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Change management efforts for VA's organizational transformation to replace the existing electronic health record (EHR) have primarily focused on supporting VA employees, while less attention has been given to the unique needs of health professions trainees (HPTs), who play a critical role in delivering Veteran care. Many HPTs experienced challenges accessing and using the new EHR, adversely impacting their education and ability to deliver Veteran care. We use real world evidence methods to identify improvement opportunities for HPTs' EHR transition. Specifically, we identify and understand HPTs' EHR transition challenges and needs and design a prototype intervention to improve EHR transitions for HPTs. In our multi-phased evaluation, we merge surveys, qualitative interviews, and EHR use data to understand HPT experiences with the EHR transition. Findings from this evaluation lead to a pilot-tested intervention to optimize EHR transitions for HPTs. This program directly addresses two major VA priorities: educating HPTs and modernizing the EHR. It identifies meaningful and actionable solutions that can ensure HPTs rapid uptake and use of the new EHR and minimize negative impacts on their clinical education and ability to contribute to Veteran care.
SCHOLAR developed three tailored playbooks to provide guidance on trainees' EHR learning and use. To develop the playbooks, we drew on trainee survey data, interviews with trainees, supervisors, and site leaders, and discussions with our operational partner. We synthesized the findings then worked through iterative consensus building within our evaluation team and with operational partner leadership. We incorporated insights from an executive board of informaticists, subject matter experts, academic affiliates, and frontline educators. The playbook for educational offices can be viewed here.
