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Healthcare organizations invest a lot of time and money in their electronic health records (EHRs). Heather Haugen, PhD, vice president of Healthcare Provider Solutions at Conduent and the creator of the Breakaway learning methodology, discusses how organizations can reap the benefits of their technology.
Healthcare organizations invest a lot of money in technology. Do you believe those investments are paying off for them?
The investments are starting to pay off. We have implementation – and it’s really impressive how far we’ve come along here – which is the first step. The place where I think we very much struggle is the adoption of those systems. Without adoption, we don’t get the full benefit of our investments. There is hard work that has to happen to make sure physicians and nurses can actually use the EHR system well to treat patients. Around the country right now, we’re probably 70 percent to 80 percent implemented but only 30 percent to 50 percent adopted. The commitment of organizations to really get the outcomes they expect from their EHRs is what we’re trying to achieve now. It’s our focus today in healthcare.
What are the most commonly made pitfalls after implementing a new EHR or health IT system?
The first pitfall is keeping the leaders and clinicians engaged around continuous improvement of the use of the EHR. We oftentimes are very project-based: once we go live, we go back to all of our other priorities. It’s very important that leaders and clinicians continue to prioritize optimizing workflows, improving overall processes and ensuring the change that’s needed happens.
The second pitfall is to believe you’re done with training at go live when you’re not. These are big, complex applications that take a long time to learn. Providing continuous education results in more proficient clinicians, which means they’ll be more productive in using these applications and the quality and accuracy of their work within the EHR will be better.
The third pitfall is to believe that technology is the driver for quality and safety outcomes. The technology allows organizations to identify places that need process improvement or areas that need to be changed in order to get better quality and safety, but it doesn’t create in and of itself better quality and safety.
What is the Breakaway learning methodology, in a nutshell?
A few years ago, we asked the question: ‘How do organizations differ who do well at adoption versus those who struggle?’ We compared their activities and processes to identify what makes an organization successful at adoption. We found four areas where healthcare leaders should focus to ensure successful adoption.
The first is that the people who are communicating the change – those who are helping others through the change – really have to understand what they’re trying to accomplish with the EHR and be very committed to doing the work required for change management.
The second is providing continuous education. Beyond the initial training, successful organizations gain proficiency by learning workflows and being trained on upgrades They don’t learn all the functions of a system, but become masters of their specific roles.
The third is the ability to measure outcomes. An organization’s ability to say: ‘This is what we were trying to accomplish when we implemented the EHR, and here is where we are along the continuum’ makes a huge difference for adoption because you can keep focused on taking steps towards improvement.
The fourth, and this was the most surprising part of our research, was organizations not providing sufficient resources to maintain their EHRs long term. Many organizations looked at the initial cost of implementation but failed to consider the long-term resources needed to sustain an EHR.
Can you tell us how that methodology has improved adoption for your Conduent Healthcare clients?
I think overall what healthcare organizations get from applying the methodology is less stress for clinicians going through a dramatic change and time back for patient care, which is really important – there’s nothing more valuable today in healthcare than time, especially for clinicians. I also think they have the opportunity to achieve the expected quality outcomes they wanted from their EHR because they’re actually using it well and they may be experiencing less turnover of people who find the change to be difficult.
We’ve seen clients experience a reduction in training time of 50 percent while achieving a higher level of proficiency, reductions in the productivity gap after EHR implementation, fewer support and help desk calls, and smoother and quicker new employee on-boarding.
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