Database programs change in new versions requiring conversions. New releases of operating systems can create changes in networking configuration and system interfaces. Multimedia interfacing using a variety of external devices and utilizing a variety of software requires technological expertise for creating a real-time electronic medical record. The development of training material needs to be multifaceted. Use of manuals, videotapes, worldwide web documents, instructional seminars, hands on training and simulations are useful in providing not only initial training but also follow-up training and demonstration.
Simulations work best for training.
The computer software must be easy to use and almost sequential. The variety of experience and skill that physicians have with computers requires a straightforward, menu driven system. While choice of options for media interface is attractive, few of the physicians have the computer experience for them to grasp the versatility of the system with some additional training or experience. A simple menu system for including data from various media and running the videoconference appears the best. Complex organizational factors exist within hospitals and between hospitals.