As I am talking with nursing homes and other long term care centers about using health information exchange (HIE), there is a lot of positive feedback, yet, I am encountering a similar story.  That is...the facility only trained one person to use HIE, and when that person left his/her job for a new job... no one was left who knows the ins and outs of using HIE.  So, what can we do about this?   It would be great to train as many staff members as possible for using the system. Perhaps we need to move to a model of not only training more people, but also using a "train the trainer" method.   Employee turnover can be problematic for long term care.  We need to help ourselves by preparing others in the organization to learn the best ways to use HIE (and other health technologies).  Ideally, HIE needs to be easier to use.  What can we do to make this easier?  

Sociotechnical theory is a lens through which to view how health information technology is ultimately used... especially in the context of long term post-acute care.  That is, the technology can provide the right capability, but it needs to fit into the daily workflow of staff members to bring the tech in line with the social patterns of use.  Yes, you need "champions" of the system to promote its use.  Yes, you need "buy in" from staff members.  But, ultimately, you need the end users to see how it benefits them, and how they are required to use it.  Little by little, long term care will benefit by health IT advances.  Once the health IT is being used, and benefits are derived, and the tech has become part of the social pattern...we will see benefits to our loved ones who may be living there or passing through after a hip fracture.  It's a journey...let's go!