How should staff who would have to change work patterns to use EHR and e-prescribing be dealt with? 

Expert Answers
Lorraine Caplan eNotes educator| Certified Educator

Switching to EHR is a complex transition that can take months and requires extensive oversight by a steering committee, a project manager and a supportive project team. Goals must be clear-cut and every aspect of job performance and patient care must be accounted for in the transition including worker comfort and record accessibility. The best way workers can be dealt with is by allowing a shared vision of goals and objectives and conceptualizing the transition as within a conceptual and human framework instead of as within a technological framework.

Training and patience are always the key to this transition.  How much training and how much patience are going to be a function of staff's comfort level with technology, of course, but even for those staff who have good technological skills and prior exposure to electronic medical record-keeping are likely to need training because there are so many different kinds of software available.

Staff need to be trained such that they can "do no harm" as they learn, getting exposure to and familiarity with the new system before they begin to make entries on real patients, understanding how the system is laid out and making practice entries first.  They need sufficient time to master these skills, which can be difficult to provide for in a busy office. Even if it involves paying overtime for a few weeks, it is often worthwhile to do this after hours in a practice or off shift in a hospital.  There is too much at stake in this training for a practice or institution to be penny wise and pound foolish. 

Some people, naturally, will learn more quickly and better than others, and those people can be used to supervise the "on the job" aspect of training, when staff must make real entries in real time.  The fast learners can be paired with the slower ones to effectuate actual entries. They will feel valued if used in this way and can troubleshoot, usually, without having to call on management. 

Training is far more than just teaching staff how to use electronic medical record-keeping software, of course.  Some other kinds of training involve understanding how electronic medical record-keeping and HIPPA interact, for example, with computer screens now being exposed in examination rooms or even in hospital corridors.  Staff must take care to not allow others to see confidential information that is on a screen all can easily see.  Another aspect of training is the management of the interaction between staff and patients.  Once we get in front of a screen, we tend to make less eye contact with patients, and this inhibits the interaction and a more free flow of information.  No one likes to interact with someone who does nothing but stare at a screen.  The proper sort of interaction should be modeled and monitored, so that staff understand the importance of this aspect of the new form of record-keeping. 

Electronic medical record-keeping is the wave of the future, and for many practices and institutions, the future is here.  Perhaps one way to look at this is not to frame it as staff being "dealt with," as much as it is to frame it as a situation in which everyone in the office is in this together, since management often knows little more than staff about how to go about doing this kind of record-keeping.