"There is always a eureka moment," says Hazim Mohammed, a software consultant with eClinicalWorks. He performs onsite trainings at healthcare facilities that use the eClinicalWorks electronic medical record (EMR) software. "Re-training is important, because we throw so much information at the staff in the initial training, no one can remember it all."
Last month, Mohammed spent four days in Birmingham at Pulmonary and Sleep Associates of Alabama. The practice has used eClinicalWorks for four years. "We could see what the EMR was capable of doing, but no one had the time to dig in to figure it out," says administrator Jennifer Neal.
Bringing the software trainer in appealed to Neal because on-site assistance would bypass the difficulties of understanding the phone support, and the consultant could witness the EMR in action with their particular specialty. "We kept having issues making it match with our workflow," she says.
The eureka moment for the front office occurred during their check-in procedures. Neal had been planning to convert the follow-up form from paper to digital and had purchased iPads several months before. But she'd had no time to figure out how to translate their form to fit the EMR.
Mohammed had customer support translate the form to the digital format. And by day two of the training, the front office was handing out iPads instead of clipboards. "Plus the trainer was here for the next few days to oversee implementation," Neal says.
That almost immediately alleviated the backlog in the front office. The new digital process helped reconcile patients' current medical and prescription history every visit, eliminating the need for manual entry. It also gave instant access to patient data to the backend nurse who no longer had to wait on front office action. "The front office staff asked me what they should do now and I said, 'I don't know, take a break?'" Mohammed says.
Neal had not had such good outcomes with in-house training at a previous practice. "It was a complete waste of time," she says. "They came and sat on the computer the whole time figuring out how to do the things we asked about." For this training, her staff composed lists of problems and questions they faced in dealing with the EMR and sent it to the consultant a week before he arrived.
Neal also said no to any presentations by the trainer. "I didn't want anything structured," she says. Instead Mohammed spent eight hours a day observing. She had him sit up front for a half day, then with nurses, and with the billers. "When he sat with my girls up front, within 15 minutes he gave them five things to help them save time," she says.
Working with the physicians became spur of the moment as slots of time became available. "I usually get with them when they have a break or at the end of the day," Mohammed says. He watches how they chart two or three patients and makes suggestions.
Those bits of time resulted in the physicians learning about the customizable screen that displays a complete menu of options for ordering medications, labs, procedures, injections, follow-ups, education and referrals for each diagnoses. What had required the physicians to hunt and click through numerous screens for each patient now appeared on a single screen. "Dr. Wilson looked up and said, 'Where's that been all my life?'," Mohammed says. "They were extremely excited. That happens commonly in these visits."
"I knew by day two we'd need an extra day with him," Neal says. Because besides introducing staff to features, the consultant also discovered technical glitches. "But he was there to deal with customer service instead of me," Neal says.
Other solutions the on-site trainer pointed out included alerts for follow-up tests to satisfy PQRS compliance (Physician Quality Reporting System) for Medicare and running a physician referral report. "We had a girl manually writing down the patient and the referring doctor on a yellow legal pad," Neal says. The report now generates in a few clicks.
"I could probably keep him here for a month to figure out all that the system is capable of doing," Neal says. With EMRs becoming more sophisticated and upgrading regularly, practices regularly end up underutilizing them. "It's like using a Lamborghini as a Toyota Corolla," Mohammed says.
More than half of eClinicalWorks' clients request the optional on-site training. Neal says it was worth the $3,500. Having the expertise in-house meant every section of the practice had personalized training instead of just a few attending a conference. "It was a big expense for us, but we weren't using the system to its full ability," she says.
Neal expects to do on-site training again next year. "I think we'll try to do it yearly because it had that much impact," Neal says. Utilizing the EMR to its fullest means decreased costs and time to see more patients. "We're more efficient so we take better care of patients. It's worth it."