Regenstrief Creates Teaching EHR System to Boost EHR Training

Regenstrief Institute and its partners have developed a teaching electronic medical record (tEMR) system that leverages deidentified patient data to improve EHR training and teach healthcare students how to use health IT.

With full EHR adoption almost widespread, the upcoming generation of clinicians need health IT and EHR knowledge at an earlier stage in medical education to gain health IT competence. However, EHR training is not always available.

Quality EHR training is critical to clinicians, especially those new to health IT. An effective EHR training program can mitigate the likelihood of clinician burden and boost satisfaction.

The data shows that adequate EHR training may be the key to improving EHR user satisfaction rates. The healthcare community recognizes the importance of better preparing future clinicians by teaching medical students core EHR competencies.

“Many students enter medical school with EHR experience,” explained an anonymous curricular leader whose institution implemented tEMR. “Unfortunately, much of this previous EHR experience is not useful for physician training as these previous roles (eg, scribe) yield EHR experiences different than a physician’s role.”

Health IT experts from Regenstrief, IU School of Medicine, Eskenazi Health, and the American Medical Association (AMA) joined forces to develop tEMR, which is an optimized version of one of the first EHR systems, Regenstrief’s Gopher.

Eskenazi Health utilized Gopher for over 30 years as its production model EHR for inpatient and outpatient care. Researchers said tEMR users could simulate every EHR task available through a commercial EHR, such as order-entry, clinical note writing, and data review.

tEMR users gained a realistic virtual patient care experience, the researchers said. This platform was especially critical during the spread of COVID-19 when medical students and clinicians could not treat a significant number of patients, the study authors explained.

The EHR platform also enabled collaboration between medical students and individuals working at disparate locations working at the same or different times.

Although Regenstrief and its partners aim to train future clinicians on the tEMR system, the group also intends to create tools that medical students, educators, clinicians, and administrators can leverage to influence how health IT should be used in healthcare, the study authors wrote.

Over the past eight years, nearly 12,000 students and 12 academic healthcare institutions have adopted the Regenstrief tEMR system.

"With the exponential growth of health-related data and the impact of health information technology (HIT) on work-life balance, it is critical for students to get early EHR skills practice and understand how EHRs work,” the study authors wrote.

“The ultimate tEMR project aim is to create tools through which our students -- future educators, administrators, practice leaders, and front-line physicians -- can develop enough HIT savvy to influence how HIT should be used in health care rather than HIT dictating how health care is delivered.”

Investing in EHR training could make the user more skilled at navigating the EHR, learning the platform’s intricacies, and potentially reducing the chances of clinician burnout in the future.  

"HIPAA [Health Insurance Portability and Accountability Act of 1996] has restricted access to EMRs so, ironically, the more EMRs are used, the less access students have to patient data, but the more they need to know," said Debra Litzelman, MD, Regenstrief Institute research scientist.

"Regenstrief tEMR offers detailed, anonymized data on complex patients as well as unique real-world functionality including patient sharing among care team members. Medical, nursing, social work and other clinical trainees who have early exposure to EMRs will think differently about patient care and about future EMR development because of that early exposure. It creates a different mindset," Litzelman concluded.