozilla products don’t often kill patients.

    When you say that physicians should take the better part of a year to master their EHR software, what is supposed to happen to their efficiency and most importantly their patients in the meantime?!? At what point is it permissible to say “This software really stinks” and not have it be attributed to inadequate time spent on training.

    Apple seems to be able to make readily usable products that physicians are willing to adopt in droves and that have almost no learning curve. Why should we expect less of extremely expensive EHR software that is critical to people’s lives???

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