In a recent webinar, seasoned NHS chief information officers outlined the challenges that they had encountered with training for big system go-lives and heard how uPerform by ANCILE Solutions can address them; building on the experience of Infirmary Health in the US.
“Training is a hot topic,” Cindy Fedell, a former NHS chief information officer who is now working in Canada told the ‘Rethink your digital training’ webinar. “It’s hot because it’s never been cool. Training has always been an issue for us in the health tech world.
“In all the go-lives that I have done, training is one of the things that comes up. In the wrap-up, it is one of the things that we often say we could have done better.” So, why is that? Or, what are the challenges that CIOs face?
Time and resource challenges
Fedell, who oversaw the deployment of the Cerner Millennium electronic patient record in her last job at Bradford Teaching Hospitals NHS Foundation Trust, said one of the big challenges is “time”.
“With big EPR programmes, you are often training ten-weeks before go-live, and nobody can remember everything they have been taught ten-weeks earlier,” she said. Plus: “There is a money issue. Getting people out of wards and sitting down in a classroom for days on end is expensive.”
David Kwo, an experienced CIO who led Epic implementations at both Cambridge University Hospitals and University College London Hospitals NHS foundation trusts, gave the webinar an insight into just how expensive traditional training can be.
“At Cambridge, we had to put mobile offices at the back of the car park to get the classroom space that we needed,” he said. “At UCLH, we had to hire two buses, adapted to create ten-workstations, in order to increase capacity.
“The cost of all that is huge, and then there is the cost of the trainers. But, if you don’t do it well, you get into catch-up training, and that is an additional cost. There are also cost implications from doing this badly.” So, is there a better way?
The training challenge for Infirmary Health
Bobby Zarr, senior director of healthcare strategy at ANCILE Solutions, said he’d found one for Infirmary Health, where he was customer relationship management and business development manager.
“My uPerform journey started when I was handed responsibility for training for an Epic go-live.” he explained, adding that, initially, he thought things would be fine. After all, “Epic said they had the training materials, so I thought: we just need classrooms.”
But things were not that straightforward. “The system that Epic was training us on was different to the one we were getting,” he said, because, of course, Infirmary Health wanted to use the flexibility in the EPR to customise it to meet its own needs.
“Plus,” Zarr added, “as David [Kwo] said, training is costly and space is very costly.” With much less space than he would have needed, Zarr concluded that e-learning “was the only way to do it.”
uPerform from ANCILE Solutions
uPerform is a digital learning platform that is widely used in the corporate world for SAP, Workday, Infor, Guidewire, and Oracle. More than half the Fortune 100 companies use it to train staff on their systems and provide them with ongoing support.
Infirmary Health put Epic’s content into the platform to train 1,500 clinicians, and then took the same approach for its nurses. It went live with Epic in 2016, but that was not the end of the uPerform journey. “When Covid-19 arrived, we put all our resources on uPerform and updated them hourly,” Zarr said.
“Updating is the heart and soul of this. Unless you keep [your resources] updated and build in [material to respond to changes in systems and processes] it becomes useless. uPerform makes that much easier.” How?
ANCILE Solutions describes uPerform as “a digital trainer for the EPR.” Trainers can upload company training content to the system, or create their own training materials, using the version of the system that clinicians and other staff are going to use.
Those materials can include courses, videos, and tips and tricks sheet; and all of these can also be accessed from within the EPR if users need a refresher or help in their day to day work. Users can even ‘follow’ content they are particularly interested in, to hear about anything that’s new, and share material with others.
Or, as Zarr told the webinar: “uPerform is a clinical learning ecosystem and an ecosystem is where things live. With uPerform, all your training and support materials are collected together, and they live there, and hopefully they thrive there. Then, it delivers that content into the hands of the right users at the right time.”
Google-style search and YouTube-style tutorials for healthcare
Zarr also pointed out that uPerform delivers support in a way that is familiar to system users from other areas of their lives. “Google and YouTube are used a lot in society these days,” he said.
“If you want to know something, you type your question into Google and you get the answer back, or you go on YouTube and you watch a video. uPerform mirrors those experiences. People can look for help, get the answer, watch a video or tutorial, and share that with others.”
Independent research has also shown that uPerform can deliver measurable benefits. Survey data from ANCILE customers suggests the platform can reduce the amount of time that learners spend away from their jobs by 45%, and also that it can decrease training costs by 40%, decrease help desk calls by 40%, and enhance system user efficiency by 15%.
The last figure caught the attention of webinar chair Andy Kinnear, who has just started working as a consultant after a 30-year career in the NHS, most recently as director of digital transformation for South, Central and West Commissioning Support Unit.
“It’s really interesting to hear an estimate of the impact of inefficient use of a system,” he said. Webinar watchers agreed: in a spot poll, 59% said inefficient use of an EPR was “very costly” and 35% “costly”.
A no-brainer for health tech teams
Kinnear concluded by arguing that it’s time to address investment in training. “I think we have all had a desperate experience of go-live. We do our best, but in our guts, we probably know that what we do is not ideal,” he said. “So, it would be good to move towards these kinds of tools.”
The panel agreed. Neil Ralph, head of technology enhanced learning at Health Education England, who earlier in the webinar had outlined the different strands of work taking place to support digital transformation in the NHS, said that while he couldn’t endorse a specific product there was no doubt that e-learning needed to play a bigger role in training efforts.
“I think if you have good tools, just-in-time advice and resources, within the EPR, you will have more success with implementation and roll-out,” he said. “So, I think that something like what we are talking about here will be part of the roll-out of these solutions.”
Fedell said a tool like uPerform would be useful to CIOs at all stages of roll-out, while Kwo went further and described it as “a no-brainer.” “I wish we had had a product like uPerform at Cambridge, at UCLH,” he said, “because real-time, on-demand training linked to the individual user is ideal.”
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