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Simulation-Based Education: The New Paradigm in Healthcare Technology – Breakaway Thinking

Posted on July 19, 2017 I Written By

The following is a guest blog post by Heather Haugen, PhD, Managing Director and CEO at The Breakaway Group (A Conduent Company). Check out all of the blog posts in the Breakaway Thinking series.
Heather Haugen
Imagine a warehouse filled with classroom training sessions running simultaneously, hotel lobbies packed with consultants checking in and out at the same time, overrun parking lots, buses shuttling employees off campus, and more. These are the harsh, yet common challenges healthcare organizations face with classroom training – a predicament explored in the second edition of Beyond Implementation: A Prescription for the Adoption of Healthcare Technology. As the book explores the real-life headaches of classroom training, it calls on healthcare leaders and organizations to embrace a new education paradigm.

Today the healthcare industry has made considerable advances in technology. Enterprise applications now offer more features and functionality than ever before. Analytics programs, telehealth platforms, mobile health applications – each represents one of the many innovations changing the face of our industry. Yet despite these advances, classroom training remains one feature that has yet to change, a feature deeply-engrained in the habits, mental models, and beliefs of the industry. Healthcare executives already face significant pressure from making multi-million-dollar investments in clinical information systems. Changing how users are educated disrupts another component of healthcare for which executives become solely responsible, and must address and manage.

Despite the strength of the status quo, Beyond Implementation calls for healthcare’s departure from the classroom training model, as research highlights its ineffectiveness for teaching learners how to use new technology – a reason why most industries have abandoned or redesigned the model. Instead of face-to-face instruction, the book recommends healthcare organizations take a simulation-based approach to education, which provides learners with hands-on experience completing their workflows in a simulated EHR. The value of simulation-based education was first proven in the commercial airline industry. Like healthcare today, the airline industry experienced significant disruption through technology as the industry transitioned from analog to flight control systems. Unable to educate pilots quickly enough, the industry developed flight simulators that provided hands-on training that was relevant, accessible, repeatable, and sustainable. The new education model produced impressive learning outcomes, which is why the book argues for a similar model to be applied to healthcare.

Unlike classroom training, simulation-based education is more personalized and targeted. Education is role-specific and teaches learners how to complete their daily tasks in a simulated EHR environment. Users learn to complete their daily tasks according to best practice workflows guided by real-life clinical scenarios that increase relevancy, retention, and engagement. One significant benefit is users accumulate experience in the application without risks to patient safety. They also access their education at a time most convenient to them, as education is accessible 24/7 anywhere there is an internet connection. The accessibility of simulation-based education eliminates the headaches and costs of renting out warehouses, hiring trainers and consultants, scheduling staff to attend three eight-hour training sessions, and more.  It’s no wonder why simulators are shown to improve confidence and knowledge in the system – which are key indicators of proficiency.

Considering the challenges and opportunities facing healthcare organizations, the need for a better education paradigm is apparent. Now more than ever, our industry is grappling with the challenges of swapping their legacy systems with new enterprise applications, which research has shown brings significantly greater challenges than the switch from paper to electronic. In addition to new strategies around leadership and other areas, organizations must provide education that helps users make the transition from old workflows, keyboard shortcuts, and habits more quickly and seamlessly. Our industry is also beginning to focus on improving outcomes through technology, a trend that requires organizations to create a workforce of proficient users efficiently and effectively.

In every aspect, healthcare stands to benefit by replacing its analog approach to education. Whether reducing costs or improving knowledge and confidence in the system, the argument for classroom training is obsolete. It’s time that our industry embrace a new model that reflects the level of innovation healthcare leaders and professionals are working so hard to adopt.

Conduent is a sponsor of the Breakaway Thinking series of blog posts. The Breakaway Group is a leader in EHR and Health IT training. Download their Free Whitepaper “Leadership Insights: Gaining Value from Technology Investments.”

The New Leadership Agenda: 6 Effective Strategies for Driving the Adoption of Healthcare Technology – Breakaway Thinking

Posted on June 28, 2017 I Written By

The following is a guest blog post by Heather Haugen, PhD, Managing Director and CEO at The Breakaway Group (A Conduent Company). Check out all of the blog posts in the Breakaway Thinking series.
Heather Haugen
In executive conference rooms around the country, a common dialogue is emerging. In the wake of multi-million-dollar investments in electronic health record (EHR) systems, healthcare leaders are admitting that they underestimate the “care and feeding” of adopting these new applications. Whether this realization occurs from implementing a new system for the first time, or replacing an existing legacy application, the challenges are largely the same. Change fatigue, resource shortages, user resistance, workarounds, patient safety concerns – all reflect barriers healthcare leaders face adopting new healthcare technology.

