Advanced Proficiency EHR Training: Effect on Physicians’ EHR Efficiency, EHR Satisfaction and Job Satisfaction
- 1 Introduction
- 2 Methods
- 3 Data Analysis
- 4 Results
- 5 Discussion
- 6 Conclusion
- 7 Appendix
- 8 My Comments
- 9 References
Inadequate Electronic Health Record (EHR) training, as well as poor computer literacy, of clinicians, are major factors of EHR systems adoption and implementation.
The article examines the effectiveness of Advanced Peer-Led Proficiency Training on experienced clinician EHR users’ EHR efficiency, EHR satisfaction, and job satisfaction. 
This program uses Kaiser Permanente Northwest (KPNW) EHR called KP HealthConnect (KPHC), “the largest not-for-profit integrated health delivery system in the United States serving 8.6 million members in 8 regions spanning 9 states and the District of Columbia.”
Pathway to Proficiency
In order to improve the proficiency of experienced clinicians (physicians, physician-assistants, and nurse practitioners) EHR users, a 3-day intensive off-site program called “Pathway to Proficiency” (P2P) was implemented in 2010. Sessions were given by clinician peer instructors on different functions of the HER, such as “computerized physician order entry, physician documentation, lab results retrieval, etc.”
Design and study population
This program conducted the study on 155 clinicians were five different training session were given throughout 2010. Clinicians were also given a pre-test (30 days before the training programs) and post-test (30 days after the training programs) using an online questionnaire.
The questionnaire contained a five-point Likert scale questions used to evaluate how the clinician perceived of their efficiency, their satisfaction with the system, and their job satisfaction.
139 out of the 155 clinicians filled out pre-surveys and only 76 clinicians filled out the post-surveys. SPSS statistical analysis tool was used for descriptive analysis and related samples Wilcoxon signed rank test.
Preferred source of support (Pre- survey)
The questionnaire permitted entry of multiple responses. 126 clinicians participated and 260 responses were received.
- Clinician Peer (> 78%)
- Local support desk (38%)
- Onsite non-clinical support staff (35%)
- National help desk (31%),
- Nurses/MAs (17%),
- Web-based help (2%).
Demographics in the paired-analysis
- Physician (MD/DO) – 47
- Nurse Practitioner – 3
- Physician Assistant – 4
- Dentist (DDS) – 1
- Podiatrist (DPM) – 1
- Mental Health Practitioner – 1
Areas of Specialty:
- Surgical Specialty – 18
- Medical Specialty – 16
- Primary Care – 19
- Mental Health – 3
- No Response – 1
EHR efficiency and satisfaction
Clinicians reported receiving adequate training and improved efficiency, as well as, ease of fining orders and diagnoses (both p < 0.001). Clinicians also reported spending less time outside of their scheduled work hours using EHR compared to the their colleagues (p = 0.012).
Clinicians reported improvements in self-rating of general computer skills (p = 0.003) and specific EHR skills (p < 0.0001).
Job satisfaction and Work/Life balance
Clinicians reported improvement in self-ratings of job satisfaction (p<0.001) and work-life balance (p = 0.004).
Participant’s perception of the program (Pathway to Proficiency)
Over 90% of clinicians “Strongly Agreed” with the response “I am glad that I attended the Pathway to Proficiency training.”
Prior to the start of advanced training, a significant number of clinicians reported their preferred source of support were their peers. This program determined that advanced off-site physician-peer-led provided adequate training, improved efficiency, self-rating of general computer and specific EHR skills, self-ratings of job satisfaction, and work-life balance.
Advanced peer-led proficiency training of experienced clinician EHR users, is effective in the improvement of self-perception of EHR efficiency, EHR satisfaction, and job satisfaction.
- Who do you usually turn to for help when you have an information system/KP HealthConnect problem? 
- Questions/Results for EHR efficiency and satisfaction 
- Questions/Results for EHR skills 
- Questions about job satisfaction and work/life balance 
- Participant responses from ambulatory pathway to proficiency post survey 
- Participant responses from inpatient pathway to proficiency post survey 
I found this article interesting because it focused on peer-led training. I can relate to this from a professional (healthcare worker) and personal standpoint, as I find it easier for me to go through training sessions on EHR or electronic device (new cellphone) when the trainee is my peer. Sometimes companies send non-clinical representatives for EHR training and they have difficulty fully explaining functions and tools in the EHR, in relation to the clinicians' specialty area. I don't really have any criticisms, but I'm curious about what the outcome would be if the same study was conducted using non-peer-led training.
- Dastagir, M. T., Chin, H. L., McNamara, M., Poteraj, K., Battaglini, S., & Alstot, L. (2012). Advanced Proficiency EHR Training: Effect on Physicians’ EHR Efficiency, EHR Satisfaction and Job Satisfaction. In AMIA Annual Symposium Proceedings (Vol. 2012, p. 136). American Medical Informatics Association. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3540432/
- Who do you usually turn to for help when you have an information system/KP HealthConnect problem? http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3540432/figure/f1-amia_2012_symp_0136/
- Questions/Results for EHR efficiency and satisfaction. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3540432/table/t1-amia_2012_symp_0136/
- Questions/Results for EHR skills. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3540432/table/t2-amia_2012_symp_0136/
- Questions about job satisfaction and work/life balance. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3540432/table/t3-amia_2012_symp_0136/
- Participant responses from ambulatory pathway to proficiency post survey. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3540432/figure/f2-amia_2012_symp_0136/
- Participant responses from inpatient pathway to proficiency post survey. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3540432/figure/f3-amia_2012_symp_0136/