← Becker’s Healthcare Podcast
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- [00:01]
A
Hello, everyone, and welcome to this episode of Becker's Healthcare Podcast. I'm Stephanie Lahr, chief Medical Officer at Uperform, and I'm thrilled to be joined today by Dr. Brian Jarabik, CMIO at M Health Fairview. Dr. Jarabik is a practicing hospitalist and CMIO who's led major EHR Optimization and Digital transformation efforts with a strong focus on clinician readiness, scalable education, and making change stick at Fairview. His work has helped reshape how teams approach health IT training, moving beyond go lives to continuous learning that truly supports adoption. I'm excited to explore what's worked, how education and change management come together, and what leaders should be thinking about next. Brian, thanks so much for being here today.
- [00:46]
B
Thanks, Stephanie.
- [00:48]
A
All right, well, let's dive right into the conversation. M Health Fairview's approach to health IT education and clinician readiness have been really successful and I think, think also a bit of a journey of transformation to get there. I would love for you to share a bit more about your key wins, key changes, strategies that kind of contributed to getting to this successful place that you are today.
- [01:12]
B
Yeah, thanks, Stephanie. Just excited to be able to share about this and all the improvements that we've done with our training teams for our caregivers. Everything's done as part of a community. So Derek Harley and Jen Steinhaus are two of our leaders and wanted to just say thank you for all that they've done in the last few years that we'll be talking about here. We've really transformed the way we deliver training at M Health Fairview. We're a large academic health system. We have 10 hospitals and around 60 clinics. And we're based out of Minneapolis, Minnesota. And over the last couple years, we've really transitioned the way we do all of our training. So it's been a big change for the entire organization. It was driven by wanting to adjust to the way that our healthcare staff really wants to engage technology and how they want to be trained, which is really different than the old school model of, you know, line me up with a teacher, let me learn something from somebody in a classroom. They really wanted more asynchronous technology to be used where, you know, teach me as I want to learn something, when I want to learn something, keep it short, keep it video based, put it directly in my workflow, like, we heard all those things. And so now we went away from in person training. We started doing everything asynchronously. We developed all the material differently. So we took all that classroom material, divided it up into really small little segments that are more bite sized that you can really learn from. And then we really developed these learning pathways that are all the way from beginner up to mastery. And I'll say it's really transformed the way we deliver training in a really successful way. The feedback that we got from people is it's not like drinking through a fire hose anymore. Sometimes those classroom trainings are just intense, four or eight hours. Try to learn everything. Now it's more bite sized and you can feed it back to them as they're kind of learning and developing. So those have been some of the big transitions that we've made. It's been really helpful. I'd also say continuing to emphasize change management and kind of high touch, ongoing support. Support has been key. So we've been doing a lot in that where we actually go out and do rounds now. So it's not as much about training them in that classroom or figuring it out right away, but having touch points all along the way with people. So if you can combine that asynchronous learning with some high touch personalized support and ongoing learning, that's been the trick that's really led us to. Over the last seven years now, we've had EHR satisfaction improvements every year for seven years in a row. And so some of our training teams are really proud of here at mhealth Fairview.
- [04:10]
A
Yeah, that's amazing. I mean, seven years, year over year of improvement. I don't know that I've heard really any organization 1. The fact that you're measuring that and evaluating it is commendable in and of itself. But the fact that you're able to every year continue to improve on that is really fantastic. You knowing that obviously you have, and you mentioned some of them already, a really stellar team that is supporting this and that many organizations that are listening right now might be thinking, wow, that's the kind of transition that we'd like to take on as well. They can't take your team, but they can take some of your ideas. So maybe dig in just a little bit. If an organization is thinking that this resonates and is trying to figure out where to start. Maybe talk just a little bit more about in the beginning of this transition. Did you start, for example, with your onboarding and then created that? You know, did that happen first or did you actually start with, you know, new elements that were coming out and then back into the onboarding? Because there's a lot of elements and there's a huge amount of work that went into this transformation. So knowing that some of the listeners are going to be saying, where do I get started and how do I do this? Maybe just dig into that a little bit.
- [05:31]
B
Yeah, great point. As you're thinking through it, you'll have two big decisions kind of where you do the most classroom training. You could start big and go with say, you know, all your nurses and then say, okay, I'm going to develop training that way first. The advantage of doing it that way is you end up with a lot of materials that then you can use for all the other training that you're going to do later. We, we didn't do that right away. Right away we were like, well, let's try this out on a smaller population. So we did some stuff with like resident training, which is a smaller group, and we said, well, let's make that material and see how we could convert a classroom to asynchronous. And it might be best to kind of do what we did of start with a couple small groups, but then pretty soon you're going to want to hit that bigger group because that's where you get so much content done that now it makes everything else easier later as you're wanting to convert eventually all of your classroom TR over to this asynchronous model. The other thing we learned afterwards is once you have all this material now, you can start to think about, well, maybe we don't do in classroom training for this group of people, but now wait, we have a bunch of content that actually applies to them. So you might be able to do training of smaller groups more effectively by just adding a couple extra, you know, asynchronous kind of videos and modules and build out training materials to groups that you maybe haven't done training with. So yeah, that's how we kind of tackled it. But it's a good thing to think through as people are starting to think through how they could do this kind of asynchronous transition.
