Strategies for Successful EHR Adoption: Whom are You Training?

by Lisa A. Eramo, MA
(Adapted with permission: For The Record Vol. 30 No. 9 P. 22)

An EHR conversion or implementation is a large undertaking. Consider these strategies to ensure success.

Focus Training on End-User Needs and Workflows
Although EHR vendors provide basic training, this education usually isn’t tailored to the specific needs of the organization, including its unique workflows, says Zack Tisch, PMP, consulting services executive at Pivot Point Consulting.

In addition, it’s easy to make assumptions because there’s often no documentation to support each workflow (eg, this individual performs these tasks using these specific steps). Employees often perform tasks that go beyond what’s required in their job descriptions. These are training aspects that can be overlooked, says Becky Manne, vice president of training and activation at Optimum Healthcare IT.

For example, a nurse who isn’t technically required to schedule patients may perform the scheduling function on the fourth Saturday of every month because the scheduler is out of the office. Or a nurse may handle admissions at night because the unit clerk doesn’t work that shift.

“It’s about knowing what questions to ask so the right training is given to the right person for everything that they do,” Manne says.

Jeannine M. Arnold, RN, solution director at CTG Healthcare Solutions agrees, citing the examples of a security guard who performs registration when the night clerk goes on a break or a nurse who primarily works in the emergency department but floats to the medical/surgical floor a few times a month as needed. “It’s never a one size fits all. Each end user has unique needs,” she says.

Perform an in-depth analysis of the workflow and build EHR training around that analysis, Manne says. When developing workflow-specific training, consider the following questions:

  • What daily tasks does this individual perform?
  • Does this individual perform any additional tasks during evenings and weekends?
  • For the same basic role (eg, nurse), are there different titles (eg, staff nurse vs charge nurse)? If so, do their responsibilities differ? Does the charge nurse run certain reports? Does he or she need access to certain information that might otherwise be restricted in the EHR?

“Training should be ‘a day in the life of.’ It’s running people through their role as it pertains to the patient experience,” Manne says.

Engage Superusers From the Start
Best practice is to engage employees—especially superusers—during the design, validation, and testing phases to provide them with a basic familiarity with the system, Tisch says. “When you get to the traditional training period right before the go-live, people already have the basic knowledge,” he says. “They’ve moved past their anxiety. And because you’ve let them participate in the project, they understand why the system is architected the way it is, and they’re ready to do more scenario-based training.”

This approach eliminates scenarios in which organizations bring in trainers one or two months before go-live. “They come in, quickly learn what you’ve set up, and do a ‘just-in-time’ training,” Tisch says. “Instead, think about the 12 or 18 months you might have allocated for the whole project. Where are the touch points and opportunities to help set your training program up for success?”

Distinguish Between New and Existing Hires
Just as training should accommodate end-user needs, it should also differentiate between new and existing hires. Arnold says training for new hires should be built into the orientation process to prevent unsanctioned workarounds that don’t follow validated workflows. Some organizations also assign a “buddy” to new hires after they receive training to ensure that they’re following protocols and to answer questions as they arise, she adds.

Existing staff may have different needs. For example, they may be stuck on certain workflows, or they may have inherited bad habits that need to be addressed, Tisch says. They may also need workflow crosswalks (ie, here’s how we used to do this in the old system, and here’s how we do it now), he adds.

In addition, existing staff may need change management support, Arnold says. Trainers must be able to acknowledge that new technology can be daunting at first. They must help employees navigate this uncertainty and provide additional support when needed.


eLearning Library Subscription
Unlimited access to over 60 courses, assessments, and training curriculums designed to enhance job-specific, self-paced learning for one full year.

Includes online courses focused on hospital coding (ICD-10-CM, ICD-10-PCS, CPT) from beginner to advanced, as well as credential prep (both AHIMA and AAPC), and specialty topics (including home health, HIPAA, and pediatrics). Learn more here.

About the Author

Lisa Eramo, MA
Lisa A. Eramo studied creative writing at Hamilton College and obtained a master’s degree in journalism from Northeastern University. Lisa has owned and solely operated her own freelance business since 2009, providing quality writing and editing services to clients primarily in the healthcare industry–and more specifically, in health information management. Lisa is a member of the American Health Information Management Association, Society of Professional Journalists, and the American Society of Journalists and Authors. Contact Lisa at [email protected] or

Comments are closed.