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Individual Training to Improve Provider Efficiency and Confidence in EMR Use

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Key Points

  • Individualized training improved provider sense of efficiency and confidence in EMR use.
  • Reductions in time spent in the EMR system were observed.  

In a study reported in the Journal of Oncology Practice, Kadish et al found that individually tailored training improved provider confidence in electronic medical record (EMR) use and offers promise of improving efficiency in use. The study was undertaken at Dana-Farber Cancer Institute after physicians (MDs), nurse practitioners (NPs), and physician assistants (PAs) expressed frustration with the use of a recently implemented EMR system. 

In the study, three trainers delivered one-on-one training to MDs, NPs, and PAs specializing in medical oncology. Providers chose between a single 2-hour session and two 1-hour sessions delivered in the provider’s office.

Providers were sent surveys before and after training that used a 5-point scale to measure confidence in the EMR overall and in the activities of placement of orders (excluding chemotherapy), documentation, chemotherapy ordering, clinical review, and inbox message management. Content of the training was individualized according to provider survey, EMR utilization profile, and shadowing in the clinic.

Study Outcomes

Overall, a total of 185 (90%) of 205 targeted providers completed the training, consisting of 133 MDs, 42 NPs, and 10 PAs. Of these, 66% participated in one 2-hour session. Among participants, 87 (47%) responded to the pretraining survey and 92 (50%) to the posttraining survey.

Overall, 98% of posttraining respondents indicated that the training improved their sense of efficiency in EMR use. Among 47 providers (26%) who completed both pretraining and posttraining surveys, the proportion expressing confidence in EMR use overall increased from 58% to 94% (P < .001).

Time in the EMR system was available for 147 participants for 5 consecutive months. After training, time in the EMR system was reduced from 26.69 to 25.88 minutes per appointment (P = .104), including reductions in time spent on documentation (8.02 vs 7.55 minutes, P = .019), placing orders other than chemotherapy (4.44 vs 4.28 minutes, P = .042), and other activities including chemotherapy orders (5.85 vs 5.56 minutes, P = .036).

The investigators concluded, “A personalized and data-driven training approach was highly regarded by providers. EMR usage reports provided extensive data to identify and prioritize training content and were valuable to measure the impact of training on provider time in system. With the growth of EMR implementation and the reported relationship of EMR use to burnout, continuous and personalized training after EMR implementation is effective to reduce the time in system and increase confidence.”

Andrew J. Wagner, MD, PhD, of the Dana-Farber Cancer Institute, is the corresponding author for the Journal of Oncology Practice article.

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.


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