EHR Optimization

Notes About the Report Sample Data comes from ambulatory care providers at 24 healthcare organizations: These organizations have all implemented ambient speech for at least some of their providers and have also measured EHR satisfaction via the Arch Collaborative. Providers that haven’t adopted ambient speech at these organizations act as a control group to which the ambient speech users can be compared. Data is aggregated across multiple ambient speech vendors: Of the 24 organizations, 18 use Microsoft DAX Copilot (now part of Dragon Copilot), 3 use Abridge, and 1 each uses Ambience Healthcare, DeepScribe, or Nabla. Data comes only from providers using Epic: At the time of this report, 96% of providers whose ambient speech experience had been measured through the Arch Collaborative are Epic users. This does not reflect broader market adoption, as KLAS has validated ambient speech in use by organizations using many other EHRs. Use of ambient speech is self-reported: Surveyed providers indicated whether they use ambient speech for a significant portion of their documentation but did not specify the percentage of encounters Surveyed providers had higher rates of preadoption burnout: Many organizations in this sample likely targeted inefficient or burned-out clinicians for their initial ambient speech program Additional Ambient Speech Insights from KLAS Additional ambient speech reports as well as real-time data on the performance of specific ambient speech vendors can be accessed on the KLAS website . AMBIENT SPEECH OUTCOMES Ambient Speech Is Leveling Up the EHR Experience & Bringing Focus Back to the Patient Compared to peers, providers that use ambient speech to document a significant portion of their encounters are much more satisfied with their EHR experience (see first chart below). Examining data specifically from providers whose EHR experience was measured both before and after adopting ambient speech reveals that the most positive impacts are seen in overall EHR usability, perceived efficiency, and ability to deliver patient-centered care (see second chart below). Providers particularly appreciate that ambient speech allows them to move away from the computer and spend more time face-to-face with patients without the cognitive burden of having to take notes during the visit or recall information to document later. Not only can AI-generated notes reduce charting time and allow providers to spend that time on patient care activities (such as patient education and patient messages), but providers say that their notes are more thorough and that they are better able to follow through on things discussed with the patient (such as orders), all leading to higher provider satisfaction with the quality of care delivered. “The time I spend documenting has improved significantly, and I am continuing to see improvements. . . . I am very happy using this technology, and this is probably the first bit of technology that has lived up to its hype about making professional life better.”  —Physician “Ambient speech has been the single best experience I have had documenting.” —Physician Ambient Speech Is Alleviating Burnout for Providers Struggling with Documentation, Workload & Work-Life Balance  For many providers, the introduction of ambient speech has come with notable wellness improvements—not only making providers feel better about the quality of their patient care but also leading to better work-life balance by enabling faster chart closure. Even providers still experiencing burnout or stress are less likely to cite the EHR as a contributor to their burnout, and many feel better supported by their organizations. While the causes of burnout are multifactorial and ambient speech is not a silver bullet, when implemented and supported well, the technology can make a significant difference in providers’ lives.  “Due to access issues and having to address too much in each visit, I struggled to document as I was always running late and then having to do follow-up work later. With the ambient speech solution, I went from feeling like a complete failure and being close to quitting medicine to now having a completely improved quality of life at work. I would tell my organization to keep this solution at all costs!”  —Physician “I have gained such work-life balance; once I get home, I feel like I can disconnect and focus on my young, growing family. I am so thankful to [this ambient speech solution] for allowing me this freedom.” —Physician Are Providers Willing to See More Patients to Justify the Cost of Ambient Speech? Most said no. Four organizations specifically asked their providers who have adopted ambient speech whether they would be interested in adding more patients—over 80% responded no, preferring to invest any efficiency gains into improving patient care activities or their work-life balance. What about the 18% that said yes? Nearly 1 in 5 providers expressed some interest in adding patients, especially if they weren’t feeling short-staffed and it could help the organization justify investment in the technology. Advanced practice providers were more likely to express willingness than physicians. Approach the topic with sensitivity. Discussions about ambient speech’s impact on patient volumes require balance, sensitivity, and transparency—ambient speech can allow for higher volumes, but many providers want to first focus on improving their practice and well-being. KLAS has validated one organization that has successfully walked this line, allowing willing volunteers to add patients; organizations that have required or encouraged it largely report negative reception and adverse outcomes among providers. How Consistently Do Organizations See Positive Outcomes from Ambient Speech? The short answer is very consistently. At least 75% of organizations that surveyed providers before and after the providers adopted ambient speech saw positive outcomes in terms of an improved NEES, higher perceived efficiency, and decreased burnout. Thoughtful Change Management Can Maximize Ambient Speech Outcomes Though providers typically find ambient speech solutions easy to use, thoughtful change management during implementation is still critical in maximizing the technology’s impact. Such management should include setting expectations with providers about (1) what the tools can and can’t do, (2) the accuracy of AI-generated notes, and (3) the lift required to review notes. This is particularly critical for providers in specialties with unique, nuanced documentation needs; providers currently report that specialty-specific functionality varies across ambient speech solutions (see next page). Change management should also include training for providers on how to personalize the technology to fit their charting workflows and preferences and how to suggest fixes and optimizations to fine-tune the output. Change Management in Action—Legacy Health’s Case Study Legacy Health has seen positive, measurable outcomes from their ambient speech pilot program. Much of their success came from being highly intentional in choosing providers, setting clear expectations up front, providing both in-person and on-demand training, and obtaining leadership buy-in through ROI calculations. For detailed insights into Legacy Health’s success, see their Arch Collaborative case study . AMBIENT SPEECH USE CASES Generalist Providers in Ambulatory Settings Have Been the First Adopters; Specialty & Inpatient Adoption Is Limited but Growing Many organizations start their ambient speech journey by rolling out the technology to family or internal medicine providers in ambulatory settings. These providers are commonly seen as ideal candidates for adoption due to their high patient volumes and generally lower visit complexity. To date, adoption in specialties has been more limited and scattered. This is partially a function of the technology’s capabilities, which have historically been viewed as not optimized for specialty providers. However, many vendors have now developed or are actively developing specialty-specific functionality, and this will likely increase specialty adoption in coming years. In aggregate, early data indicates that even in its current state, ambient speech has a positive impact for specialists. WHAT'S NEXT? Ambient Speech Is Just Getting Started—Where Do Providers Want It to Go Next? After a year of intense growth and promising outcomes, most early adopters are satisfied with ambient speech and optimistic about its future. That said, many providers acknowledge that there are opportunities for improvement and expansion. Below are specific developments providers want to see in coming years. Continued refinement of output to decrease the need for editing Over the last 18 months, the most common problem providers have reported with ambient speech is inaccurate or clunky output that requires editing. Among other things, they note that the technology sometimes excludes critical information, includes irrelevant information, incorrectly labels pronouns or gender, or misunderstands accents. As ambient speech solutions improve with advancements in generative AI, providers would like to see continued fine-tuning and clear methods by which they can give feedback if they see repeated errors. “I just started using [ambient speech] to help with documentation. It is good in terms of not typing in the room with the patient, but the amount of work has not decreased. I still have to enter orders and instructions. Also, it is not accurate and does miss information many times. Hence, the amount of time I spend has increased because I am looking for errors and then documenting.”  —Physician “I wish I could give feedback to have [my ambient speech solution] learn typical things I find myself correcting over and over.”  —Physician Ability to adapt the tools to the provider’s voice & documentation style Providers may feel that AI-generated notes don’t represent their voice or conform to their personal style of charting. Specifically, providers want the tools to learn from previous notes to better match an individual’s voice. They also want the ability to better adapt the tools to EHR personalizations, such as templates. As ambient speech technology continues to advance in these areas, organizations should make sure to train providers on the personalization tools already available within many ambient speech solutions today. “I didn’t like how the notes read. They didn’t sound like my dictation at all, and the way they were organized made me feel uncomfortable sending them off to referring providers as my consult. I ended up redoing a lot of the note for each patient. I will probably try it again at some point, but at this time, I just use dictation and typing.”  —Physician “I want better integration with an individual’s preferred way to document.”  —Physician Expanded capabilities, including in areas beyond the note Providers see significant potential for ambient speech to be expanded, reporting that while most solutions excel at capturing HPI, some could do better at capturing other elements of the encounter, such as assessment and planning and risk assessments. They also see a need for AI to go beyond the note to help with things like orders, coding, and billing, which would positively impact downstream revenue. Some vendors and healthcare organizations are in the early stages of implementing such capabilities. “[Ambient speech] in primary care is a game changer. It should be deployed to all units. AI-assisted diagnoses/orders and billing will positively impact us, and I strongly recommend adoption when available.”  —Physician “I wish [this ambient speech tool] would populate the problem list and generate billing information as I talk with the patient.”  —Physician More functionality for specialists, nurses & allied health professionals Though specialty-specific functionality varies across ambient speech solutions, specialists often view the tools as having limited functionality for the complexities of specialty care, saying they oversimplify or skip needed information, lack specialty-specific vocabulary, or don’t meet documentation needs. Additionally, providers believe ambient speech functionality could be thoughtfully adapted to the unique workflows of inpatient providers and additional clinician groups, such as nurses and allied health professionals. KLAS has validated a number of recent pilots for nurses and will share future insights as adoption grows. “Right now, [this ambient speech solution] seems to be more catered to primary care and less to specialty care. I have used the sections in my notes to help organize things, but it still puts the notes outside of the sections, so I still have to copy and paste. This does not help with efficiency.”  —Physician “I would like the vendor to optimize AI. [Our ambient speech tool] does not work effectively for my specialty in the manner in which we need to document.”  —Physician Measure Your Clinicians’ Experience with Ambient Speech As your organization adopts and expands its use of ambient speech, it will be critical to measure your clinicians’ experience to understand both the technology’s impact and the areas in which it can be optimized or better supported. The KLAS Arch Collaborative partners with healthcare organizations to administer surveys and provide benchmarking specific to ambient speech. To learn more about measuring your clinicians’ experience, visit our website . Future ambient speech research from KLAS:  Insights and perspectives from organizations that measure their clinicians’ ambient speech experience will be published in an updated version of this report in 2026. Over the next year, KLAS will also publish additional ambient speech case studies and success stories as well as a report on how ambient speech solutions are expanding beyond the note. Vendors Partnering with the Arch Collaborative Ambient speech and EHR vendors that have partnered with the Arch Collaborative to understand the impact of ambient speech and assist customers on their ambient speech journey include the following: Ambient speech vendors Abridge Ambience Healthcare DeepScribe IKS Health Microsoft Nabla Onpoint Healthcare Partners Solventum Suki EHR vendors athenahealth Dedalus Epic Greenway Health InterSystems MEDITECH Oracle Health Note: Healthcare organizations can leverage the Arch Collaborative to measure their clinician experience with any EHR/ambient speech vendor. They are not limited to the vendors listed above. What Is the KLAS Arch Collaborative? The Arch Collaborative is a group of healthcare organizations committed to improving the EHR experience through standardized surveys and benchmarking. To date, almost 300 healthcare organizations have surveyed their end users and over 600,000 clinicians have responded. Impact reports such as this one seek to synthesize the feedback from these clinicians into actionable insights that organizations can use to revolutionize patient care by unlocking the potential of the EHR. About the Sample Organizations represented in this report measured their providers’ experiences with ambient speech through either (1) system-wide EHR experience surveys in which providers could also self-report their use of ambient speech or (2) targeted pre- and post-implementation surveys intended specifically to measure the impact of ambient speech. Surveys were administered by healthcare organizations to their clinicians and collected via an online survey tool. Note that because data was collected differently at different organizations and because not all organizations asked the same questions, sample sizes will differ between charts. Data was collected from November 2023 through March 2025. Below are other important things to note about the data sample. Data comes from ambulatory care providers at 24 healthcare organizations: These organizations have all implemented ambient speech for at least some of their providers and have also measured EHR satisfaction via the Arch Collaborative. Providers that haven’t adopted ambient speech at these organizations act as a control group to which the ambient speech users can be compared. Data is aggregated across multiple ambient speech vendors: At the time of their survey, 18 of the 24 organizations represented in this report were using Microsoft DAX Copilot (now part of Dragon Copilot), 3 were using Abridge, and 1 each was using Ambience Healthcare, DeepScribe, or Nabla. Data is aggregated across these solutions to provide a general overview of the provider experience with ambient speech. Data comes only from providers using Epic: At the time of this report, 96% of providers whose ambient speech experience was measured through the Arch Collaborative were using Epic. This does not reflect broader market adoption, as KLAS has validated ambient speech in use by organizations using many other EHRs, including Altera Digital Health, athenahealth, eClinicalWorks, MEDITECH, and Oracle Health. Findings are based on feedback from physicians and advanced practice providers: Respondents are referred to collectively throughout the report as “providers.” Use of ambient speech is self-reported: Surveyed providers indicated whether they use ambient speech for a significant portion of their documentation but did not specify the percentage of encounters. Surveyed providers had higher rates of preadoption burnout: While organizations may differ in which groups they choose to target for their initial ambient speech programs (including volunteers, superusers, or inefficient/burned out clinicians), many organizations in this sample likely targeted the latter. In aggregate, providers represented in this sample were experiencing higher rates of burnout and inefficiency with the EHR compared to peers before adopting ambient speech. To account for the variance in the selection process, much of this report looks at providers who were surveyed before and after their use of ambient speech. Organizations were in various stages of adoption when data was collected: Most organizations in this sample were in the early stages of rolling out ambient speech to initial provider groups, some were piloting solutions, and a few had moved toward a system-wide rollout.

Key Findings: Program Goals Keys to Success Organizational Outcomes What Olmsted Medical Center Did How Olmsted Medical Center Did It What Is the KLAS Arch Collaborative?

Key Findings: Program Goals Keys to Success Organizational Outcomes What Carle Health Did How Carle Health Did It Conclusion

Arch Collaborative EHR Experience Levels: Clinicians Are More Likely to Have a Poor EHR Experience Than an Elite One, Most Are Stuck in the Middle To date, roughly 45% of US health systems have measured clinician EHR satisfaction through the Arch Collaborative EHR Experience Survey. To help organizations better understand their survey results and improvement opportunities, the Arch Collaborative has created the EHR Experience Levels (see below). The healthcare industry has work to do regarding clinician EHR satisfaction, as only 22% of nurses and 18% of physicians have a strong (Level 5) or elite (Level 6) EHR experience. Most organizations hit a ceiling at a moderate EHR experience (Level 4). However, the Arch Collaborative can help organizations break through that ceiling. Improvement is possible when healthcare organizations and HIT vendors prioritize improving clinicians’ well-being and organizational culture. Improvements & Challenges from the Past Year What Is Improving? The following table outlines significant improvements to the EHR experience that nurses and physicians have reported seeing in the last 12 months. Nurses Enhanced training: Nurses credit ongoing training and superuser support with improving their EHR proficiency. Enhanced training has equipped many nurses to use tools (e.g., charting templates, macro tools) to more quickly and consistently document patient information. Enhanced user interfaces: Revamped interfaces and easier navigation have helped nurses more quickly find data and complete tasks. Some also note their EHR runs more quickly and reliably, which makes the tool less frustrating to use. Secure messaging: These tools have improved communication and care coordination. Improvements to patient communication tools (e.g., patient portals) enable nurses to electronically send education materials or instructions. Physicians Ambient speech: AI-powered documentation assistants have significantly reduced physician documentation time and improved their quality of life. To learn more about ambient speech vendor performance, see KLAS’ 2025 report on this segment . Enhanced user interfaces: Recent EHR updates have refreshed and streamlined user interfaces with cleaner layouts and easier navigation (particularly for order entry). Secure messaging: Physicians value being able to chat with other care team members in real time via the EHR, improving collaboration and reducing delays in communication. For many physician teams, secure messaging is an indispensable tool. What Is Stuck? The following challenges are trends that the Arch Collaborative has seen through our data over the last 12 months. Nurses Documentation burden: Reducing the documentation burden is the number-one requested EHR fix for nurses. 