Why Your Biggest EHR Training Investment Is Disappearing (And How to Fix It)

Let’s be honest. As a leader in your healthcare organization, you’ve poured an immense amount of resources into your EHR onboarding. You’ve invested in top-tier trainers, meticulously designed curricula, and dedicated weeks of your clinicians’ valuable time to classroom sessions.

You check all the boxes. So why does it feel like you’re constantly re-plugging the same holes?

Weeks after a successful go-live or a new hire orientation, the familiar problems creep back in.

Help desk tickets for basic workflows skyrocket. You hear whispers of frustrating, home-grown workarounds that bypass safety protocols. Clinicians are spending their evenings on documentation; that dreaded “pajama time,” and the tell-tale signs of burnout are becoming more and more visible.

If this sounds familiar, you’re not alone. The problem isn’t that your training is bad or that your clinicians aren’t paying attention. The problem is that the traditional, front-loaded onboarding model is fundamentally flawed. It’s a leaky bucket. You can pour as much knowledge as you want into it, but our natural human cognitive processes ensure that most of it will drain out long before it’s ever needed.

It’s time to confront the uncomfortable truth: a significant portion of your onboarding budget is being wasted. But more importantly, there’s a strategic, proven way to stop the leak and transform your training from a one-time event into a continuous engine for performance and satisfaction.

Your Onboarding’s Greatest Enemy

The core of the problem lies with a 19th-century psychologist named Hermann Ebbinghaus and his groundbreaking discovery: The Forgetting Curve.

This isn’t just an academic theory; it’s a daily reality for your EHR users. The curve demonstrates that humans forget information at an astonishing rate. Within just a few hours of learning something new, we can lose up to 60% of that information if it’s not actively reinforced. After a day, 90% could be gone. After a week, your clinicians might only retain a fraction of what they learned in that intensive, 40-hour onboarding week.

Think about what that means in practical terms. You’ve spent the equivalent of a full work week teaching a new physician dozens of complex workflows, order sets, and documentation standards. By the time they see their first complex patient a week later, they may only have a firm grasp on the 10% of the training they’ve already used. The other 90%? It’s a fuzzy memory, requiring them to stop, search, or guess, precisely when they need to be most focused on the patient.

This isn't to say that a robust initial training plan isn't critical. Getting that first week right is a science in itself. (In fact, if you’re looking to refine your foundational program, this detailed guide on succeeding with Epic software training offers a great blueprint.) But even the world's best onboarding program runs headfirst into a formidable opponent: the human brain.

This isn’t a sign of failure. It’s brain science. Two key factors accelerate this knowledge decay in a clinical setting:

• Interference Theory: A busy hospital floor is a firehose of new information. A critical lab value, a family conversation, a code blue; these urgent, immediate inputs actively interfere with and overwrite the less-reinforced memories from last week’s training.
• Decay Theory: Memories that aren’t used simply fade away. The workflow for a rare diagnosis or an annual compliance task will inevitably decay from disuse, leaving the clinician stranded when they finally need it.

When your entire training strategy hinges on a single onboarding event, you are placing a bet against the fundamental wiring of the human brain. And it’s a bet you are guaranteed to lose.

The Domino Effect

This "leaky bucket" of knowledge doesn't just result in a poor return on your training investment. It sets off a domino effect of negative consequences that reverberate through every level of your organization, impacting the very metrics you, as a leader, are measured against.

A Threat to Strategic Imperatives for CIOs, CMIOs, CNIOs

• Compromised Patient Safety: This is the most critical domino. A clinician who can’t recall the correct multi-step process for medication reconciliation or forgets to document a key allergy creates a latent safety risk. Every workaround developed to bypass a forgotten workflow is a potential patient safety incident waiting to happen.
• Diminishing the Return on Your Biggest Tech Investment: Your EHR is likely one of the largest capital expenditures your organization has ever made. It was procured based on a promise of transformative value, packed with powerful capabilities like sophisticated order sets, personalization tools, and integrated analytics designed to streamline care and provide critical insights. But what happens when clinicians, overwhelmed and reverting to what they vaguely remember from onboarding, only use a fraction of that capability? They stick to the bare minimum required to close a chart, ignoring the very features designed to make their lives easier and care delivery more efficient. It’s the equivalent of buying a high-performance sports car and never taking it out of first gear; the power is there, but it’s going completely untapped. This underutilization represents a massive, silent drain on your bottom line. Every efficiency-boosting feature that sits unused means your organization is not realizing the value it paid for. Your nine-figure investment risks becoming a hugely expensive, underperforming asset rather than the strategic driver of efficiency and clinical excellence it was meant to be.
• Fueling the Clinician Retention Crisis: The link between EHR frustration and burnout is undeniable. As KLAS Research found, a third of providers cite IT tools as a driver of burnout. This isn't just about software design; it’s the daily, soul-crushing feeling of being inefficient and incompetent with your primary tool. Every hour of "pajama time" is a push factor driving your most valuable talent toward the exit.

