I’ve seldom been a part of an electronic health records (EHR) installation where Nurse Super Users (SU) were not identified, trained, and utilized. A few years ago, I was tasked with developing SU curriculum for nurses. As I began, I wondered, what makes a super user “super”? The traditional answer to “what is a ‘super user’?” is someone with a profound understanding of a process. In my experience with EHR platform migrations, super users typically receive anywhere from 50-100% additional training in the job they perform. There really isn’t anything “super” about that. A person capable of functioning at a certain level in their position is an expectation. That isn’t super, it’s just proficiency.  

After working on the curriculum, I developed an idea and decided to take it to the CNO of the organization I was currently supporting as a contract consultant. To me, a real super user is someone that has the knowledge base and capabilities to help those around him/her. For example, a nurse on a unit that is designated and trained as a super user should be able to help their fellow nurses, as well as help the unit secretary, patient care tech, or a provider with basic job functionalities such as charting/documentation, order entry, order/task completion, and chart review.  

An EHR super user should be a person on a unit or in a practice who thoroughly understands the system and best practice workflows. This is someone the rest of the staff can look to for guidance. In some instances, they can train new hires and work with staff who have changed roles within the practice or organization.

I recommended that every EHR nursing super user be cross trained for all roles in their unit so they can function as true super users. Super users can also augment your organization’s Informatics or training teams to help educate staff on optimization and system updates. They can then provide the rest of the staff with updated information. Keeping the staff informed with pertinent updates will help prevent end users from falling behind and becoming frustrated with the EHR. 

In the practice setting, the EHR super user might be a nurse or medical assistant but should be able to support the front desk, additional nurse/medical assistants, and providers. 

Whether you are converting to a new EHR or continuing with your current system, an EHR super user can be very beneficial. The timing of your Nurse Super User program can be crucial to the success of your EHR implementation. Your nurses should play a critical role in the entire EHR project from the planning phase, to the actual go-live, and beyond.  

It is often thought that a new EHR or technology will solve the challenges your organization faces, but it is more likely your issues are related to process, workflow, and adoption. Who is better than a nurse to champion and drive the success of your current or future state EHR? Nurses face these challenges every day and can help their organization navigate an implementation, optimization project, or the everyday issues related to their current state EHR.  

Even if you have an IT education team or a full-scale informatics department, Nurse Super Users can augment these teams in a fundamental way. These nurses are “in the numbers” on their units, are part of their unit’s fabric and culture, and are the front-line workers with intimate access to their co-workers. The super user’s buy-in and engagement will transcend throughout their unit.  

Super users can be utilized to augment your IT staff from the very beginning. Selecting and engaging your Nursing Super Users in the early stages of the project cultivates excitement, engagement, and ownership at the unit level of your organization. A “local” champion that team members know can create enthusiasm, build credibility, and manage anxiety levels.   

Other ways early engagement of nursing super users can benefit your project:

• Offer workflow knowledge during the design and build phase 

• Work with contracted instructional designers/trainers to ensure workflows and other client specific information is incorporated into classroom training 

• Serve as proctors for classroom training to be readily available to speak to policy and other client-specific questions 

• Function as a true super user at go-live and beyond 

• Decreases the need of support from a third-party vendor at go-live and doesn’t create gaps in support models for provider end user groups 

When organizations develop an EHR super user program or team, some organizations recruit on a volunteer basis, while other organizations appoint their team.

There are benefits to both approaches however, you should look for super users with the following qualities:

• Understands workflow 

• Knowledgeable about computers 

• Learns quickly and is eager 

• Currently keeps track of updates 

• Understands the culture and climate of their unit/practice and can be an engaging champion 

• Self-motivation: the super user should enjoy finding solutions, understanding the reason behind each activity, analyzing, and sharing information. This encourages colleagues to seek solutions to problems, creating an atmosphere of continuous improvement in the department. 

• Interpersonal skills, including well-honed communication skills. The super user coaches each person on the team and may need to adapt the message to everyone. 

 Acute care organizations and practices in the ambulatory setting should include Nursing Super Users in the project planning for EHR programs from the beginning. A successful project isn’t as much about IT, but more about the planning, engagement, excitement, training, and culture that fosters success for all end-users.  

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