35% of nurses spend three or more hours per week on unproductive charting  (e.g., charting that is duplicative or adds no value). For insights on the nursing documentation burden, see this report . Physicians Message burden: 47% of ambulatory physicians report an excessive message volume, and the number of physicians reporting a high message burden is projected to grow as patients’ use of messaging tools expands. For a look at how ambulatory physicians are balancing message volume with patient expectations, see this report . Interoperability:  Among the 11 metrics used to calculate the NEES, clinicians are least satisfied with external integration—only 44% of clinicians agree their EHR provides expected integration with outside organizations. In particular, physicians most frequently cite interoperability as their top fix request, saying that external patient data often isn’t available in the EHR or is difficult to leverage. To learn more about clinicians’ experiences with interoperability, see this report . Key Takeaways for 2025 You May Not Know How Much Your Clinicians Are Struggling with EHR Response Time For 80% of organizations who have measured with the Arch Collaborative, less than 70% of clinicians agree that the EHR has a fast response time. Most healthcare leaders do not realize that many clinicians struggle with slow EHR response times , which can be caused by a variety of reasons. Healthcare organizations and EHR vendors need to partner together to examine the broader clinician EHR experience and identify why many clinicians report slow EHR response times (e.g., login or Wi-Fi challenges). Poor response times can frustrate other aspects of clinicians’ experiences, though they often tolerate this issue because they don’t know that the problem can be fixed. Luckily, healthcare organizations who have measured with the Arch Collaborative prove that EHR speed can be improved —see this Success Pathway for best practices around creating a stable, fast EHR experience. Voice of Organizational Leadership “From a metrics perspective, we often hear levels of frustration, but we don’t exactly know where to look or how to peel back the layers of what is working versus what isn’t working. One crucial piece of information that we have learned is that no matter how many updates or modifications we made to our EHR, if our VDI experience or our login experience isn’t where it needs to be, then it doesn’t matter how many improvements we make with the EHR if the device is still slow. We are living that right now and truly understanding how crucial it is. I started doing some rounding with my team, and clinicians can’t do what they need to do to take care of patients in front of them if their devices aren’t working. The survey really opened our eyes into thinking about the holistic experience to satisfaction and not just the EHR experience.” —Director of clinical transformation Strong Organizational Culture Is the Key to Moving from Good to Great & Encourages Clinicians to Stay Healthcare organizations who have achieved Level 6 have the fewest clinicians who say leadership is a contributor to burnout (see chart below), as these organizations know that importance of moving from an “us versus them” mentality to a shared “we” that includes both leaders and clinicians. As more and more clinicians leave their organizations or the healthcare industry altogether, organizations need to figure out how to reduce or eliminate burnout factors (including leadership and EHR decisions) for clinicians. What Did Pinnacle Winners Do to Improve Organizational Culture? Moved from an “us versus them” mentality to a shared “we” that includes both leaders and clinicians Prioritized and validated clinicians’ voices Made clinicians critical stakeholders in EHR decision-making in partnership with IT teams Clinicians who are dissatisfied with their organization’s leadership or IT are almost twice as likely to plan to leave their organization within the next two years than satisfied clinicians Voice of the Clinician “I am leaving due to burnout from a chaotic work environment and lack of shared values from organization leadership. [There has been] inconsistent, poor, and even a complete lack of communication from leadership. I love my job, the nurses, and the interdisciplinary relationships with other medical professionals. The leadership is what has driven me away .” —Advanced practice provider “The EHR should be a collaborative effort between IT and providers. At best, IT is very protective of its privilege and little fiefdom. At times, it seems like they think providers are here to make IT’s work smooth and efficient. IT management , as opposed to the trainers and helpers, really does not understand our needs or even seem interested in what they are .” —Physician Voice of the Executive “Culture is a soft metric that is highly consequential. It isn’t the kind of thing people can enter in a spreadsheet to prove a monetary ROI, but culture is a massive metric. Our culture has improved because we invested in improving the clinicians’ experience. There are innumerable factors to culture, but we have created a strong presence with our providers. We let them know we are listening to them and making changes. We get in front of the providers every quarter to let them know about major changes that are coming based on the pain points they have reported. I think this matters a lot.” —Executive Success Stories from EHR Experience Pinnacle Award Winners  See below for success stories from Pinnacle Award winners. Click on each organization’s logo to see their full case study. For the 2024 Arch Collaborative award winners, see this section of the report. Johns Hopkins Aramco Healthcare credits their success to their strong EHR governance structure and culture of celebration , building high trust and goodwill among clinicians. Each governance committee includes a formal charter to clarify key elements of the committee , including ownership, purpose, members, function, meeting recurrence, and decision-making. Children’s Nebraska focuses on EHR support and shared ownership , with the guiding philosophy of “satisfy the users, simplify the systems, and secure the environment.” The organization’s governance board keeps clinicians in mind when making decisions and provides them with well-honed tools that enable effective patient care. Children’s Nebraska also abides by set governance philosophies to make standardized decisions and prevent inconsistencies when simplifying the EHR. Mackenzie Health views all EHR changes through the lens of the clinicians that the changes will impact. In particular, nurses are engaged at every stage and are empowered to contribute to decision-making. This collaborative approach fosters a positive perception of organizational leadership among clinical staff and reinforces a culture of shared responsibility and innovation. UTHealth Houston believes that strong shared ownership and collaboration have empowered their EHR success. When rolling out a new EHR module, the organization’s shared ownership committees and councils disseminated information and provided support to clinicians. Physicians are empowered to make decisions and enact change. When a physician needs at-the-elbow EHR assistance, they can turn to one of several physician champions, who are embedded within each department. Organizations Are Making Dramatic Improvements to Clinicians’ EHR Experiences—Focus Is Key to Success The myth that clinicians will never be happy with the EHR is untrue —many healthcare organizations are making great progress toward improving their clinicians’ EHR experiences. However, achieving the highest EHR Experience Levels doesn’t happen by chance. Healthcare organizations must intentionally focus on aligning strategic priorities and creating an elite EHR experience for their clinicians. At a high level, an elite EHR experience requires the following elements shown below. What Does an Elite EHR Experience Look Like for Clinicians? An environment of shared values, teamwork, and a patient-first mentality Quick login and system response times so clinicians don’t have to waste patients’ time Onboarding education that prepares users for their specific workflows Ongoing education and EHR personalization so that the system works the way users think EHR governance structures that involve clinicians in decision-making Effective communication around EHR-related changes Celebrating Progress Along the Way—One Organization’s Journey to an Elite EHR Experience Many of the healthcare organizations who have won an Arch Collaborative EHR Experience Pinnacle Award didn’t immediately achieve excellence; rather, success was a journey that required measurement, ongoing focus, refinement, and remeasurement. One organization who measures with the Arch Collaborative started the journey to improving their clinicians’ EHR experience in 2017, initially scoring a Level 3. In response, this organization focused on continually refining the EHR experience and increasing clinician satisfaction through improved EHR education. As a result of the organization’s efforts, between their 2019 and 2020 measurements, their NEES increased by 20 points and they rose to Level 5. The organization did not stop there—they continued to enhance the EHR for clinicians, ultimately resulting in a NEES of 68.9 for physicians in their most recent measurement—a 40-point increase from their first measurement. This increase led to this organization achieving Level 6 and receiving an EHR Experience Pinnacle Award. Number of organizations who received a Breakthrough Recognition between 2024 and 2025 Want to Know How Your Organization Is Doing? Measure with the Arch Collaborative By working with the Arch Collaborative, healthcare organizations can gain a deeper understanding of their clinicians’ experiences as well as specific guidance on what to improve. Measure your clinicians’ experiences and learn your NEES/EHR Experience Level Adopt best practices from Arch Collaborative case studies and reports Measure your improvement year-over-year Celebrate progress through the EHR Experience Breakthrough Recognition Continue progressing to achieve the EHR Experience Pinnacle Award 2024 Arch Collaborative EHR Experience Pinnacle Award & Breakthrough Recognition Winners For more information on how to qualify for the Breakthrough Recognition or Pinnacle Award, see here . 2024 EHR Experience Pinnacle Award Winners Nurses (NEES of 75.0 or higher) Physicians (NEES of 60.0 or higher) 2024 EHR Experience Breakthrough Recognition (15-point or greater increase) Nurses Amsterdam UMC Arkansas Children’s † Centra Health † Frances Mahon Deaconess Hospital Intermountain Health Jefferson Health Southern Illinois Healthcare The Guthrie Clinic † University of Texas Health Science Center at Houston Valley Children’s Healthcare Physicians Advocate Health Allina Health † Baptist Health Montgomery † Baylor Scott and White Health Bellin Health Connecticut Children’s Cottage Health † Dayton Children’s Hospital Franciscan Health Harbin Clinic † HCA Acute (New Hampshire) † Henry Ford Hospital Inova OhioHealth † OrthoVirginia † Penn Medicine † Piedmont Healthcare The Queen’s Health System † RUSH University Medical Center Scripps Health † SUNY Upstate University of Kansas Medical Center University of Utah Hospital UVA Health UW Health Both physicians and nurses Children’s Nebraska CommonSpirit Health Corewell Health Door County Medical Center King Faisal Specialist Hospital & Research Centre Lehigh Valley Health Network † Mayo Clinic Mount Sinai Health System † Ozarks Healthcare Royal Children’s Hospital Sutter Health UMass Memorial Health † University of Vermont Medical Center WellSpan Health † Not current members What Is the KLAS Arch Collaborative? The Arch Collaborative is a group of healthcare organizations committed to improving the EHR experience through standardized surveys and benchmarking. To date, over 300 healthcare organizations have surveyed their end users and over 600,000 clinicians have responded. Reports such as this one seek to synthesize the feedback from these clinicians into actionable insights that organizations can use to revolutionize patient care by unlocking the potential of the EHR.

