Demand for Training Hampers EHR Implementation: Survey

Hospital IT departments need more training as EHR adoption picks up, according to a survey by HIMSS Analytics and TEKsystems.

As the health care industry moves to adopt electronic health records, proper training in EHRs could hold them back, according to a survey announced March 5 by workforce-planning company TEKsystems and HIMSS Analytics, a division of the nonprofit Healthcare Information and Management Systems Society.

Sixty-six percent of respondents said finding workers with the appropriate skills is a challenge, according to the survey, for which HIMSS Analytics and TEKsystems interviewed 300 single and multi-hospital organizations and health professionals in the United States.

Supply of talent in health care IT is falling behind demand for positions such as clinical trainers, builders, consultants, and project and program managers, according to the survey.

Skill sets in demand in health care include being able to adapt to consumer online bill paying, process the International Classification of Diseases (ICD)-10 claims codes and meet meaningful-use criteria, Allen Kriete, TEKsystems vice president of health care services, told eWEEK.

Finding the right people with these skills is essential for successfully implementing EHRs, and the quality of the training that health care professionals do receive for EHRs is poor, said Kriete. A lack of training was an issue for more than just a couple of hospitals, he noted.

Eighty-five percent of respondents said poor EHR training resulted in rework, and 84 percent said a lack of quality training resulted in a lack of applicability to real-world scenarios. Meanwhile, 84 percent cited low levels of user adoption, 82 percent reported long learning curves and 77 percent said health care professionals are unable to satisfy federal meaningful-use objectives.

A lack of effective data gathering from poor training could lead to billing issues, an inability to share data and a detrimental effect on patient care, said Kriete.

"Training was somewhat of an afterthought and brought in late in the implementation—sometimes so late that the ability to develop a curriculum and customize that curriculum to map it to job roles and functions within a real-world environment can cause problems," he said.

To overcome training obstacles, health care organizations must build customized training programs led by educators with clinical and technical expertise in EHRs, said Kriete.

The study found that many health care organizations are not allowing workers to provide feedback on the implementation of EHR systems. Becoming acclimated to an EHR system could take up to six months, according to more than 50 percent of health care organizations surveyed.

Implementing an EHR system may not mean a health care provider's employees have fully "adopted" the technology, according to Von Baker, TEKsystems health care practice director.

"The work does not stop once the implementation is complete," Baker said in a statement. "Providing post go-live support is critical to ensure the end users fully adopt the system."

Health care organizations should offer a mix of performance support tools based on the facility's culture, workflow, specialties and available technology, said Baker.

"Underestimating the amount and degree of post go-live support can cause a decrease in productivity and performance and increase end-user frustration," he said.

With unemployment ranging between 8 and 11 percent over the last several years, people might think plenty of skilled workers were available. "When you get into health IT, that's just simply not the case," said Kriete.

To deal with a lack of qualified employees outside organizations, companies need to develop the EHR skills of internal employees rather than recruiting outside service companies to handle the work, Kriete suggested.

Organizations that might be "banking on" using EHR software from Epic Systems will need to train internal employees on Epic core skill sets rather than outsourcing, said Kriete.

"Some of these skill sets you're going to have to implement in-house," he said.

More than two-thirds of health care CIOs report labor shortages in IT staffs, according to a September 2012 survey by the College of Healthcare Information Management Executives (CHIME).