Using eLearning Technology to Support Sustainable and Standardized EMR System Training Jen Antilla 1, Anya Nartker 2, Charles Atelu 1, Veronica Muthee 1, Nancy Puttkammer 1, George Owiso 1, Willis Akhwale 1

Background  In 2010, Ministry of Health, partners, and I-TECH developed a curriculum on EMR system use  Since 2012, this curriculum has provided select health care workers at 341 facilities with off-site or on-site classroom training on KenyaEMR use  Using KenyaEMR at point-of-care and staff turnover has led to an increase in demand for KenyaEMR training at a low cost  eLearning technologies can potentially expand the reach of KenyaEMR system user training

Background "E-Learning refers to anything delivered, enabled, or mediated by electronic technology for the explicit purpose of learning." * Best practices for implementing distance or eLearning include:  Select eLearning technologies according to the setting and knowledge or skills to be developed  eLearners need continuous support and monitoring  Blended approaches that include face-to-face orientation/instruction is crucial, especially for content involving practical skills  Ensure that any eLearning technology runs on hardware/software available at sites *American Society for Training and Development (ASTD)

Background: Curriculum Review  UW/I-TECH conducted a curriculum review in October 2013  Purpose:  to determine the feasibility of converting existing classroom sessions to eLearning formats  make recommendations of appropriate eLearning technologies and strategies for maximizing usage.  Results used to develop and implement a phased strategy for integrating eLearning technology into the current mentorship model for training EMR system users.

Strategy: Builds on Existing Strengths KenyaEMR eLearning Strategy builds on the following strengths:  The existing KenyaEMR User curriculum is strong enough in its current state to require fewer resources to convert to eLearning (i.e.: no need to develop learning objectives, content, etc)  Facility Champion Mentors are in an ideal position to orient, motivate, and monitor health care workers working through eLearning sessions as context to hands-on system OJT.  MOH/I-TECH have established mechanisms (review meetings) through which facilitators, county and facility leadership, and champion mentors can be oriented to eLearning technologies as they become available  The eLearning technology can be made available on a variety of eLearning platforms and as a part of the KenyaEMR software package.

Strategy: Uses Recommended eLearning technology  Videos and self-paced, asynchronous modules  Can both be done at participants’ own pace  Do not require an internet connection  Videos for demonstrating KenyaEMR features  Can be recorded as features are introduced and enhanced  Self-paced, asynchronous modules for theoretical content  Focuses on standard content that supports quality EMR system use  Based on existing curriculum sessions  Sessions prioritized for conversion based on feedback from facilitators, users, and content experts

Results  Seven video “job aids” developed in December 2013  Focus on features to  enroll patients in the HIV program  record data from HIV initial and follow up visits,  track patients’ ART history  Available through the KenyaEMR application  Does not require an internet connection  Two self-paced, asynchronous modules developed in March 2015  “Using EMR Data for Decision Making”  “Improving and Maintaining the Quality of EMR System Data.”  Available on the local KenyaEMR server  Can be loaded onto other platforms

Conclusion  Health care workers drive their own learning by  watching demonstrations on using key features of KenyaEMR,  completing lessons on improving data quality and using KenyaEMR data for decision-making  Champion Mentors facilitate learning  introduce KenyaEMR and the eLearning technologies to health care workers  guide and target their face-to-face time on other KenyaEMR topics, such as security and troubleshooting.