- [07:10]
A
Yeah, and the other thing I love that you mentioned earlier was talking about freeing up your training team to be able to do this sort of higher quality, high touch interaction and similar. You know, when I was at Monument Health as CIO and cmio, we went through this transition as well. And I know that was super satisfying both for our trainers and for the clinicians was that rounding and having them, you know, at the elbow when it really could be meaningful and impactful. And they were able to do that. I'm guessing, you know, for your organization similar to ours was because they weren't tied to the classroom. So it could sound overwhelming to an organization to say, well, wait, how are we going to get them out there? Rounding. But the reality is once the content was built and the asynchronous part was happening, they had more time. Is that a fair reflection?
- [08:05]
B
Yeah, definitely. And I think you'll want to think through bringing in the right people because a lot of our people that did classroom training, they just naturally synced over to this. But we brought in a couple special people that were more specialized in this asynchronous platform and people that kind of knew you perform tools, whatever your delivery system is, as well as the materials and how to efficiently make those materials and record them. I think you need a different skill set there. So you'll need to bring in a couple people, do some up training. You know, maybe you'll hear some people really like the classroom stuff and so they don't want to be part of the new model and they might need to transition. Pretty much all of our teams knew this was kind of the way training was going everywhere and so they were excited about this. But bringing in a couple people that have that new skill set of, you know, making the videos, editing the videos, making the walkthroughs, that. That's a really good point. I think Stephanie, and I think encouraging the team that this is what people want on the end of receiving it. They don't want to sit through the classroom and only have the four or eight hours to learn all of it at once. They want ongoing materials and touch points where they can learn over time. And kind of that beginning phase of learning needs to go on to more. What do I do to become an advanced user? What do I do to become a master user? How do you set that up? And I think, yeah, it's a great way to set that structure up. And so we've really been. It's a new adventure to go into all this stuff, but it's been really exciting, I think, for our teams and for our caregivers.
- [09:44]
A
And given the success that you've had with this transformation in the EHR side of the world, which is obviously where you have the highest volume and complexity of learners and topics to be educating on. But knowing that there are many other technologies, systems, software programs, etc, that the organization leverages both clinically and beyond, is Fairview considering taking the same sort of asynchronous training strategy and approach in other applications and other areas beyond the way you are leveraging today with, with EPIC and the ehr?
- [10:21]
B
Yeah, the short answer to that is definitely yes. The question is just how to do it. So you could start with big things. So like we have a new ERP that we're deploying, so we could do a large project and say, well, maybe we can help with that at least doing some consulting around. What would it mean to have asynchronous training set up? What would it mean to use uperform in that kind of structure to be able to do that project? We also have a huge Fairview Pharmacy Solutions where we actually are teaching other pharmacy systems and large health systems all around the country about how to use their pharmacy systems better because we have one of the most successful one in all the Midwest. Could we maybe talk about at least asynchronous in that training model, be part of that rollout and consulting? We've also talked about a lot of the smaller groups, so coding review, you know, imaging workflows. There's a lot of small areas where we do training. Maybe we can take some of these benefits that Jen and Derek and the team have developed and these strategies can be actually applied to lots of the training things that we do across M Health Fairview. So, yeah, looking for more and more ways to kind of use this since it has been successful and I think it is the future of how training is going to be delivered. I think we're excited about where that could go and other places we could use those tools.
- [11:44]
A
And philosophically, you know, some of what I hear you talking about is there's, there's the training specifically, right? There's the, here's where to move the cursor, here's the button to click, here's the content that you might need. But I also am hearing elements in this that are related to big picture, right? Like we're making changes, we're setting the tone for the organization or maybe even beyond your organization with the pharmacy work that you mentioned. So as you think about the blend of how education comes together with really communication and change management to prepare clinicians and end users for ongoing transformation, which given the era of where we are today, feels like an hourly situation. If you know when we used to think on days and months, how are you thinking about how those things come together and bringing the opportunity of both the tactical elements of what people need to learn, but also bringing in the elements of change management, communication, the why all of those things? So that you get to the level of adoption that you're really trying to achieve.
