An example of one chiropractic office and the impact of proper EHR integration training for staff that turned out to be critical for success
Although the Rolling Stones sang about not being able to get no satisfaction, chiropractors may just be able to get more of it — if they invest in their businesses by providing staff training in Electronic Health Records and EHR integration support.
When health care providers began transitioning to EHR from paper records, there were struggles. Some refused to do it, which caused them to fall behind in innovation. If they did make the change, but didn’t provide proper training, keeping records could become a nightmare for clinical staff members, leading to lots of frustration for them, their DCs, and the patients who frequented the practice.
Pre-change checklist
According to Andrea Nazarrenko, DC, who with her husband, Eric Nazarrenko, run Old Mill Chiropractic in Lexington, S.C., chiropractors need to be ready to properly implement EHR integration.
There are three things that determine if a chiropractor is ready to implement EHR into their practices:
- The general functioning of the office — is the office well structured? Are staff competent? Are there resources available? Is the practice flourishing or struggling?
- The specific abilities of the staff to use EHR (do they have the skills?)
- The motivation of the staff.
The Nazarrenkos state that in order to build readiness, it is important to provide evidence-based support. There are four components of support:
- Tools (e.g., direction manuals, troubleshooting guides)
- Training (e.g., webinars, training in person)
- Coaching/Technical Assistance (1:1 or groups support to help use EHR)
- Quality Improvement/Quality Assurance (making sure that problems are identified and addressed through compliance standards or observations/tests)
Training is an important component of this support.
In their office, the Nazarrenkos explain, training was critical to successful EHR integration training.
“Before launching, we watched a series of online training videos on how to use our system. All staff were required to watch. Trainings were short and focused on the ‘how to’ in terms of implementation.”
What were the results of providing training? “This training made staff feel more comfortable and willing to use the software. Those who took the training seriously did much better with the transition. There were fewer mistakes by those who watched. Those who were slower to watch were slower to change.”
EHR integration training and more
“The training was necessary but not sufficient, however. We also provided technical assistance and coaching to our staff in real time, and then had weekly meetings with reps from the EHR company to help troubleshoot. This helps us dive deeper and get individualized attention to our needs. As the owners, we additionally developed tools and guides to help support staff with the transition and regularly observed and evaluated performance. We took time to assure quality and spent time in staff meetings to improve quality based on our own evaluation.”
For more information on these topics of implementation, see https://www.ncbi.nlm.nih.gov/pubmed/22538406 and https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4676714/. Andrea Nazarrenko is an author of the latter peer-reviewed paper on readiness. She was involved in the former (but not at the authorship level) and has operationalized this in action.