But there is good news for healthcare leaders. This month marks the release of the new edition of Beyond Implementation: A Prescription for the Adoption of Healthcare Technology. The book offers healthcare leaders a playbook for approaching and leading the effort to adopt clinical information systems.

The book explores several important leadership strategies that have proven invaluable to healthcare executives around the country.

Strategy #1: Establish a New Leadership Agenda

Leadership is the most fundamental driver of EHR adoption. Because of its importance to the success of the initiative, leaders must relentlessly commit to making EHR adoption a daily priority for executive teams. This includes focusing on the factors that drive optimal use of clinical information systems long after the implementation.

Strategy #2: Stop Doing List

Time is a scarce and vital asset for every executive team, which faces a host of competing priorities and time-sensitive initiatives. The most successful leadership teams prioritize the right projects that add the most value to the organization. One strategy is to develop a Stop Doing List, a concept popularized by renowned author Jim Collins. The Stop Doing List is the process of choosing which initiatives to stop in order to focus on the most crucial activities. For healthcare leaders, this means eliminating or reprioritizing enough projects to make EHR adoption among the top three priorities for the organization. To develop a Stop Doing List, Beyond Implementation recommends prioritizing initiatives per these criteria:

  • Projects/meetings that do not directly affect quality of care or safety
  • Projects/meetings that are not related to compliance or legal risk
  • Projects that can be delayed with little overall impact
  • Meetings that can be eliminated or consolidated

Strategy #3: Engage Clinical Leadership

Providers carry a powerful voice in a healthcare setting. Leaders must actively engage providers and promote their buy-in through several strategies. One strategy includes developing a provider council. Including representation from across the organization, endorsement from top leadership, and a formal charter and vision for the body, this council should oversee and govern EHR use.  Another strategy is to engage members of the council to serve as champions of the effort by helping their departmental colleagues and serving as an extension of leadership.

Strategy #4: Create a Tone at the Top

Crucial to engaging users in the effort is establishing a tone that emphasizes EHR adoption. Leadership must promote awareness of the initiative by creating a value proposition and brand that connects the EHR system with the organizational vision and mission. Leadership must also establish a rhythm with their messaging and ensure it remains authentic when interacting with users. Leadership should make it a focus to answer key questions about the transition, such as how EHR adoption improves clinical and financial outcomes and how the change will affect users individually. Establishing the importance of the effort, as well as being open and transparent, helps users navigate and accept the transition more easily.

Strategy #5: Governance

Governance is also another key ingredient of effective leadership. Competing interests, differing opinions, and varying experiences all pose barriers to EHR adoption. Leadership must develop a well-defined governance process, which overcomes these barriers by creating policies and procedures that hold users accountable and define expectations and best practices around use of the system. The governance process should evolve over time to address the evolving needs of users as they adopt the application. After developing the governance process, leadership must measure its effectiveness to enforce accountability and make continuous improvements.

Strategy #6: Track Performance Metrics to Drive Continuous Improvements

To improve outcomes, leadership must track the clinical and financial results of EHR adoption. Leadership should identify, select, and empower the right individuals to lead this effort. These individuals should collect, analyze, and report performance metrics that are important to caregivers and will motivate engagement and improvement.

To see improved clinical and financial outcomes, healthcare leaders must ignite and sustain the movement toward the adoption of clinical information systems. It starts with establishing a new leadership agenda that places adoption at the forefront of organizational priorities and continues through strategies that facilitate engagement, communication, governance, and measurement. When leaders engage in these activities, adoption becomes a pervasive mindset across the organization for optimal results.

Conduent is a sponsor of the Breakaway Thinking series of blog posts. The Breakaway Group is a leader in EHR and Health IT training. Download their Free Whitepaper “Leadership Insights: Gaining Value from Technology Investments.”

Are You Wasting your EHR Investment? – Breakaway Thinking

Posted on August 31, 2016 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

The following is a guest blog post by Heather Haugen, PhD, Managing Director and CEO at The Breakaway Group (A Xerox Company). Check out all of the blog posts in the Breakaway Thinking series.
Heather Haugen
Healthcare leaders and clinicians continue to be disappointed with the value Electronic Health Record (EHR) technology provides in their organizations today. The challenges are real, and it will take some time and effort to improve. The technology will continue to evolve at the pace we set as leaders, vendors and healthcare professionals.