- [12:58]
B
Yeah, there's lots of good questions in there. So I would say first kind of thinking of what do you need to make it successful in the new world that's coming? I would say a well designed training platform. You also need that asynchronous content, however you're going to generate it or get it from other organizations. And then you need the appropriate pathways for learning to really be developed from beginner to advanced to mastery. And then I think you overlay with those things. The putting it into the workflows and the high touch part of that, that's what I think will really bring the success. Physicians and nurses will do almost anything for their patients. But when it comes to taking time to invest in themselves so that they can really learn the new. I know you guys have come out and done rounding with us. It's just everything is so busy in the hospitals and clinics. Like to even talk to them about, hey, can you take a little time to just learn this thing? That'll save you 10 minutes every day. It's like, well, but I'm busy. There's a patient right over here that I need to go see. And so I think change management is really the other big area that often gets missed. So, yeah, I think figuring out a way to engage them and do that. Change management is the key. Once you have a structure in place. We have a small but amazing change management team here in Informatics, our informatics department as well. They teach a lot about our AD CAR model, which is from proi. It's awareness, desire, knowledge, ability and reinforcement. I think a lot of people have heard about that, but I think we overlook the desire and the reinforcement part in healthcare are the two things we really struggle with. How do you generate desire from the care team when they're so busy? One thing that we've done that's been somewhat successful is we have a change agent and smart user program that we deployed where we really engage. We try to engage all the managers throughout our organization saying, you really are a change agent. That's what your job is as a manager. And one of your most important things as a change agent is to find some smart users that are really trying to help everybody else around them level up and be better. And so I think desire comes much more readily if a doctor or nurse sees another doctor or nurse saying, wow, I use this tool and it saved me 10 minutes and got me home quicker. Or I used ambient dictation for when I was seeing this patient and now I've had lunch for the first time I've ever had lunch. Which is something I actually heard a couple weeks ago. So I think that desire change agent and the smart user program could really go that way. And then reinforcement is the other thing I think we struggle with. Again, this is where that classroom to asynchronous training I think could really help because you have to circle back and we've learned you can't mandate training. What happens if you mandate training is people just click the boxes and get it done, but they don't really learn. But how do you really motivate people and create that desire that they should be wanting to reinforce their learning, Take time for themselves. I think the materials are getting it there, but then also having the change management principles where there's, you know, somebody at least in their group that is a smart, smart user and trying to incentivize and promote to everybody else. Hey, do take some time for yourself, learn a little bit about, you know, your workflows to make them a little faster, get you home a little quicker, maybe do a little bit better care for the patient. So those have been a lot of the principles that we've learned and used here at M Health Fairview.
- [17:01]
A
Yeah, I really appreciate you sharing the specifics. A listener right now can be truly taking notes and thinking about real takeaways that they could deploy organizationally within their own constructs to have some similar success. So really great recommendations as we sort of close out and finish up our conversation today. Today, knowing that we are at the beginning of a new year and that there are lots of thought processes that we all have right now around what the future can bring, how we want to do things differently, et cetera. I'd love for you to maybe, you know, just spend our last couple of minutes talking about key recommendations that you would share with informatics or education leaders as they consider their approach to health, IT education and change management.
- [17:55]
B
Yeah, thanks again for the opportunity to kind of be here and talk through some of our successes. I have two big recommendations I usually give to healthcare leaders. The first recommendation is to take some time to build and invest in a community network where you can teach and learn from others. You know, we're in the world of training others with informatics and training, but often you need your own network and sometimes you can create that at work. You know, some of the managers are really good at creating that network and that team building. You can do it through huddles, you can do it through meetings, you can do it for one on ones. But I think another thing to really do is broaden that out through organizations like Upperform or the American Medical Informatics association or find ways to build your network that are people outside of your own institution where you can really learn from others, whatever way that is. But it's really important to have a network so those ideas are constantly flowing. And then my second recommendation to everybody is to set aside some time for yourself to learn about artificial intelligence and not just learn about it, but use it. You'll learn really quickly. You have to ask AI about the resources that it's getting things from. You know, are you hallucinating? Is a great question. And it's weird how honest it is that it's like, yeah, I didn't know. I kind of don't know exactly. But yeah, I think taking the time and learning about AI, we are all going to be asked to teach everybody about those use cases, Find the value in it. I think would strongly recommend that people take that time as leaders because I think it's going to benefit all of our healthcare team, those doctors and nurses that aren't taking the time to do it themselves. If we spend the time for them and then we take that to them with those high touch, asynchronous learnings, I think AI is going to change a lot of workflows. And like I said, one of my providers said it's probably the best time right now to be a cmio. The computers are finally helping us do something. And so I think us leaning into that and figuring out how to teach others how to do that. Well, that would be my recommendations there.
- [20:15]
A
Yeah, absolutely. What comes to mind for me is as much as AI might be a buzzword, I feel like we have a whole other podcast in the making here where we can talk about AI and its opportunity to impact training and education, because it's going to have an impact there. We didn't even have any time to get into today, but I know you guys are thinking about that. We're thinking about that. So there we go. Podcast number two. We'll have to get scared for a future time to be able to have that conversation. That wraps up today's episode of Becker's Healthcare Podcast. Dr. Jarabik, again, thank you so much for your insights, your experiences and all of the incredible work. Congratulations on that. That is happening at M Health Fairview. Thank you to all of our listeners. This podcast is sponsored by uperform. Uperform is an AI powered just in time learning and support platform that helps leading health systems realize the full value of their software investments by accelerating onboarding, reducing screen time and boosting proficiency and satisfaction. You can tune in to more podcasts from Becker's Healthcare by visiting the Beckers podcast page@beckershospitalreview.com.