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EMR Staff and Training – Challenges and Solutions

By Amy Madore | 28 May, 2009

On Tuesday I attended a meeting convening a small but diverse group of individuals who are developing, implementing, or considering implementing OpenMRS (http://openmrs.org/wiki/OpenMRS_Overview). During one of the afternoon breakout sessions we discussed challenges organizations often face when deploying OpenMRS in the field. Most of the challenges we identified fell into one of the following themes or categories: cost, infrastructure, human resources/training, and technology (product).

Here I’ve outlined the key issues we raised pertaining to human resources (i.e., staff capacity and support needs) and training. When able, I've also included links to resources that address these issues. This list is hardly complete, and it would be great to have other Health IT members expand on it! Please feel free to share additional challenges, proven or potential solutions, related questions, and especially your own experiences. While the meeting breakout discussion focused on OpenMRS, it would also be helpful to learn from folks who are implementing alternative EMR systems.

OpenMRS Challenges Related to Human Resources (Staff Capacity) & Training:

1. Training technical staff in OpenMRS development and implementation
     > Partners In Health (PIH) has developed a course in Rwanda called "E-Health: Software Development and Implementation" (EHSDI) to train local computer science graduates how to develop and implement OpenMRS software:

     > Go to http://www.ghdonline.org/tech/discussion/rwandan-openmrs-training-course/ to read a previous Health IT discussion about the EHSDI curriculum and to learn how the Sustainable Sciences Institute (SSI) plans to implement a similar course in collaboration with the MOH in Nicaragua.

2. Training clinicians in use and benefits of OpenMRS
     > For a high-level checklist of staff and training needs based on PIH's experience, please go to http://model.pih.org/node/536
     > What resources, training materials, and strategies are other organizations and programs using to train their clinical staff?

3. Clinician buy-in and involvement
     > How do you include local staff in design and testing to ensure on-site investment?



Rowan Seymour Replied at 9:17 AM, 30 May 2009

Hi Amy - sorry for the lack of updates until now. Our course is continuing here in Kigali, and we have now reached the Enterprise Java Programming unit of the course. We are slowly making course materials available on http://openmrs.org/wiki/EHSDI_Training_Course but we are a bit behind on that, as it takes time to refine and organize the materials before making them available. Currently the first two units (IT Foundations and Web Design) are complete, but the materials for the other two completed units are still being worked on.

It's very exciting for us to know that in only a few months our students are going to be at the level where they can add functionality to OpenMRS.

Om G Replied at 7:28 PM, 30 May 2009

What great idea! Congratulations. I'd like to take the course!

Nadeem Chaudhry Replied at 12:00 AM, 13 Apr 2010

This thread is about a year old so I am not sure if people even read it or not. I am trying to contact Rowan Seymour or any one else regarding EHSDI. Please provide me email address.
Thanks Nadeem

Rowan Seymour Replied at 10:27 AM, 16 Apr 2010

Ok so a little update from Rwanda - we are now into the second year of the training course. The students from last year all graduated and got a technical certificate from the Rwanda Development Board, and were mostly placed in jobs with the Ministry of Health, where they are currently developing software for a national EMR implementation. However, one of the students is now employed as a mentor in the this year's course.

This year we have 12 students and are trying to take them through the course in 9 months instead of 11. We will also be ensuring that all the course materials are available and well documented.

My email address is on my GHD profile page

John Roberts DNP Replied at 6:22 PM, 3 May 2014

I visited the high-level checklist forTraining clinicians in use and benefits of OpenMRS link above and found only direction for the data management team. Where does one begin to assess clinicians' readiness to use any EHR, nurses in particular, ands what are the steps one takes to move to use and integration of a CIS into clinical workflow?

Steven Wanyee Macharia Replied at 1:39 AM, 4 May 2014

We have implemented KenyaEMR, a customization of OpenMRS in Kenya at close to 200 public health facilities and trained thousands of workers. Our training approach is competency based and currently we have 3 tracks for; health managers, end users (lots of clinicians here) and systems administrators. The curriculums for these tracks was informed by a training needs assessment we conducted a couple of years ago, which we have also complemented with local and international best practices. Email me separately and I will link you up with my colleagues in the capacity building team.

Joaquin Blaya, PhD Moderator Replied at 8:55 AM, 4 May 2014

That is a really good question with no straight forward answer. As far as I
know there is no one tool that can measure readiness, at least in the
public domain. But this is a very relevant question which I believe it's
getting a lot of research funding.

Stephen, there is no way for John to contact you off list because GHDonline
does not publish your contact information. As far as I know the only way is
for you to place your email in this thread.

John Roberts DNP Replied at 8:19 AM, 5 May 2014

Thanks Steven & Joaquin. Steven, I appreciate your offer and would love to take you up on it. You may email me at . Thank you.

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