When Free Is Expensive
Several years ago, a reputable IT vendor offered us free use of their software, which provided monitoring of equipment that would be valuable to us. Initially, we were excited; the functionality perfectly aligned with our needs, and the application was robust enough to grow with us. We had a need and the software fulfilled the need. We couldn’t wait to have access to the dashboard of data promised by the vendor.

Months after the implementation, we were still waiting. The “free” price tag was alluring, but we quickly recognized the actual maintenance costs and labor required to make the application truly valuable to our organization were far from free. This story drives home a concept that we all understand, but often overlook. Underestimating the “care and feeding” required to maintain a valuable investment puts the entire project at risk. We all need to remember the importance of sustainability even when we are initially excited about a new investment.

EHR systems are expensive and require tremendous resource investment, but the effort is ongoing and we need to plan accordingly.

The Key to Long Term Behavior Change
The difficulty of moving from implementing an EHR to maintaining high levels of adoption over the life of the application is strikingly similar to weight loss and weight management efforts. The percentage of overweight adults in the U.S. is staggering and continues to rise. Today, over 66 percent of adults in the United States are overweight and 59 percent of Americans are actively trying to lose weight. But the problem isn’t weight loss – it’s weight maintenance. Many of us have successfully lost weight, but can’t keep the weight off. As a matter of fact, we regain all the weight (and often more) within 3-5 years.

This isn’t a complex concept: dieting doesn’t incent long-term lifestyle change, thus we re-gain weight after we settle back into old habits. To be successful in the long-term, we need to practice weight management behaviors actively – for years, not months.

We’ve taken the dieting approach to implementing new software solutions in healthcare for too long. We prepare for a go-live event, but fall back into our comfortable old habits afterwards – resulting in work-arounds, regression to ineffective workflows, insufficient training for new users, poor communication and errors. The process of adoption requires a radically different discipline, and the real work begins at go-live.

Instead of checking the project off your to-do list after a successful implementation, you need to create a plan to sustain the changes. A sustainment plan addresses two critical areas:

  • It establishes how your organization will support the ongoing needs of the end users for the life of the application. This includes communication, education and maintenance of materials and resources.
  • It establishes how and when your organization will collect metrics to assess end user adoption and performance.

Lack of planning and execution in these two areas will lead to a slow and steady decline in end user adoption over time.

Effective sustainment plans require resources – time and money. Keep in mind that adoption is never static; it is either improving or degrading in the organization. A series of upgrades can quickly lead to decreased proficiency among end users, completely eroding the value of the application over time. Leadership must plan for the investment and fund it to achieve improved performance.

Most organizations only achieve modest adoption after a go-live event, and it takes relentless focus to achieve the levels of adoption needed to improve quality of care, patient safety and financial outcomes. Sustainment plans are most successful when they are part of the initial budgeting and planning stages for EHR.

Metrics Make the Difference
Metrics are the differentiating factor between a highly effective sustainment plan and one that is just mediocre. End user knowledge and confidence metrics serve as a barometer for their level of proficiency, providing the earliest indication of adoption. Ultimately, performance metrics are powerful indicators of whether end users are improving, maintaining or regressing in their adoption of the system. If we get an early warning that proficiency is slipping, we can react quickly to address the problem. These metrics ensure the organization is progressing toward high levels of adoption, overcoming barriers and gaining the efficiencies promised by EHR adoption. Metrics act just as the scale does in long-term weight management; they are the first indicator that we are falling back into old behaviors that are not consistent with sustainable adoption.

Metrics also keep us on track when performance does not meet expectations. Two potential scenarios in which the go-live event is successful but performance metrics fail to reach expectations help illustrate this idea. For instance, performance metrics could not be achieved because the system is not being utilized effectively. This may be due to inadequate training and therefore lower proficiency, or a problem with the actual performance by end users in the system. Measuring end user proficiency allows us to identify “pockets” of low proficiency among certain users or departments and make sure they receive the education needed. Once users are proficient, we can refocus our attention on the performance metrics.

A second scenario is less common but more difficult to diagnose. Users could be proficient, but specific performance metrics are still not meeting expectations. In this case, we need to analyze the specific metric. Are we asking the right question? Are we collecting the right data? Are we examining a very small change in a rare occurrence? There may also be a delay in achieving certain metrics, especially if the measurements are examining small changes. A normal delay can wreak havoc if we start throwing quick fixes at the problem. In this situation, staying the course and having confidence in the metrics will bring desired results.

Like sustained weight loss, EHR adoption is hard work.  Commit to a sustainment plan and a measurement strategy to ensure your EHR continues to provide the long-term value that was promised at go-live.

Xerox is a sponsor of the Breakaway Thinking series of blog posts. The Breakaway Group is a leader in EHR and Health IT training.