The presentation discusses challenges and solutions related to implementing an EHR system at Regional One Health. Regional One Health is a large healthcare organization with over 25 outpatient clinics that serves Tennessee, Mississippi, and Arkansas. It faces challenges with educating and training attendings, residents, students, and midlevels on the new system. Specific issues included attendings refusing to use the system, ensuring timely access for residents, and defining the student role in documentation. Solutions proposed were improving education through web-based training, manuals, and hiring dedicated educators. It also addressed improving communication around licensure and purchasing more licenses to accommodate staffing changes. The future state discusses ongoing education enhancements and establishing advisory boards and on-boarding policies to facilitate physician and

2. Topic
Level
Presenter(s):
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Mid-levels, Residents and Students, Oh My!
Client
Candice Douglas
Diane McGarry

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Things our lawyers make us say...
Neither NextGen Healthcare nor any presenter at the ONE
User Group Meeting is engaged in rendering legal or other
professional advice and this presentation is not a substitute
for the advice of your attorney, accountant and/or other
professional advisor.

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Session Guidelines
• Silence all cell phones
• Questions will be addressed at the end of the
presentation
• Refrain from personal discussion

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Topics
In this presentation we will cover:
• Our Healthcare Organization
• Challenges faced
• Solutions
• Future State
• Questions

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Regional One Health
• ROH Center of Excellence in Trauma, Burn, High-Risk
Obstetrics and Neonatal Intensive Care.
• Over 25 Outpatient Specialty Clinics and 6 Satellite
Clinics
• Serves Tennessee, Mississippi and Arkansas

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Regional One Health
• Outpatient clinics designed to deliver a wide range of
primary care and specialty services within one network
• Satellite locations have broadened the reach of
services and create need for the use of an EHR system

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Provider MakeupAttendings
•Faculty of
UTHSC, the
affiliated
teaching
institution of
ROH
•Functions in
role of
supervisor to
midlevels,
residents and
students
•A select
number of our
attendings also
see patients as
the sole
provider for
patients
Midlevels
•Fellows
•Nurse
Practitioners
•Render
services in the
subspecialty
areas
Residents
•Practices
under the
supervision of
an attending or
fellow
•Provides
clinical care
•Documents in
EHR system
as rendering
provider
Students
•Gain clinical
experience in
the outpatient
setting
•Works under
the immediate
supervision of
residents and
/or fellows
•Limited
documentation
in EHR system

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Challenges
In our ambulatory setting, there are many factors that play
into our day-to-day experiences.

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Challenges:
Education and Training
• Dedicated NextGen trainer
• Time available from start of
project planning to
implementation
• Tools and resource
materials for staff
• Culture change

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Challenges: Attendings
I refuse to
use this
system
This is
impacting
patient care
All of this is
because of
Obama
Care!
HMPF!

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Challenges: Attendings
• Some Attendings refuse
to use the system.
• Attendings often require
their residents to do all
the work and prefer to
never log into an EHR.
• Many Attendings have
been practicing at ROH
for several years and are
adamant to using old
paper processes.

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Challenges: Residents & Students
• Partnership with teaching
hospital – UTHS
• Providing timely access to
the system
• Handling transitions of
residence
• Where does the student
fit in the documentation
process?

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Challenges
Licensure
Licenses to meet
demand
No identified
UTHSC liaison
Knowing who will
be on staff and
when

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Solutions
Solutions in the
land of
Mid-levels,
Residents and
Students

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Solutions
Education and Training
• WBTs – Web Based Training
• Super User Program
• Educators
• Manuals & Job Aids
• Key relationships with management and administration

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Solutions
Education and Training
• WBTs – Web Based Training
• Super User Program
• Educators
• Manuals & Job Aids
• Key relationships with management and administration

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Solutions: Licensure
• Increase communication
between Residency Program
administration and I.T.
• Run reports for inactivity
• Complete annual assessment
of licenses and break downs
• Purchase more licenses

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Solutions
Attendings
- Leadership involvement and
partnership Accountability from
above
- Fostering Relationships
- Bridging the Gap between Old and
New
Residents
- Identifying and Involving Key
Stakeholders
- Onboarding Letter and Form
Students
- Work in Progress
- Specialized/Customized Template
for Histories and Review of
SystemsProviders

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Future State
Objective Details
Responsible
Party
Workflow
Considerations
1. Education: Improve WBTs In addition to maintaining our current
WBTs, we plan to create more WBTs,
specific for our specialties.
Information
Technology
New required Physician
Training.
Maintaining new WBTs
with system upgrade and
workflow changes.
2. Physicians: PAG or Advisory
Board
We are working to develop a Advisory
Board for NextGen users. This board
will consist of Physicians as well as
administration and supporting staff.
Information
Technology
Chief Medical
Information Officer
UTROP physicians
Will need to incorporate
members from other areas
of clinical support
3. Education: Hire more Educators Need staff of 1-2 educators that focus
on education, material development,
implementation support
Information
Technology
Seek educators that are
well rounded and have
analytical skill sets; would
help in environment we
service
4. Licensure: Buy more licenses There are constant provider additions
and need supply available to support
increased number of practicing
providers
Information
Technology

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Future State
Objective Details
Responsible
Party
Workflow
Considerations
5. Physicians: On- boarding
physicians
Establish written policy and procedures
that will streamline preparedness in
regards to license availability and
adequate training
Information
Technology
6. Medical Students: On- boarding
physicians
To institute documentation for medical
students in clinical setting
Information
Technology
UTHSC Leadership
Must determine what is
allowable for
documentation and
oversight of students when
using electronic medical
record

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Any Questions?