Mayo Clinic EHR Training Program Boosts User Confidence Postimplementation

A Mayo Clinic EHR training program helped improve user confidence and proficiency in the EHR postimplementation, according to a study published in JAMIA.

Physician leaders in informatics designed an intensive program called reBoot Camp to enhance ongoing education of the EHR after initial implementation. Mayo Clinic offered the program from April 2018 through June 2020. There were 37 two-day and 43 one-day sessions, with 673 unique participants.

Researchers used survey data to study baseline, immediate, and long-term perceptions of program satisfaction and self-assessed skills with the EHR.

Confidence in skills increased by 13.5 points for general EHR use and survey results showed that this confidence level stayed the same after six months.

Informatics leaders designed the training program to reiterate fundamental principles, efficiency tips, and best-practice configurations across multiple specialties and all Mayo Clinic sites.

“The range of participants’ clinical practices was wide—from small community critical-access hospitals to large academic destination medical centers and across primary care, medical specialties, and surgical specialties,” the study authors wrote.

“Having practitioners from various specialties in the reBoot camps allowed for identification of departmental-level build opportunities, alternative workflow considerations, appreciation of interdepartmental nuances for shared care models, and general maturation in cross-disciplinary camaraderie,” they added.

Additionally, peer instructors helped ensure that material would be applicable in real-world settings. They also explained the importance of each EHR click, including clicks for administrative and other reasons (clinical research reporting, payor, regulatory, clinical decision support).

Instructors were encouraged to share their struggles and concerns, which ensured a safe environment for participants’ questions.

The program had direct practice applicability, the researchers noted. Six-month results of the post-camp survey found that one-third of participants ranked the “impact of the program on running my practice at Mayo Clinic” as greater than 90 on a 0–100 scale.

 This finding correlated with post-survey comments that described the program experience as “revolutionary,” “mind-blowing,” “practice transforming,” and “spectacular.”

Mayo Clinic incentivized participation with continuing medical education (CME) and quality improvement Maintenance of Certification credits within the participants’ specialty medical boards.

“Giving CME credit to participants is a small incentive for completing the training and an avenue to justify the time away from clinical duties to participate,” the study authors wrote.

“The actual time allocations were not recorded for analysis, but participants were surveyed about how they allocated their time for the reBoot camp,” the researchers continued. “Only 39 percent reported that they used their CME time allocation to participate, and nearly as many reported that the time used to improve their skills was directly supported by their department.”

The study authors noted that finding the time to participate in the reBoot camps remains a critical barrier for some providers, and ongoing studies are needed to find solutions.

They also pointed out that while cost-effectiveness is difficult to measure and requires formal evaluation, other healthcare organizations could benefit from adopting this training model.

“The discussion on the return on investment is a complex and multifaceted conversation, and attributing changes to training alone would be misleading,” the researchers said.

However, turnover rates of reBoot camp participants during the study period were lower than Mayo Clinic’s average turnover rate during this same period.

“The EHR has been implicated as a contributor to physician burnout, and burnout has been associated with turnover,” the researchers said. “It is not unreasonable to assume that effective EHR training may also reduce turnover associated with burnout, although specific studies are needed to determine whether this is true.”