Training the EMR: A Case Based Perspective - Best Practices and Training the Trainer

Part Three of a Four-Part Series

It is estimated that only 5% of hospitals in the US have a completely electronic medical record system (EMR). Given this statistic and wide-spread public support for President Obama's healthcare reform initiative, the EMR is standing on the eve of an era of accelerating growth. In the first two articles in this series, Training the EMR: A Case-Based Perspective and Training the EMR: A Case Based Perspective - Drilling Down, I have compared this position to pioneering on a new frontier and have discussed some of the challenges and decisions clinicians and trainers face in "charting" new territory. In this third and final article I want to briefly comment on training the trainer and best practices in training the EMR.

Training the EMR: A Case-Based Perspective - Drilling Down

Part Two of a Four-Part Series

In the first part of this series, we took a look, from a case-based perspective, at some of the general complexities and challenges faced  in implementing a new Electronic Medical Record System. In part two, I want to drill down a bit more to look at some of the barriers and challenges that clinicians and trainers encounter as they try to learn and use an EMR. I will also offer up some suggestions, as a jumping-off place for considering solutions.

Stories from the Farm - The Adventures of Kate and Annie among the English

Or an impromptu tour of our neighborhood through the eyes of Kate and Annie ...

Monday evening around 7 pm, Benny was finishing up a fence expansion for the mules, and I, accompanied by my cat, had just plunked down on the white adirondack chair on our infrequently sunny back porch of late. With a glass of blackberry wine in one hand and my laptop in the other, I was ready to relax after a rugged day of landscaping, cleaning the carpets, and preparing for a flight to Dulles the next morning for my brother's surgery. I had barely taken the first sip from the glass when our neighbors Mike and Jacci pulled into our driveway. They climbed out of their Suburban to inspect the latest additions to our family, Kate and Annie - a team of Belgian mules who used to work for the Amish.

Training the EMR: A Case-Based Perspective

Part One of a Four-Part Series

I have had some interesting and intensive encounters with hospitals in the past six months. I am currently sitting in the rarified atmosphere of the Johns Hopkins Hospital in Baltimore, MD. My family and I are in the Family Surgery Waiting Area while my brother is two hours into a craniotomy for removal of a brain tumor. Only last December I spent about ten days on the East coast hanging around the Neuro ICU at Fairfax Inova Hospital in Virginia. In between I briefly worked as a trainer for a Electronic Medical Record System at a brand new hospital built by a local outpatient care organization in our community.

Meet Kate and Annie

In my previous post, I said that I had unexpectedly entered job search mode again - after a successful two and a half years in my field and then taking a new job. But in every life along with a little rain, the sun must also shine. :)

It's spring! And while I lost my job, it's been wonderful to have time to catch up with friends and family and work on spring-cleaning the house and landscaping the yard - which have been so seriously neglected since the job hunt, job transition, and a couple of family illnesses involving prolonged travel and hospital stays over the holiday season.

I haven't had this much uninterrupted time at our new home since - well, ever! (we moved here 4 years ago.) So I'm giving her the old white glove, while I have the opportunity! Of course I'm job-hunting too.

Benny was so excited when I got my new job this winter that he finally decided to pursue a life-long dream. Ever since we've been married, he's talked about owning a team of draft horses or mules. He acquired an antique wagon several years ago that he's refurbished and we've used to advertise his antique refinishing on this corner. So this late winter/early spring he set about building stalls in the pole barn and putting up fence - and the opportunity came along to buy a team of Belgian draft mules from our neighbors complete with harnesses for a really good price.

Kate and Annie are 18 years old and still in wonderful shape. They pulled Benny's wagon to Stockwell yesterday. They worked together for the Amish their first six years of life and have been owned by 3 families (including us) since them. Actually they were separated when the Amish sold them to the next family. The second family reunited them and then our neighbors have owned them for about 6 to 8 years.

Even though I lost my new job, I told Benny I sincerely hoped he would go ahead and buy them. His brother died of a brain tumor at age 65 - the same year Benny had his open heart surgery. And last year his sister died of cancer at age 74. I told him he'd better be doing some of his dreams while he still has the health to enjoy them. I have hope we'll be able to financially maintain - even if I have to work in part time retail or part time factory again. Like Kate and Annie, I'm hoping I still have enough of my wits, skills, health, and vigor, that some employer in my field will still find value in me. Whether they do or not, we are still blessed.