Key Findings: Program Goals Keys to Success Organizational Outcomes What Atlantic Health System Did How Atlantic Health System Did It

Healthcare organizations around the world have become more digitally mature since implementing their go-forward EHR, and now, they are prioritizing EHR optimization (see KLAS’ 2024 and 2025 reports sharing global healthcare IT trends). As momentum around EHR optimization continues, the KLAS Arch Collaborative aims to help organizations worldwide fully support their clinicians in their EHR experience. This report uses data gathered over the last three years from 38 organizations—located across Canada, Europe, the Middle East, and Oceania—to examine how EHR satisfaction compares worldwide. Organizations that are running an EHR without measuring its impacts are inadvertently missing opportunities for greater organizational alignment and clinician satisfaction—the universal best practices in this report can help these organizations know where to focus to improve the EHR experience. Note: Though the nomenclature used to describe the core patient record used throughout a hospital varies from region to region or language to language (EHR, EPR, EMR, etc.), the term that will be used in this report is EHR (electronic health record). The Middle East Sets a High Bar for Clinician EHR Experience; Stable Infrastructure, Exceptional Training & Effective Governance Drive Their Success Healthcare organizations in the Middle East are a model of success for clinician EHR satisfaction thanks to their strategic investments in three areas: foundational infrastructure, sustained training programs, and effective governance with organizational support. Regarding infrastructure, the organizations prioritize system reliability and speed, and they ensure that their clinicians can access the tools they need without disruption. For training, many organizations have adopted a proactive approach, offering ongoing, role-specific education that helps users get the most from their systems. And finally, the organizations have governance structures that include clinician input, which further ensures that the EHR evolves with users’ needs. In comparison, other regions (including the US) struggle with infrastructure, training, and governance. Their infrastructures are often outdated or inconsistent, leading to slow system performance and connectivity issues. While most regions provide basic onboarding, they often lack the ongoing, role-specific education that is necessary to increase clinicians’ efficiency and confidence with the EHR. Furthermore, clinicians in these regions often feel left out of their organizations’ decision-making process, so they don’t feel supported in optimizing their workflows to meet their needs. These issues create an environment where EHRs are seen as burdensome, leading to higher clinician burnout and dissatisfaction. Voice of the Clinician: EHR Experience “I am highly satisfied with our EHR system in terms of patient safety, ease of use, efficiency, and team communication around patient care.” —Nurse (The Middle East) “Using the EPR has massively slowed down my workflow and had a direct impact on patients. Most of my time is now spent looking at a computer and trying to find where to log information. From a nursing perspective, I feel that the EPR has harmed nursing care and detracted from person-centred care. Our bandwidth is taken up by trying to navigate and use the EPR and other systems, and our time is being allocated away from patients.” —Nurse (Europe) Burnout Continues to Be a Global Issue; EHR Plays a Role Clinician burnout is not confined to any one region or country—it is a universal challenge affecting healthcare organizations globally. Across most regions, including the US, about one-third of interviewed clinicians experience burnout; the exception is the Middle East. Common contributors to burnout are staffing shortages, stressful work environment, and lack of control over workload. In addition, the EHR is frequently cited as a top contributor to clinician burnout and can exacerbate other contributors. Clinicians in Oceania cite the EHR as a contributor the most, and clinicians in the Middle East cite it the least. When organizations understand the extent of their clinicians’ burnout and its connection to the EHR experience, they can be more strategic about organizational priorities that would reduce burnout (see this KLAS report for more about addressing burnout). Notably, improving EHR efficiency is key to boosting EHR satisfaction and consequently reducing burnout (see this KLAS report for more satisfaction drivers). Voice of the Clinician: Burnout “The number-one factor that has influenced my current negative feelings toward my organization is the EPR. It has caused so much frustration and dislike of my job that I literally have no joy in being here. I am considering resigning from my position because of this system. It has made my job harder. It is dangerous and takes time away from my patients.” —Nurse (Oceania) “Our product is a terrible system that is designed to demoralize and waste the time of healthcare practitioners. It is not intuitive, there are too many ways to go wrong, there is no teaching or support, and there are many internal tricks that can only be learned by spending many hours trying to figure things out or begging people to help, despite them being too busy to help because they have their own issues and workload. Our system should be abandoned immediately before it collapses the whole system, causes mass physician burnout, and decreases quality of care for patients.” —Physician (Canada) THE EHR HOUSE OF SUCCESS Learn What Steps to Take to Increase Clinicians’ EHR Satisfaction Adherence to the Arch Collaborative’s EHR House of Success improves clinician EHR satisfaction, no matter what region a healthcare organization is in. The following sections share universal best practices that are organized according to the EHR House of Success, starting with the foundation (infrastructure) before moving to the three pillars of success (education, governance, and personalization). For an in-depth look at best practices for physicians and nurses, see the 2023 Provider Guidebook and the 2024 Nursing Guidebook . A Stable EHR Infrastructure Is Nonnegotiable & Should Be Organizations’ First Priority When Looking to Improve EHR Satisfaction For clinicians, a strong infrastructure—i.e., a reliable system with fast system response time—is essential for delivering safe, effective care. Frequent system slowdowns or crashes disrupt clinical workflows, leading to greater likelihood of clinician burnout and diminished care quality. In contrast, when the basics are in place, clinicians can focus on what matters most: their patients. In Canada, Europe, and Oceania, less than two-thirds of clinicians agree that their EHR infrastructure is effective. To boost EHR satisfaction, organizations in all regions must address issues with system reliability and response time (e.g., login time, load times, downtime, connectivity, consistent system performance) either before or in conjunction with extensive initiatives around education, governance, or personalization. If infrastructure issues are not addressed, the effectiveness of other initiatives will be diminished by persistent technological problems. Best Practices for EHR Infrastructure  Proactively monitor broader system performance (e.g., login, Citrix, Wi-Fi). Schedule regular downtime to reduce the number of unexpected outages; clearly communicate when scheduled downtimes will occur. Stay on top of all software updates and hardware inventory schedules. Voice of the Clinician: EHR Infrastructure “Sometimes the system is slow to load, especially during time-sensitive, emergent situations.” —Nurse (Canada) “It takes very long to start a workstation computer and log in to the system. I have had to wait for up to 5-10 minutes, which doesn’t sound like a lot, but the minutes add up when I am looking after 5-10 surgical patients in a day. The process for opening and logging in to the system should be faster.” —Physician (Canada) “Wi-Fi connectivity drops out on regular basis, making me lose my work unless it is saved.” —Physician (Europe) “I don’t know whether the issue is the EPR or the hardware we use, but the system freezes far too often. This delays the clinics and adds a huge amount of stress for both clinicians and patients.” —Physician (Europe) To evaluate your organization’s infrastructure maturity, answer the self-examination questions in the KLAS Arch Collaborative Success Pathway—EHR Reliability & System Speed . EHR Education & Training Are Essential for Clinician Success In Canada, Europe, and Oceania, clinician satisfaction with EHR education is lower. EHR education is often not as much of a priority as other projects and thus isn’t allocated sufficient resources, sometimes due to financial constraints. While cutting back on training may help reduce short-term expenditures, it can have long-term negative impacts—for example, lower EHR satisfaction results in increased clinician burnout and a higher likelihood of clinicians leaving their organization. Additionally, poor initial training can lead to greater skepticism around ongoing training. Onboarding and ongoing training are essential for building user confidence and boosting efficiency. Regarding onboarding training , clinicians need at least three hours of training but greatly benefit from receiving more; clinicians with the highest EHR satisfaction receive at least eleven hours of onboarding training (see chart below). When possible, onboarding training should include workflow-specific training. After onboarding, clinicians should receive ongoing training —in particular, training tailored to specific clinical workflows—to become more proficient, learn time-saving features, and adapt to system updates. Clinicians should receive between three and five hours of training annually so they can maintain EHR proficiency and feel empowered rather than hindered by the technology. Also, ongoing training can help retain clinicians; the Clinician Turnover 2024 report notes that enhanced ongoing EHR education is a top factor that prevents clinicians from leaving their organization. Note: The data in these charts comes from providers only and represents all provider feedback collected by the Arch Collaborative, not just that of the 38 non-US organizations examined in this report. Best practices for nurses can be found in the 2024 Nursing Guidebook . Best Practices for EHR Education Provide at least 3–5 hours of initial/onboarding training and 3–5 hours of ongoing training. Be sure trainers are well-versed in clinical workflows so they can teach effectively and