Monday, March 19, 2012

The Agony Of EMR Instruction Class

Before our hospital converted to electronic medical records, we were told we had to take a class on using the new system. And not just any class. We were stunned to find out we would have to take an entire day off on a weekend to attend. The whole thing was expected to take EIGHT hours. What the... How can a computer software take eight hours to learn, many people demanded. The glib answer that was told to us was that this is not like playing Angry Birds. This is a professional level program that requires hours of training and weeks to familiarize. It is the equivalent of learning something as complex as AutoCAD or Photoshop Pro. These programs are not designed for school children, or adults with the mindset of school children. There is even a test at the end of the class that we must pass before we can be considered successfully trained. And besides, we were told, the IT guys have already streamlined the process down to eight hours. Most other hospitals who have used this program typically required sixteen or more hours of training before certifying someone to use it. We were getting off lucky. So there.

With much grumbling, we scheduled the day we wanted to come in and waste a glorious weekend day. Thankfully our department had set up training days that were designed just for the anesthesia portion of the program. That way we didn't have to sit there and listen to how a hematologist can order a bone marrow biopsy on the system. We were also warned not to come in late. After they close the door, no one is allowed to enter. No one is also allowed to leave early either as the exam would not be handed out until the very end. But at least they will provide food and refreshments. Alas mood enhancing alcoholic beverages would not be one of them.

The morning of the lecture, we filed into the conference room which now looked like Mission Control at NASA. Rows of computers were sitting everywhere facing a lectern. We were instructed to write on a piece of paper how we would like to be addressed and hang it on the back of the monitor so the instructor can see it. Most people wrote their first names. Several wisenheimers wrote "Doctor".

The lecture started exactly on time. The instructor was very friendly and decently knowledgeable. But if somebody knows more than you about something they would seem knowledgeable whether they are smart or not. Shortly it became obvious why eight hours of instructions are necessary to use the EMR. The choices were bewildering. There were buttons and highlights all over the screen. The button labels and icons were not that helpful. Just finding your own patients took multiple mouse clicks to get there. The lecturer moved with the speed of somebody who has given the same talk dozens of time. Soon people were asking him to slow down and repeat himself. It was tremendously difficult to watch his actions on his big projector screen while attempting to do the same ten seconds later on our own computers.

The frustrations mounted quickly. After awhile, instead of asking how an action is performed in the software, my colleagues started asking why it was done that way. Why can't we order something one way instead of the other way? Who decided that the default selection should be A instead of B? Questions were asked of one of the anesthesiologists who sat on a committee that helped decide how the anesthesia portion of the system would work. It started to get ugly. The lecturer tried to answer their questions as best he could, but they were not satisfied.

My eyes started glazing over. Why are my colleagues throwing accusations at this poor instructor? Don't they understand he is only here to instruct us? He is not the one who designed the software and really has no say in how it works. He's only here to help us with the program that we have. I can't believe how absurd these people are. During a particularly long stretch of arguments, I sat back and pulled out my phone and started playing games. There really was no point in following the conversation since it was obvious that nobody in the room can change how the program functions. I'm just resentful that people are dragging this out and wasting a beautiful day fruitlessly bickering about this instead of quickly finishing it so we can all go outside and enjoy the rest of the weekend.

The hours ticked by. Soon enough lunch break arrived. Some people wanted to skip the 45 minute lunch and continue into the afternoon portion of the class. The instructor wisely said everybody take lunch. I think we all needed it. The afternoon session was more of a lab, applying the information we gained from the morning and solving a series of scenarios that were given us. It still took a lot of help from the assistants that were roaming the room to get people to understand it in even a rudimentary fashion. The exam itself was not bad. It was an open book test and we could freely ask anybody in the room to help. I couldn't wait to get out of there. I whizzed through the exam, got my passing grade, and headed out into the fading sunlight. Yes it was easy enough to use the EMR in a classroom setting with people at your beck and call to assist you. How will this work when the time comes? And will I remember any of these instructions when the system goes live in a few weeks. The countdown's on. 

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