There are a lot of articles and statistics touting how much money e-learning can save an organization. Does this hold true for electronic health record (EHR) implementations? I would like to say the answer is simple, but there are many factors to consider. 

There is an art to creating e-learning solutions that engage the mind and critical thinking skills, as well as increase retention. Unfortunately, a good majority of “e-learning” in the healthcare industry consists of automated PowerPoint slides that a participant can click through while multitasking. Clicking through a presentation typically does not really lead to “learning.” For instance, if you reduce seat time by keeping employees on the unit but they do not learn anything, have you saved money? 

Here are several considerations for e-learning in a healthcare setting. 

Flexibility–Anytime, Anywhere Learning 

• Benefits: Learners can access courses and content from the unit, from home, at the coffee shop—anywhere internet connectivity exists. This is particularly convenient for our provider audience. 

• Considerations: If your employees choose to complete e-learning outside of the normal work hours, will you have to pay them for their time? Be sure to check the U.S. Department of Labor for regulations, but most hourly employees who are completing required education must be paid for their time.

Timely Learning 

• Benefits: Online learners can take training just before they need it, rather than enrolling in a program weeks before they need the training. E-learning allows organization to push out information quickly to a large number of people right as they need it.  

• Considerations: Hospitals typically have a limited amount of resources, such as instructors and rooms. Therefore, it takes much longer to accommodate large numbers of people using traditional classroom training. When you factor in our 24/7 schedules, this becomes even more complicated. However with e-learning, if everyone waits until the week before "go-live" date, it is very difficult to measure readiness. 

Consistent Delivery

• Benefits: E-learning provides great consistency. When offering training to a large audience, using instructors in a classroom setting can carry the risk of inconsistent delivery of information unless closely monitored. 

• Considerations: Instructors in face-to-face training offer a huge value-add by being able to facilitate learning, as well as provide encouragement and extra assistance where needed. 

**Learner Engagement and Retention

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• Benefits: According to the Gartner Group, the retention of e-learning can be 2X that of traditional classroom instruction at half the cost. However, this requires interactive, engaging e-learning. Creating that type of e-learning is an art.

   

• Considerations: Healthcare is notorious for taking a great nurse off the floor and making them the “teacher” without regard for the ability to “facilitate” learning. However, a great facilitator cannot totally be replaced by technology. The ability to connect and engage learners can be flexed for each learner. 

Self-Paced Delivery 

• Benefits: Students can learn at a pace that works for their individual learning needs and circumstance.

   

• Considerations: Classroom experiences can often be too slow for advanced participants and cover information too quickly for those that are less familiar or comfortable with the subject.

Reduced cost 

• Benefits: The primary driver for most-e-learning decisions involves an overall reduction of cost, including reduced instructor costs, travel expenses, room rentals, lodging, and meals. In addition, the amount of time spent away from work for classroom training can be significant and should be factored in the overall learning time compared to e-learning. According to Brandon-Hall study, e-learning typically requires from 40 percent to 60 percent less employee time than the same material delivered in a traditional classrooms setting. Although we like to think that practitioners can complete e-learning during their shifts, interruptions and multitasking can reduce understanding and retention of information.

   

• Considerations: Travel expenses are not always applicable in a hospital setting and must be considered when looking at the cost savings of most research. Indeed, the initial investment to create e-learning is higher than classroom curriculum. So, for smaller audiences, e-learning may not be cost effective unless high turnover is experienced in those roles. A second factor in the reduced cost factor of e-learning is inappropriate application. If a click-through approach is utilized or too much information is presented via e-learning, you can actually reduce the retention and outcome ending up costing you more. 

Bottom Line 

E-Learning can save money in healthcare given the following:

• E-learning is created with adult learning principles and engages the mind and critical thinking.

• E-learning is served in small enough chunks to hold the attention of the learner but still retain thought process.

• E-learning is capable of simulating the task so the learner “experiences” their learning. You can teach how to ride a bike via e-learning to the point that the learner could pass a test. However if then given a bike, would they be able to ride it?

• E-learning is role-based and scenario driven. Learning without application and transfer to the job is simply expensive learning. The learning must be applicable and actually used to save money. Even the best e-learning requires just-in-time learning support tools and reinforcement.

To be sure, e-learning is a great tool for some audiences. In others, it works better as a great prerequisite tool and a good way to teach smaller amounts of information, such as updates. I believe the value-add of a great facilitator helps understanding, engagement, confidence, and retention of learning.

So, for a brand new implementation of an EHR application, I recommenced a blended approach. For an update or addition of an add-on application, e-learning can be quite effective.

I like to follow these guidelines when designing EHR training:

• E-Learning: Use e-learning as a prerequisite to cover basic navigation and broadly applicable information. 

• Traditional classroom: Follow the e-learning experience with an instructor-led classroom experience that allows the end-user to work through role-based scenarios and apply what they have learned while utilizing critical thinking skills. 

• Just-in-time: Complete the learning experience with rounding support at go-live and just-in-time tools such as web-based “Show-Me’s,” online books, and job aides to act as a refresher, cover tasks not frequently completed, and to avoid work-arounds. 

Moving Forward

Before implementing EHR e-learning, be sure consider the following questions:  

• Is my culture accepting and ready for e-learning?

• Is the content being taught conducive to the e-learning environment?

• Do I have not only content experts but adult education experts to put together the training so an engaging module is created verses a click-through?

• How will the content be served? 

In the next post, I will detail an example of how e-learning saved costs in an EHR training.