answer questions. Use multiple training methods to meet individual needs. For a scalable, cost-effective training method, leverage virtual learning (see recent KLAS report on this topic). Voice of the Clinician: EHR Education “I want someone to sit with me as I go through my usual outpatient clinic day and point out improvements I could make; I would need only an hour of someone’s time, and I would be so much happier.” —Physician (Canada) “We need thorough training for staff on how to use the system.” —Nurse (Canada) To evaluate your organization’s education maturity, answer the self-examination questions in the KLAS Arch Collaborative Success Pathways for onboarding EHR education and ongoing EHR education .. Effective EHR Governance Is Key to Driving Organizational Alignment & Clinician Empowerment EHR governance is defined as a healthcare organization’s strategic and operational framework for overseeing EHR management, usage, and optimization. Organizations with effective governance involve and listen to clinicians, communicate changes, and seek to optimize clinician workflows based on feedback. A key indicator of how well an organization does these things is clinicians’ agreement on whether their organization/IT leadership does a good job of implementing, training on, and supporting the EHR. In this way, the Middle East surpasses other regions, with clinicians highlighting strong leadership, clear communication and accountability, and a culture of clinician engagement. Clinicians in the other regions, in contrast, experience an us-versus-them culture with their IT team; they express frustration around not having a voice in EHR changes and say EHR changes aren’t communicated well. In Arch Collaborative data generally, clinicians who strongly agree that their organization/IT leadership delivers well report higher EHR satisfaction (see this KLAS report ). Organizations can foster effective EHR governance when there is shared ownership between organizational leaders and frontline clinicians. When clinicians have a voice in how the EHR is managed, updated, and optimized, they are more likely to feel invested in its success. Voice of the Clinician: EHR Governance “At the beginning, I was keen to give feedback on the EMR to correct some issues and improve functionality. However, the lack of receptiveness from the staff demoralized me, so until now, I have not provided feedback.” —Nurse (Oceania) “IT support needs to be available on-site at all times. Every time we have an issue, it is impossible to get in-person support, especially when things are time sensitive. When there is an issue with IT, it directly impacts patient care, so it should be an organizational priority to ensure support is on-site and available.” —Nurse (Canada) “Before the design and implementation of a new process, talk to the actual users of the system to ascertain how they work, what they want, and what will help. Prioritize the users and their needs above target-driven changes.” —Nurse (Europe) Read the Arch Collaborative Learning Summit 2023 overview for more information. Best Practices for EHR Governance Use governance as a strategic and operational framework to oversee EHR management, usage (including training), and optimization. Involve decision-makers (e.g., C-suite, directors) as well as individuals across the organization who have technical and frontline workflow expertise. Decision-makers must be aligned on a strategic plan that includes guiding principles, policies, and standardized processes. Incorporate multiple levels of governing bodies, including executives, operational and departmental leaders, and work groups. Make sure that individuals on governance committees are allotted time to participate. Personalization Leads to Enhanced EHR Usability Personalization allows users to tailor the EHR to their specific needs and workflows, including around order sets, shortcuts, and documentation templates. These seemingly small adjustments can streamline routine tasks and boost overall efficiency. Of note, Arch Collaborative data shows that any adoption of personalization tools helps increase EHR satisfaction (for more information, see this KLAS report ). Clinicians in the Middle East report the highest adoption of EHR personalization, likely due to educational resources and organizational governance that incorporates clinicians’ feedback on EHR changes. To evaluate your organization’s EHR personalization maturity, answer the self-examination questions in the KLAS Arch Collaborative Success Pathway—EHR Personalization Tools . Best Practices for EHR Personalization Incorporate personalization capabilities into ongoing training or workflow training. Monitor EHR data to identify potential EHR efficiency opportunities. Calculate time and money saved from reduced clicks to generate buy-in and keep clinicians and leaders engaged in workflow optimization. Voice of the Clinician: EHR Personalization “Make document notes easy to read and have them flow better for each specialty.” —Physician (Europe) “There is so much customization possible, but no one ever showed us the specific functionalities that are possible or what is efficient for outpatient clinics. We had to figure things out on our own, and I am sure that there are many other areas in which we could improve our efficiency, but I have no idea what is available.” —Nurse (Canada) Partner with KLAS—Determine Next Steps for Improving EHR Satisfaction If your organization wants to improve clinicians’ EHR experience and reduce burnout, KLAS can help you examine where your organization stands. Measure current EHR satisfaction by collecting clinician feedback via the Arch Collaborative EHR Experience Survey. Use survey results to identify key areas for improvement. Draw on best practices and insights from high-performing organizations (like those in the Middle East) and prioritize targeted, sustainable changes. Keep going—continue measuring your clinicians’ satisfaction and work to further optimize the EHR experience. For more details about measuring clinician EHR satisfaction via the Arch Collaborative, see this document . Leaders Worldwide Share Why Working with KLAS to Measure Clinicians’ Experience Is an Organizational Priority “By investing in the clinician experience, we aim to achieve several returns on investment, including (1) increased clinician productivity, (2) improved patient safety and clinical outcomes, (3) enhanced patient satisfaction and brand loyalty, and (4) reduced clinician burnout and turnover. Our participation in the Arch Collaborative has positively impacted our clinicians’ experience by providing valuable insights and best practices from top healthcare providers. This collaboration has helped us implement effective strategies and continuously improve our clinician experience.” —VP of IT (The Middle East) “ The KLAS partnership has added a level of commitment to the nursing experience. We have been fortunate to have participated since our go-live, so the partnership is embedded into our work as a nursing informatics team. Our surveys help to identify improvements and shape initiatives . We have focused on innovating our training experience for our graduate nurses by including mobile workflow simulation and EMR workshops into their orientation program over the past two years; that is one example of how the clinician experience has been impacted.”  —Nursing educator (Oceania) “The bottom line is I don’t know where we would be today without joining the Arch Collaborative . It has been a key lever for me as a leader to be able to have that global voice to show where we are and where we need to be to truly be successful, and I can share that message in a way that has some weight behind it.” —CMIO (Canada) Success Stories from Organizations Across the Globe  EHR Infrastructure Keys to Success: Essentia Health has a robust network infrastructure. They have transparent communication, single-sign-on functionality to streamline logins, and a strong focus on uptime and resilience metrics. The organization’s success is further fueled by dialogue with clinical users, alignment between technological financial investments and patient care outcomes, and a consistent approach to hardware replacement. For more details, see case study . EHR Education Keys to Success: Hamad Medical Corporation’s comprehensive approach to nurse onboarding education has resulted in their nurses reporting higher-than-average EHR satisfaction. The organization is in the 100th percentile for nurse agreement that (1) their initial and ongoing training is sufficient and (2) their training is workflow specific. For more details, see the case study . EHR Governance Keys to Success: Dubai Health’s efforts around shared ownership, governance structure, and EHR support have contributed to high clinician EHR satisfaction. The organization’s NEES is among the highest ever achieved in the Arch Collaborative, and they are in the 100th percentile for respondent agreement that the organization has done well with implementing, training on, and supporting the EHR. For more details, see the case study . EHR Personalization Keys to Success: UCI Health’s onboarding training goes beyond the basics by diving deep into workflow training and personalization. Simulations are used as part of the practical, hands-on experience so that nurses learn workflows rather than just basic system interactions. During classroom instruction, each nurse personalizes the look and feel of their system. For more details, see the case study . What Is the KLAS Arch Collaborative? The Arch Collaborative is a group of healthcare organizations committed to improving the EHR experience through standardized surveys and benchmarking. To date, over 300 healthcare organizations across 13 countries have surveyed their end users and over 600,000 clinicians have responded. Reports such as this one seek to synthesize the feedback from these clinicians into actionable insights that organizations can use to revolutionize patient care by unlocking the potential of the EHR. This report acknowledges organizations that have won KLAS Arch Collaborative Awards . The Arch Collaborative EHR Experience Pinnacle Award honors members of the Arch Collaborative who have demonstrated that success is possible with the EHR. Qualifying organizations must have a NEES of at least 75.0 for nurses or a NEES of at least 60.0 for physicians. To put this in context, the average nurse NEES is 47.3 (n=113,045), and the average physician NEES is 23.4 (n=53,037). The Arch Collaborative EHR Experience Breakthrough Recognition honors any participating organization whose NEES has increased by at least 15 points between measurements. This can be earned for physician or nurse scores.

