Start with Your Users.

When Winston Churchill said, “We are masters of the unsaid words, but slaves of those we let slip out.”  Mr. Churchill was not trying to build a teaching EMR in the twenty-first century.

While collaborating with both the education team and the technical team for the past two years, I’ve learned how important point of view is.  The grant was written in the point of view and benefit of the leadership funding the work.  The technology requirements were discussed and written for a standalone system from its parent application that it got most of its intelligence from (G3), an EMR for trained physicians to use.

The education pieces were designed to meet learning objectives at high standards and relate to questions that will eventually be asked on multiple medical exams, most likely years away from our current users.  I’m sure that Steve Jobs would have been calling us all horrible names because we didn’t spend enough time with our actual users, the educators, and students that would be using the teaching EMR upfront.

Imagine my surprise when I went to my first sessions of watching the tEMR in the field and their reaction was “Why are we learning this?  What does this have to do with my exam at the end of the year?  I’ve already spent time ghosting with a doc in the summer and learned the basics of an EMR then.”

Not being an educator, but someone who has always had a need to learn, it hit me that in no real way did we explain why this course was necessary and what they should get out of it before being told that they should take it.  My thoughts of how obviously important this was, how great the curriculum was built, and how well we had managed to streamline a full-fledged EMR into something an early med student could learn and use, was quickly replaced with new questions and new priorities.  If the educators in the field didn’t get it, and thus the students didn’t understand it, then what’s the point?

So, what was just a curious drive-by idea of sitting in a classroom and speaking with teachers, now became a necessary exercise. What do they want to get out of this course?  What skill level are the students really at with technology (I’ll bet it’s better than you think and better than most of your teachers). What skill, if any, do your students have already with the big box EMR’s?

We came in with the idea that they would know nothing or at least very little, working from the least common denominator up.  It’s logical, but from watching it, we don’t give our second-year med students enough credit, and we could increase the experience a bit.

So what’s your experience?  What training EMR’s or real EMR’s have you used?  What sticks out to you?  What’s missing?

Chris Power
Project Manager for The teaching EMR