We had a ton of extra IT help for about a month after our new system. I feel like everyone has gotten the basics except the providers. I don't know if they didn't get the help, didn't ask questions, or didn't listen when IT/pharmacy told them the right way, but it's frustrating. I still play nice and politely explain the right way every time, but man.. if everyone else can get it, why can't physicians? It really isn't that hard.
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When our hospital system started doing e-scripts, I was scheduled for a 30 minute "training session" that was located in a separate building (away from my office or any clinical sites). They scheduled it on a day that I had to round in the ICU in the morning and had a full clinic in the afternoon (so I had to round in the ICU, run to this off-site to do my 30 minute training (it was raining that day), then run back to my clinic site so I can start seeing patients). And the training session was a generic training session, not geared towards providers (so the part that I actually had to know was in the last 5-10 minutes). Would have stayed to try it out in the simulated training session - but I was already running late.
And that training session was 2 months before it went live.
And the day it went live - well, there was one IT person in clinic (to answer any questions the nurses/physicians had). The problem was that he wasn't in the rooms - just in our coffee break room, waiting for us to come to him for issues. For the most part, since I'm part of this younger generation, it was easy to figure out. But the older docs (in their 50s-80s) had a lot of trouble (they're the one who type with one fingers, and still dictate their notes). While most features can be self-learn, there are others that are not intuitive unless someone points them out to you. Fortunately our e-script ordering system is similar to our CPOE system so I didn't have trouble. But at my hospital (where there are lots of students, residents, and fellows), some of the attendings don't even know how to enter orders since they are used to having the fellows/residents do it for them ... and suddenly you're asking them to enter e-scripts. It was a big learning curve for a lot of them.
So when our facility started to e-prescribe, it was 2 months since I've had my "training session" which I honestly don't remember. In the meanwhile, I had to do other mandatory stuff (training on how to initiate our new alcohol CIWA protocol on the computer, corporate HIPAA annual training and recertification, renew my ATLS, BLS, and ACLS (they all expired around the same time
😡 ) . I'm sure the pharmacists in my area went crazy the day that our e-prescribe went live.
And that's just e-prescribing. Going from paper order to CPOE - I'm sure that was a bigger shock and a bigger learning curve (and knowing administrators, training of providers on using CPOE was probably not well thought out, and just added onto the schedule of an already busy schedule)
*at another hospital (a community hospital), there are many provider groups contracted to work at this hospital (I think Internal Medicine has 4 different groups working at this hospital). Each groups have their own physicians/PAs/NPs. So they're having trouble getting all the providers in all the groups to use the EMR that they just implemented. (the hospital can't really threaten the groups since they are private groups with privileges at the hospital and they want these groups to admit their patients to their hospital (and do procedures at their hospital) and not send patients to the competing hospital system across town - so if they crack down too hard or make it too difficult, these groups can just switch their affiliation and send their patients elsewhere). It's all local politics (and money).
Anyway, just a perspective on why it is difficult for some providers to use CPOE. (at the VA, it takes a few days to get used to their CPOE system because it's not the most user friendly system, and different from what I'm used to, so I have to relearn and retrain my mind when I'm at the VA and I'm ordering stuff)