Potential for Clinician Turnover Is High & Comes with a Steep Cost Clinicians represent one of healthcare organizations’ largest investments, yet many organizations fail to intentionally nurture a positive clinician experience, missing crucial opportunities to maximize their return. Affecting clinicians and patients alike, the clinician experience cannot be ignored, as poor experiences are directly tied to burnout and turnover. Intentionally Prioritizing the Clinician Experience Drives Measurable ROI By focusing on the clinician experience, the interviewed organizations hoped to achieve a variety of tangible, high-impact outcomes, including increased clinician efficiency, decreased burnout, engaged clinicians, and improved patient safety. As a result of their deliberate efforts, these organizations have achieved what they set out to do (see chart below). Decreased Clinician Burnout and Turnover Intentionally reducing burnout reinvigorates clinicians’ spark to practice medicine and leads to the following benefits, which are especially crucial given current staffing shortages: Reduced costs associated with turnover and recruiting Enhanced organizational appeal to clinician talent Increased Clinician Efficiency Investments in clinician efficiency, such as workflow optimization and workflow education, empower clinicians to get back to what they love doing: spending time caring for patients. In the face of staffing shortages, efficiency improvements also lead to: Faster task completion Faster chart-closure rates Fewer duplicate tests Increased patient volumes A more engaged workforce Improved Patient Safety and/or Clinical Outcomes Interviewed organizations consistently tie patient safety/clinical outcomes to clinician satisfaction, including: Improved medication safety Higher adherence to safety protocols Reduced penalties from unmet quality requirements Better patient access Organizations typically measure outcomes via things like observable performance metrics, clinical data, and patient surveys. Burnout levels are assessed through clinician surveys and turnover rates, while patient loyalty is measured via methods such as a Net Promotor Score. Executive Perspectives: Why We Invest in Our Clinicians “We understand that enhancing the clinician experience is essential, not just a luxury . Clinicians are central to providing safe, high-quality care, and their satisfaction directly influences patient outcomes, operational efficiency, and our ability to attract and retain top talent. By investing in the clinician experience—whether through better tools, more efficient workflows, or targeted education—we are not just improving the daily lives of our teams; we are enabling them to spend more time on what they love—caring for patients. In the face of competing priorities, it boils down to this: when clinicians thrive, the entire organization benefits. ” —CMIO “ Culture is a soft metric that is highly consequential. It’s not the kind of thing people can enter in a spreadsheet to prove a monetary ROI, but culture is a massive metric. Our culture has improved because we invested in improving the clinicians’ experience. There are innumerable factors to culture, but we have created a strong presence with our providers. We let them know we are listening to them and making changes. We get in front of the providers every quarter to let them know about major changes that are coming based on the pain points they have reported. I think this matters a lot.”  —Physician and director of clinical informatics Multifaceted Strategies with the EHR at the Heart Drive Successful Efforts to Improve the Clinician Experience To enhance the clinician experience, the 16 interviewed healthcare organizations deployed a multifaceted strategy that includes people, processes, and technology. These organizations focus on various technological areas to improve the clinician experience—and the EHR is at the heart of those strategies. The EHR experience is crucial to clinicians’ experiences, considering the significant amount of time clinicians spend in it. Ultimately, optimizing clinicians’ use of the EHR is essential to improving their experience at your organization. 100% of the interviewed healthcare leaders agree that improving the clinician experience with the EHR is vital. The interviewed organizations focus on three main principles when enhancing their clinicians’ EHR satisfaction: Strengthening the EHR’s technical foundation Enhancing the foundational infrastructure of the EHR is essential to supporting clinicians, who want to focus on caring for patients rather than stalling while waiting to log in to the EHR. Interviewed organizations focus on delivering a seamless login experience for clinicians, maintaining up-to-date equipment, and ensuring robust network and Wi-Fi performance to minimize clinicians’ frustration of waiting on the EHR to respond. Prioritizing professional development through EHR education Interviewed organizations invest in robust EHR onboarding and ongoing training, emphasizing strong workflow education, trainings provided by specialists, and a strong support structure so clinicians feel confident using the EHR and put their best foot forward in front of patients. It is hard for clinicians to be great with patients if they haven’t mastered the EHR. Establishing strong EHR governance structures that foster a culture of clinician engagement Clinicians feel supported and connected when their voices are included in EHR decisions as they help build meaningful changes to streamline documentation and workflows, leading to not only great patient relationships but also great relationships with organizational leadership and IT. Beyond the core EHR program, respondents elevate the clinician EHR experience by leveraging the following technology and resources (includes only technologies mentioned by at least two respondents): Measuring Clinicians’ Experience, Especially with the EHR, Promotes & Accelerates Improvement The 16 interviewed healthcare organizations participate in the Arch Collaborative EHR Experience Survey to: Accelerate the success of their EHR improvement efforts by highlighting the areas specific to their organization that will drive the most impactful improvements Understand where they perform well while receiving clear direction on where to prioritize their efforts to achieve higher clinician EHR satisfaction Build a strong culture of collaboration and trust that leads to better alignment between frontline EHR users and organizational leadership Leverage opportunities to reduce burnout and turnover that might otherwise be missed Enhancing clinician EHR satisfaction does not necessarily require a significant financial investment. As illustrated in the Arch Collaborative report titled Easy Lifts for Quickly Improving EHR Satisfaction , many high-performing organizations have achieved meaningful improvements by strategically reallocating existing resources and implementing small but high-impact interventions. Benefits of Arch Collaborative Membership Data from the Arch Collaborative Executive Scorecard to help organizations secure buy-in and resources from leadership teams to improve EHR satisfaction and highlight financial risks of not properly addressing the EHR experience. Access to a tremendous library of best practices through a robust library of case studies , reports , webinars , and provider and nursing guidebooks . These resources include successfully executed interventions to improve clinicians’ EHR satisfaction and overcome barriers. The opportunity to connect directly with other members to understand how they solved similar challenges. These opportunities include the annual KLAS Arch Collaborative Learning Summit and topic-based quarterly networking sessions. Prioritize your clinicians’ EHR experience by joining the KLAS Arch Collaborative. Find more information here . Executives Explain Why They Measure Their Clinicians’ Experience “The Arch Collaborative EHR Experience Survey helped us peel back the layers; I don’t know that we would have recognized the importance of the ancillary implications to the EMR experience. We were so focused on looking at the EMR data and how we could improve pajama time and those types of things. The survey really opened our eyes into thinking about the holistic experience to satisfaction and not just the EMR experience. That was enlightening. The individual comments were really helpful to understand what themes and where we have the most potential to impact clinician perception. For example, the challenge may be that we haven’t done a great job communicating changes. We have made enhancements, but the perception may be that we are not doing something well. It was helpful to use the data to really understand the pulse of the organization.” —Director of technology adoption and clinical transformation “Participation in the Arch Collaborative has provided us with a wealth of resources to guide our projects. We are not reinventing any wheels; we just modify them for our needs. We have learned so much from KLAS and the assessment of our results and plans as well as from other Collaborative partners, and we have fostered great relationships and the sharing of projects and plans. I can tell we are making an impact when physician or nurse leaders come to me and ask to participate and want to be in the pilot group. Having a central theme and central focus has been an immense benefit to getting our entire organization behind these efforts. Our Arch Collaborative participation has allowed us to emphasize our needs and gain major investments in people and tools from the senior team and our board to support our EHR usability efforts. We would not have attained this money without the help of data from the KLAS Arch Collaborative.” —CMIO What Is the KLAS Arch Collaborative? The Arch Collaborative is a group of healthcare organizations committed to improving the EHR experience through standardized surveys and benchmarking. To date, almost 600,000 healthcare organizations have surveyed their end users and over 380,000 clinicians have responded. Reports such as this one seek to synthesize the feedback from these clinicians into actionable insights that organizations can use to revolutionize patient care by unlocking the potential of the EHR. The data for this report comes from 16 in-depth interviews with healthcare leaders whose organizations are deeply invested in improving their clinicians’ EHR success and have measured clinician satisfaction with the Arch Collaborative EHR Experience survey.

