HealthManagement, Volume 17 - Issue 4, 2017

Training medical students in EHR usage

Training medical students in EHR usage
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A training initiative that introduces medical students to EHR use early on to mitigate patient care risk is growing in momentum.


Electronic health records (EHR s), or electronic medical records (EMRs) continue to be received with a mixed reception from physicians and nursing staff. While the tool, in theory, enables swift sharing of medical data, in practice, medics have voiced concerns over difficulties in navigation and in incorporating use into busy work lives.


In spite of rollout of EHR s across the healthcare sector, most of today’s doctors leave medical school without any comprehensive training in their use. To counter this, the American Medical Association (AMA) and the Regenstrief Institute have collaborated on a training initiative aimed at ensuring that more medical students and trainees have access to real-world EHR use experience during their training.


“Our medical schools are very good at preparing students for the basic and clinical sciences that are essential to providing patient care,” said AMA Vice President for Medical Education Susan Skochelak, M.D.. “However, many residents and young physicians are coming out of medical school with gaps in their ability to practice in the modern health system. Too often, students enter residency training without the ability to effectively and efficiently work with EHR s, even though they are one of the primary tools physicians use in everyday practice. The Regenstrief EHR Clinical Learning Platform is one major result of this collective work to ensure physicians are prepared to hit the ground running when they enter practice.”


The Regenstrief EHR Clinical Learning Platform, launched earlier this year, has been developed by Indiana University School of Medicine (IU) and the Regenstrief Institute under the AMA’s initiative to create the medical school of the future and is now being disseminated by both organisations to medical schools across the U.S.. The platform is a cutting-edge, educational content delivery, and critical evaluation tool designed for health professionals. Through the use of both mis- and de-identified real patient data, the first-of-its-kind platform facilitates learning in simulated, realistic clinical scenarios. It is expected to greatly improve education in clinical informatics, health system delivery science, and population health.


The first-of-its kind platform uses real, de- and mis-identified patient data from Indianapolis-based Eskenazi Health, to allow students to virtually care for ‘patients’ suffering from multiple, complex health conditions. Critically, they have the opportunity to do this safely within an application that is similar to EHR s used in the real work environment. It also offers a state-of-the-art, immersive teaching platform for educators. Tools for creation of customised content aligned with curriculum goals and student evaluation are some of the features for educators.


EHR training is just one of the innovations identified by the AMA’s Accelerating Change in Medical Education Consortium. This 32-school strong consortium is a forum for sharing healthcare innovations. IU School of Medicine received a $1 mln AMA grant to collaborate with the Regenstrief Institute for development of a method of incorporating EHR training into its curriculum with the objective of establishing a model that could be implemented by other medical schools. Following a year of development, the platform was fine tuned for the purpose of encouraging medical educators to incorporate it into their medical schools’ curricula.


“It is ironic as EHR s have proliferated in the past decade, significant medical student exposure to these systems has decreased,” said Regenstrief research scientist and Assistant Professor of Clinical Medicine at IU School of Medicine, Blaine Y. Takesue, M.D. “EHR s are a tool most physicians will use every day in their practice, and data from EHR s will impact all physicians. This new collaboration between Regenstrief and the AMA reflects two realities. First, health professions schools regard EHR and informatics training as necessary for their students. Second, the Indiana University School of Medicine, the Regenstrief Institute, Eskenazi Health and the AMA believe investment in the Regenstrief Electronic Health Record Clinical Learning Platform will improve healthcare by improving the informatics ‘IQ ’ of medical students and other healthcare profession students.”


UConn School of Medicine has implemented the training into two of its courses with an interesting focus; introduction of students to patients within virtual families embedded in the EHR for clinical context to basic science, clinical medicine and social science principles. The school is also using the platform for an opportunity to mine an extensive database of mis-identified patients to learn about populations and social determinants of health and disparities.


“UConn’s medical school is excited to further enhance our educational innovations by integrating the available Regenstrief EHR platform into our curriculum—taking advantage of the endless possibilities that the platform offers to explore all aspects of medicine and patient care,” UConn School of Medicine Senior Associate Dean for Education Suzanne Rose, M.D. said. “In our growing digital age, healthcare delivery is rapidly changing. It is critical that all medical students have exposure to integrated EHR s which will be a mandatory part of their future care of patients.”


The AMA launched its Accelerating Change in Medical Education initiative in 2013—providing $11 mln in grants to fund major innovations at 11 of the nation’s medical schools. Together, these schools formed a Consortium that shares best practices with a goal of widely disseminating the new and innovative curricula being developed. The AMA expanded its Consortium in 2015 with grants to an additional 21 schools to develop new curricula that better align undergraduate medical education with the modern healthcare system. Most recently, through its work with the 32-school Consortium, the AMA launched a new health systems science textbook that can be used by all medical schools to help future physicians navigate the changing landscape of modern healthcare, especially as the nation’s healthcare system moves toward value-based care. The AMA will continue its efforts to accelerate change in medical education to ensure future physicians learn about the newest technologies, healthcare reforms and scientific discoveries that continue to alter what physicians need to know to practice in modern healthcare systems.


Key Points


  • Many young healthcare staff leave medical school ill-equipped to operate in the modern work environment
  • The American Medical Association (AMA) and the Regenstrief Institute have devised real-world EHR use training
  • Called The Regenstrief EHR Clinical Learning Platform, the EHR training is part of the AMA’s initiative to create the medical school of the future
  • It is now being disseminated by both organisations to medical schools across the U.S.
  • EHR training is just one innovation identified by the AMA’s Accelerating Change in Medical Education Consortium
  • It is critical that medical students are exposed to integrated EHR use for future patient care

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