So without further ado, meet Kate and Annie!




JuneBug

Changes

A lot has happened since I first started this blog to write about my job search and photography/scrapbooking interests. After working in a few interesting stop gap jobs I found and have been successfully employed in a job in my field for two and a half years.

Now I am in job search mode again.

I didn't expect this to happen. Even though the economy was going bad, I had gotten a wonderful offer to work with the new electronic medical software at a new hospital- albeit under somewhat questionable circumstances. I wouldn't have started looking except that the cost of benefits was going to double in my current position come January - and I knew I was going to have to start working two jobs or find a better paying job. The hospital had just started up in October and we had heard rumblings - the friends of friends kind of thing that happens in a small community. The gist was that people thought the hospital needed a lot of help with their new system. So when an educator consultant position was posted that sounded like a match to my experience, education, and interests, I finished my online application to the hospital around 2 am one morning in November/early December, and the hospital called me back the same day. That just never happens. Their HR interviewed me in early December and set a second interview date for late December. It was evident the staff were very excited and proud of their innovative new hospital and approach to medicine. During that period my then current employer, a not-for-profit, offered to bring me on as a 40 hour FTE (I had been a 30 hour FTE) if I would agree to end the job search and stay with them - with the understanding that if the hospital made an offer, I would consider that one. But I didn't hear from the hospital after the second interview. I did make the prerequisite one or two follow up calls - and they did sound encouraging - which gave me hope. But time passed and I didn't hear - and I felt that I would be okay since I was now working full time for my then current employer. At least as okay as any employee can be during these uncertain times. Then the hospital contacted me at the end of January with a really nice job offer. My new boss wanted me to start as soon as possible. When I asked my then current employer if they had ever heard from the prospective employer, turns out the hospital never contacted them at all. We all thought that was odd. But to be involved in the health field with the new medical record software (I had helped bring in a new billing and patient tracking system to a University Health Center several years ago) and to bring in my instructional design and educational background as well just sounded like a wonderful opportunity in spite of the warning signs that the position/employer might be unstable/a revolving door. I said I needed to give my current employer two weeks notice, but could start immediately after that. So I put forth a monumental effort to finish up with my old employer and leave my position in the best shape possible for the new person to start. I even skipped vacation - which now adds up to amost three years in a row that I haven't had one.

I started at the new hospital February 16th. They kept me barely over two months and then terminated me at an early 90 day review. The decision seemed based entirely on less than a day's time spent with my new boss one on one over the entire two month employment period - most of it after he had threatened and intimidated me about something that was really no fault of my own. None of the decision seemed based on the assessments (what there were of them) of the capable trainer consultants who were training me or the nurses I trained. I had gotten the sense from their feedback that I was making satisfactory progress in mastery of the material and in my training techniques. They were complimentary when they didn't need to be. I was learning things of value to the organization - I thought. I was beginning to connect with the healers, the people I was hired to train. Not that I didn't have things to learn - but I was making satisfactory progress in the overall scheme of that department trying to get things done and implementing a new instructional delivery strategy for the hospital. It was actually a really cool time to come on board- I got to watch how the team worked together to put the new delivery strategy into action in the most effective way possible. It was impressive. The department hired one person after me - from within the ranks. She was onboard during the startup in October - so she had considerable expertise with using the software and supporting clinical staff in the units - but like me, she hadn't spent her work life as a professional trainer consultant.

So ... it was all very odd how the job ended and I found myself unexpectedly on the unemployment line having left a job who wanted to keep me to help a new hospital break new ground. But it was still a very interesting learning experience - and I got to work in a brand new hospital, learn an EMR in depth, and be trained through various methods in technique and content by some really great, professional trainers.

So while the stint was brief, I don't want to lose what I've gained, and I will be posting about Electronic Medical Record software ... the benefits and the challenges facing us. With President Obama's initiative, it's a hot topic. Stay tuned ...