Key Findings: Program Goals Keys to Success Organizational Outcomes What Children’s Hospital of Philadelphia Did How Children’s Hospital of Philadelphia Did It

Key Findings: Program Goals Keys to Success Organizational Outcomes What Mercy Did How Mercy Did It

Key Findings: Program Goals Keys to Success Organizational Outcomes What Children’s Hospital of Philadelphia Did How Children’s Hospital of Philadelphia Did It

Key Findings: Program Goals Keys to Success Organizational Outcomes What Legacy Health Did How Legacy Health Did It

Defining Virtual Training For the purposes of this report, virtual EHR education is defined as the combination of self-directed virtual education (asynchronous) and instructor-led virtual education (akin to an online classroom setting). This report focuses more on self-directed virtual education due to its scalability and high energy in the market. Self-Directed Virtual Education Is Revolutionizing Clinician EHR Training Benefits of Self-Directed Virtual Education For the organization Geographic barriers are removed Familiar methods and technologies are leveraged Training is constantly available Clinicians spend less time on training because it is focused to their specialty/role Variation between trainers is eliminated, which can reduce confusion for clinicians Clinician participation is higher Actionable analytics are generated Education can be broadly scaled with fewer resources (people and money) Content can be more quickly created For the clinician Geographic barriers are removed Familiar methods and technologies are leveraged Training is constantly available (including in clinicians’ moment of need) Clinicians spend less time on training because it is focused to their specialty/role Variation between trainers is eliminated, which can reduce confusion for clinicians Clinicians can self-pace progress based on familiarity with concepts Training can be reaccessed to strengthen understanding Both healthcare organizations and clinicians benefit from self-directed virtual training. Contrary to popular belief, physicians and nurses of all experience levels—from less than a year to over 10 years—agree that self-directed virtual training is useful. Several interviewed organizations report that their clinicians spend fewer hours on self-directed virtual training, enabling them to begin caring for patients more quickly, which is especially helpful in this time when staffing is stretched thin. Healthcare organizations also value self-directed virtual EHR education for the actionable analytics on clinicians’ content usage and progress; these analytics help leaders focus on individual learning needs and maximize the impact of education. Additionally, due to the scalable and resource-light nature of virtual education, EHR trainers no longer have to spend hours teaching in a classroom; rather, they can work with clinicians one-on-one and maintain touchpoints over time, providing an additional layer of education for clinicians who need more support. Virtual EHR Education Has Caught Up with & Now Rivals Traditional Education Methods for Physicians & Nurses In addition to being scalable and requiring fewer resources, both self-directed and instructor-led virtual EHR education have proven to be as effective as the traditional methods of classroom training and departmental meetings, with little to no difference in Net EHR Experience Score † (for either physicians or nurses). Further, self-directed and instructor-led virtual learning often correlate with higher EHR satisfaction than other traditional methods, such as scheduled one-on-one training and rounding. Clinicians often prefer self-directed virtual education in a microlearning format that is short and focused—enabling users to learn information in a manageable way that improves comprehension. eLearning Platforms Can Reduce Time It Takes Trainers to Create Content for Self-Directed Virtual Learning Some organizations report that commercially available eLearning platforms enable faster content creation, minimizing the time trainers spend developing content and allowing them to focus on other training needs. According to Derek Harley, EHR learning and development manager at M Health Fairview , the organization’s instructional designers have saved a significant amount of time by creating content in a commercially available training platform. “In the industry, the average time to develop super engaging simulated content is 66 hours per 17 minutes of eLearning time. At our organization, the instructional designer that developed the nurse efficiency course created 105 minutes of eLearning in 95.5 hours, equaling a time savings of approximately 76% over the industry.” —Derek Harley Read about M Health Fairview’s case study with their eLearning platform as well as other case studies below . Virtual Education Is a Game Changer & Self-Directed Virtual Education Maximizes Training Value Overall, clinicians at healthcare organizations that offer multiple types of EHR education—blending traditional and virtual methods together—report the highest satisfaction. Taking a blended approach to education helps organizations cater to a wider variety of learning preferences and enables organizations to benefit from the virtual options that are less resource intensive. When clinicians participate in only one training type, virtual instructor-led training is correlated with a slightly higher Net EHR Experience Score (NEES). Clinicians who participate in self-directed virtual education report very similar scores as compared to those who participate in other training types. Beyond that, self-directed virtual education is often less expensive, more scalable, and less resource intensive than other types of training. Organizations that blend self-directed virtual education with other approaches often use self-directed virtual education for onboarding and leverage more traditional methods for workflow-specific education. Still, there are many paths to success depending on an organization’s specific needs. Optimizing Virtual EHR Education: Best Practices for Enhanced Effectiveness As healthcare organizations continue to strengthen their virtual EHR education programs, a successful blueprint includes the following four steps: 1. Prioritize clinician convenience Store educational content in a centralized place and provide direct access via the EHR; include content on mobile and desktop platforms Ensure content is easy to find —include user-friendly filters and a powerful search tool, and configure the system to display only courses relevant to the clinician’s role/specialty Design a clear education path; ensure tip sheets, videos, and courses are well organized and include reliable, up-to-date information Create concise courses (15–60 minutes each) and microlearning modules (3–5 minutes each); for courses longer than 15 minutes, add a description of the learning goals 2. Build with clinicians in mind Create a video of a senior leader introducing the virtual EHR education program  and promoting its benefits (e.g., centralized resources, 24/7 access, etc.); use real examples of positive outcomes Design content that engages learners —maintain consistent branding and leverage multiple approaches (e.g., videos, tip sheets, community discussions, hands-on learning, gamification, etc.) Design courses specific to roles and specialties so that clinicians don’t have to sift through irrelevant content; emphasize this targeted content as an advantage Give clinicians protected time to participate in virtual EHR education Explain the “why” behind actions in the EHR Include some repetition over time to solidify concepts “High-quality training in our learning management system can be great as long as it is geared toward my specialty. For example, it is useful to have med-surg updates, but I do not want to be assigned to mother-baby or NICU training because those areas are not applicable to my job.” —Nurse 3. Create a strategy for clinician engagement Direct clinicians first to the centralized learning repository so that they can adapt to a self-service mentality Ensure learners have access to reliable equipment Have clinician peers promote the benefits of virtual EHR education Implement a teaching element for learning clinicians to promote better retention Establish a variety of ways for clinicians to ask questions and receive support and guidance Consider paying clinicians to engage in virtual EHR education (for more information, watch this presentation from Inova Health System) 4. Plan for long-term success Ensure leadership is aligned with virtual EHR education strategy and recognizes its value Build in additional help for struggling clinicians Test for learner competency via proficiency tests and EHR user-efficiency data Regularly evaluate and update virtual EHR education content Identify education gaps; review service-desk tickets to understand whether training-related requests have decreased and to uncover additional training opportunities Pair clinicians who have completed virtual EHR education with a peer/informaticist/ superuser to solidify concepts and provide on-the-job training Strengthen Your Virtual EHR Education Foundation for Future Success Measure clinicians’ education satisfaction: No matter where your organization is in your EHR education journey, measuring your current state is a crucial part of the process. Administer short internal surveys to clinicians who have completed their virtual EHR education to get feedback on what went well, where they needed additional help, and what improvement ideas they have. Persistently asking for and incorporating clinician feedback will show care for clinicians’ needs and help improve virtual EHR education. Learning from other organizations and making iterative changes will ensure continued success. Track trends in clinician EHR satisfaction: Measuring and remeasuring your clinicians’ EHR satisfaction via the Arch Collaborative EHR Experience Survey will help your organization identify year-over-year changes in EHR satisfaction, demonstrate the strengths of your virtual EHR education program, and reveal opportunities to further improve the program. Measure specific pieces of your virtual EHR education program via pulse surveys offered through the Arch Collaborative. Monitor the success of trainers and education programs: Leveraging the Arch Collaborative Trainer Quality Benchmark survey will quickly pinpoint key trainer competencies as well as areas for development. Need help getting started? Start with your EHR vendor’s training offering: Leveraging your EHR vendor’s virtual education can be an easy way to begin establishing a virtual EHR education program or to supplement an existing program. Explore third-party vendors and services firms: Find information about vendors and firms that can help you create or further develop a virtual education program in the 2023 EHR Education Vendor & Firms Capabilities report . Or read about how Ozarks Healthcare successfully partnered with Sedona Learning Services to reimagine their onboarding training with online and self-directed education modules. Additionally, the third-party vendors and services firms below are members of the Arch Collaborative and offer platforms and/or services for virtual EHR education. Validated outcomes for several of these vendors are included in the case studies in the next section. 