VA Addresses Workforce Training in New EHR Site Rollout

The Department of Veterans Affairs’ Walla Walla medical center in Washington is now live on VA’s new electronic health record (EHR).

The go-live period for Walla Walla runs through April 8. During this time, VA’s Electronic Health Record Modernization Integration Office will provide “at-the-elbow support” for onsite staff to help them learn to use the new system, adapt to new ways of delivering and documenting care, help answer questions and quickly route issues for escalation and resolution, a VA spokesperson told GovCIO Media & Research.

“After go-live, Walla Walla will go into a sustainment period, during which super users at the facility are available to provide support to their peers and answer questions about workflows or applications,” the spokesperson said. “In addition, we will continue to monitor clinical issues, end-user training needs, patient-safety issues and resolve tickets logged by the facility. We will also continue to monitor the system’s performance and ensure the best experience for our end users.”

Just over a year ago, VA began a strategic review of its EHR program, which uncovered challenges with the initial implementation strategy around training, management and governance. In December 2021, the agency implemented new changes, like updates to its timeline and reorganization of its oversight and leadership structure, to overcome these challenges.

As VA continues to implement EHR, the agency is turning to change management and workforce training to ensure that staff understand and can effectively use the new system. VA’s workforce training includes virtual and in-person modules for medical personnel on their specific roles and how they will complete their work with the new system. The agency also leveraged lessons learned from its initial Mann-Grandstaff rollout to improve future site implementations.

“In response to feedback, VA made over 2,000 content changes since the conclusion of training at Mann-Grandstaff in October 2020, including improvements to both the quality and quantity of training,” a VA spokesperson said. “Training includes access to the EHRM Phase One Sandbox, a hands-on practice environment to foster end-user understanding and adoption of the new EHR. The Sandbox allows users to review and practice what they learned and become more familiar with the system.”

Starting with VA’s Walla Walla site, the agency has also taken the following steps to help ensure training is completed, so the workforce is prepared to use the EHR:

• Maintain a training completion dashboard that identifies training completions and outstanding training items by user and training item
• Report training status in recurring facility meetings
• Provide daily summary emails of training completions and no-shows leading up to go-live
• Deliver pop-up classes to accommodate facility needs and provide opportunities for end users to complete required classes

Moving forward, VA will continue to enhance training content, including expanding the course catalog and increasing the number of computer-based trainings offered, to provide end users more flexibility and autonomy to meet their training requirements. VA also plans to establish additional processes and procedures to improve training quality and ensure training completion.

VA will also launch a Sustainment Resource Center that provides online access to system alerts, training artifacts and other supplemental training materials, like tip sheets, job aids and quick reference guides, to better guide the workforce through implementation.

As the agency makes these shifts, VA is honing in on integration between its EHRM Office’s technical teams, the Office of Information and Technology (OIT) and VHA Office of Health Informatics (OHI) to drive a unified approach to implementation. This collaborative effort enabled VA to perform a mock go-live at Walla Walla with joint support and integrated response teams. It has also streamlined communication and faster turnaround when addressing facility needs, the VA spokesperson said.

“One of the things that we’ve been changing is working closer with the OIT group,” Laura Prietula, acting deputy CIO of VA’s EHR Modernization Integration Office, said during the HIMSS conference in Orlando, Florida earlier this year. “We used to be removed from the overall OIT arena … I’m bringing both of them together so that we can be much better together as a team.”

The VA Central Ohio Healthcare System in Columbus, Ohio, is the next VA facility scheduled to go live on the EHR on April 30, 2022.