A Constant State of Firefighting for Informatics Leaders

• Overwhelmed Support Teams: Your informatics and help desk teams are trapped in a reactive loop, answering the same basic questions over and over. They spend their time being a human "reset button" for forgotten training instead of focusing on strategic optimization, system improvements, and innovation.
• Failed Optimization Projects: You roll out a new feature or workflow designed to save clinicians 10 minutes per day. But without a mechanism to reinforce this new knowledge, adoption fizzles out after a few weeks, and users revert to old, inefficient habits. Your optimization efforts fail to deliver their promised ROI. An 

Unsustainable and Ineffective Model for Training Leaders

• Wasted Resources: You and your team spend countless hours developing what you believe is world-class training content, only to see it forgotten. This leads to a constant, resource-intensive cycle of retraining, creating endless documentation, and deploying expensive "at-the-elbow" support that simply isn’t scalable.
• Diminished Credibility: When users consistently forget what they’ve been taught, it can create the perception that the training itself is ineffective. You’re left defending a model that is systematically designed to fail, which can undermine your team’s role and influence within the organization. 

The Antidote - From a "Training Event" to a "Continuous Enablement" Ecosystem

The solution is not longer onboarding or more binders. The solution is a strategic pivot. We must accept the reality of the forgetting curve and build a support system that works with our brains, not against them. This means shifting from a "one-and-done" training event to a culture of continuous, in-the-moment enablement. In fact, embracing this shift is crucial, which is why ongoing EHR training is the modern healthcare must-have for any organization looking to maximize its technology investment.

This modern approach is built on a simple but powerful idea: provide your people with the right answer, at the right time, directly in the context of their work.

Here’s how it works in practice:

1. Reinforce With Spaced, Micro-Dosed Learning

Instead of a single, overwhelming information dump, break down learning into bite-sized, digestible pieces and deliver them over time. This is called spaced repetition, and it’s the number one way to flatten the forgetting curve. Each time a clinician revisits a piece of information, the memory becomes stronger and more durable.

For Training Leaders: This means transitioning a portion of your resources from developing monolithic onboarding courses to creating a library of microlearning assets: short (60-90 second) videos, quick tip sheets, and interactive guides that can be pushed out in a "Tip of the Week" email or a monthly refresher.

2. Personalize the Experience

A cardiologist and an orthopedic surgeon use the EHR in vastly different ways. A one-size-fits-all approach guarantees that most of the content will be irrelevant to most of your audience.

For Informatics Leaders: Leverage your knowledge of clinical workflows to segment content by role, department, and specialty. This ensures that the continuous learning being delivered is highly relevant, making it far more likely to be retained and applied.

3. The Ultimate Weapon: Help in the Moment of Need

This is the absolute game-changer. Just-in-Time (JIT) training, a concept detailed in this ultimate guide for healthcare leaders, provides answers at the precise moment a user is stuck, without them ever having to leave the EHR.

Imagine a nurse is trying to document a complex wound care procedure, a task they only do occasionally. They can’t remember the specific steps.

• The Old Way: They stop their work. They call the help desk and wait on hold. They interrupt a busy colleague. Or, they make their best guess, potentially leading to a documentation or safety error. The workflow is disrupted, efficiency plummets, and frustration skyrockets.
• The Just-in-Time Way: They see a small, unobtrusive help icon in the EHR. They click it. A pop-up window instantly appears with a short video or a step-by-step guide showing them exactly what to do when they ask a question. They complete the task correctly in seconds and move on.

This is the power of providing help in the moment of need. It’s not just support; it's the most effective form of learning possible. The knowledge is acquired and immediately applied, creating a strong, context-rich memory.

For the C-Suite: This is your solution to the burnout and efficiency crisis. JIT tools transform the EHR from an intimidating system to be memorized into an intuitive co-pilot. It reduces the cognitive load on clinicians, gives them back precious time, and builds the confidence and psychological safety that are essential for a healthy work environment.

Stop Pouring Into a Leaky Bucket

Continuing to rely on an onboarding-only training model is like trying to fill a bucket with holes: a frustrating, expensive, and ultimately futile exercise.

The future of healthcare IT proficiency is not about more training; it's about better learning. It’s about building a supportive ecosystem where foundational knowledge is laid during onboarding and then continuously reinforced and instantly accessible at the point of care.

By shifting your strategy to one of continuous enablement, powered by Just-in-Time support, you can finally stop the leak. You can unlock the full potential of your EHR investment, empower your clinicians to work at the top of their license, and build a more resilient, efficient, and safer organization for everyone. The question is no longer if you can afford to make this shift, but how much longer you can afford not to.