314e Amplifire CSI Companies MedPower Nordic ReMedi Health Solutions Tegria uPerform Virtual EHR Education Success Stories: Best Practices from Leading Organizations Click on link to access full versions of the case studies summarized below A Transformative Training Experience through Adaptive & Role-Based EHR Education Aspirus Health partnered with uPerform to introduce a computer-based learning-on-demand training program. The organization has centralized a wide breadth of learning materials (nearly 600 tip sheets) and resources, and users can quickly and easily access these directly from the EHR. As Aspirus moved to computer-based training, they leveraged curriculum review boards, created and implemented role-based training, and incorporated the “why” behind specific actions in the EHR workflow. Role-specific tip sheets and live simulations reduced the need for live training sessions while enhancing the accessibility of training materials. Organizational Outcomes Fast Lane to Efficiency: How Emplify Health’s Virtual Training Strategy Accelerated Onboarding & Educator Effectiveness Emplify Health (formerly Gundersen Health System) leverages virtual EHR education to ensure training occurs at the right time, in the right place, and for the right person, as this helps decrease the time clinicians spend in training. Virtual EHR training has enabled Emplify Health to overcome geographic constraints, standardize education content, and more efficiently use their resources. The organization has upskilled their trainers by turning them into coaches. These coaches can answer questions, work with providers in a one-on-one setting, help with EHR personalization, and promote further learning through the EHR’s playground environment. Organizational Outcomes Improving EHR Training & Support Through Role-Based Training & a Structured but Flexible Support System Note: This case study has not yet been published and will be available in the near future. Frances Mahon Deaconess Hospital partnered with MedPower to create self-directed virtual education for both their clinical and nonclinical staff members. Realized benefits include accessibility for staff members to complete training at their own pace, scalability of EHR education that is now delivered efficiently in a standardized format, reduced costs for in-person training experiences (since neither learners nor instructors travel), enhanced learner engagement with the interactive microlearning content that caters to various learning preferences, real-time analytics to identify training gaps and provide targeted support, and reduced disruption since self-directed virtual learning enables learners to complete training in smaller increments, minimizing time away from patient care and administrative responsibilities. Organizational Outcomes Comprehensive Initial Training Sets Up Nurses for EHR Satisfaction Hamad Medical Corporation’s (HMC) comprehensive approach to nurse onboarding training helps them ensure that nurses leverage the EHR successfully from the beginning. HMC’s onboarding training pairs web-based training (eLearning modules tailored to specific roles and work locations) with classroom training, mentorship, and competency testing. This approach has resulted in a high percentage of nurses agreeing that the virtual training met their needs, the initial training prepared them to use the EHR, and the training was workflow specific. Organizational Outcomes Partnering to Improve EHR Education & Trust in IT by Enabling Learning & Efficiency M Health Fairview integrated their EHR with uPerform’s learning platform to centralize and simplify access to learning materials and resources. The organization also centralized the processes of contacting live support for real-time assistance and booking additional efficiency training sessions. M Health Fairview’s live support personnel can guide clinicians to existing resources in the learning library to reinforce the concept that these resources are constantly available to clinicians. New hires now engage in asynchronous eLearning before attending virtual instructor-led classes. Organizational Outcomes Optimizing Clinician Training by Leveraging Data & Expertise UTHealth Houston successfully pairs eLearning with other education methods (e.g., at-the-elbow support, department meetings, one-on-one training), relying on Epic Signal data to confirm where EHR tools may be underutilized and matching training to clinicians to fill knowledge gaps. UTHealth Houston utilizes gamification tools like Kahoot! to engage learners, and the organization ensures training is relevant to learners. Based on end-user feedback, the training team centralized more than 800 tip sheets on SharePoint to foster clinician learning with easy and quick access to learning materials. UTHealth Houston has provided growth paths for their training specialists, many of whom are now physician builders, EHR champions, and informaticists. Organizational Outcomes   Transforming Initial EHR Education UW Medicine partnered with Amplifire and implemented virtual EHR education in carefully planned phases. Tegria advised UW Medicine on curriculum mapping, performed a gap analysis, authored content, and helped facilitate user feedback. Additionally, Tegria helped to upskill the organization’s trainers by teaching them to author content in the Amplifire platform. UW Medicine feels that including subject matter experts from the beginning fostered the success of the Amplifire rollout. The organization consistently collects end-user feedback and leans into Amplifire’s analytics to identify improvement opportunities and further optimize their virtual EHR education. Leveraging eLearning for onboarding has reduced the time clinicians spend on onboarding courses, enabling clinicians to be on the floor more quickly. Overall, UW Medicine has reduced nurses’ training time by 75% and physicians’ training time by 50%. Organizational Outcomes Healthcare Organizations & Clinicians Weigh In on the Benefits of Virtual EHR Education Voice of the Organization “A barrier to classroom training is our large footprint. We span multiple states, and we are expanding. We are not going to have a provider drive for hours just to get in a classroom. That is illogical and doesn’t make good use of our resources or our time.” —Corporate IT trainer “As we move from classroom training to online training, we follow the experience in classrooms taught in high school and college. People are coming to us with more of an adaptable learning style and are able to get what they need from the content.” —Director of clinical informatics “The platform enables us to follow up with people who are struggling. We have so much more data that allows us to follow up with individual users, look for themes and trends, and check annual competencies. We can see the big things that people generally struggle with.” —Director of clinical informatics and education “With eLearning, we are moving toward educating clinicians up front and then having touchpoints over time. That was impossible and not scalable with instructor-led training.” —Director of clinical informatics and education “We don’t pull people into classrooms for new employee EHR training. I’m very specific when I say that because we have absolutely no problem whatsoever meeting with people one-on-one for efficiency training, and that gives us a bigger bang for our buck. We do not get a bang for our buck by bringing people into the classroom. The name of the game is efficiency—and speed. We need clinicians taking care of patients as soon as possible. We will remove as many barriers as we can.” —Corporate IT trainer Voice of the Clinician “Self-directed virtual training allowed me to find additional Epic features that were not being utilized, specifically the tap-and-go in the ED STAT narrator. With some work, our team was able to identify barriers to its use and submit tickets to improve access to promote its use for the intended functionality.” —Nurse “Hands-on self-directed virtual training was the best training for me because I was able to work through the steps that are applicable to my role.” —Nurse “I prefer to do virtual self-directed training. I can review whatever I might need to. While I like the direct contact with a person, I don’t remember all they say and then I need to repeat what they said. It is not as efficient as when I’m working with the computer on my own.” —Nurse “I find that the training available through the learning management platform is the most helpful because I can do it on my own schedule and review it if I need a refresher.” —Nurse “I like being able to participate in training on my own schedule and at my learning pace. Group courses are too painfully slow and teach to the lowest common denominator.” —Physician “Self-directed training enables me to learn at my own pace and experience level.” —Physician What Is the KLAS Arch Collaborative?  The Arch Collaborative is a group of healthcare organizations committed to improving the EHR experience through standardized surveys and benchmarking. To date, almost 300 healthcare organizations have surveyed their end users and over 380,000 clinicians have responded. Reports such as this one seek to synthesize the feedback from these clinicians into actionable insights that organizations can use to revolutionize patient care by unlocking the potential of the EHR. The Arch Collaborative has been surveying clinicians about their EHR experience since 2018. To make sure we are reporting the most up-to-date trends, the data charted in this report includes responses only from 2022–2024. Report data comes from three sources: (1) clinician responses to the Arch Collaborative EHR Experience Survey, (2) in-depth interviews with organizations that heavily leverage virtual EHR education, and (3) case studies written in partnership with organizations that receive high marks from clinicians for the helpfulness and effectiveness of their virtual EHR education.