EHR Optimization

Key Findings: Program Goals Keys to Success Organizational Outcomes What Hackensack Meridian Did How Hackensack Meridian Did It What Is the KLAS Arch Collaborative? About Hackensack Meridian Health

In our last report on clinician turnover , the KLAS Arch Collaborative examined the likelihood and cost of turnover and how the EHR experience impacts burnout. This year’s report delves deeper to understand why clinicians are leaving and reveals how healthcare organizations can leverage strong organizational leadership to address their turnover challenges head-on, improve the EHR experience, and break the cycle of costly clinician turnover. THE REALITY: LEADERSHIP IS FAILING CLINICIANS Outside of Personal Considerations, Organizational Leadership Is the Number-One Cause of Clinician Turnover Aside from personal considerations, such as retirement or career advancement, dissatisfaction with organizational leadership is the number-one reason that at-risk clinicians (at the end of this section) plan to leave their organization. Clinicians—especially nurses—don’t feel sufficiently supported in all the responsibilities that have fallen to them due to staffing shortages, including tasks that go beyond the scope of patient care. Amid the current climate of reimbursement concerns and pressures to cut costs, this reason for leaving is perhaps not surprising. However, it is alarming and represents a significant financial risk to healthcare organizations given that the organizational cost of losing a nurse is $52,350 ( 2024 study ), while the cost of losing a physician can be up to $1,000,000 ( 2017 study ). Dissatisfaction with Leadership Often Arises in the Aftermath of a Poor EHR Experience The EHR experience is a significant factor in how positively or negatively clinicians view their leadership, and dissatisfaction with the EHR often manifests in dissatisfaction with leadership. Among at-risk clinicians, those who cite misalignment with leadership as the primary reason for leaving are also the group most dissatisfied with their EHR experience. This is especially true among at-risk physicians, who have an average Net EHR Experience Score of just 7.7 (on a -100 to 100 point scale). When leaders fail to provide a fast, reliable EHR bolstered by strong support and education, clinicians don’t just feel inefficient or burned out—they feel that leadership has failed them, and they begin to make plans to leave. Voice of Clinicians: Why Is Leadership Causing You to Leave Your Current Organization? Nurses “I’m leaving because of a lack of shared values, specifically with upper leadership; we as an organization do not enforce and stand by the promises and values we promote. ” “I’m leaving because I am burned out from a chaotic work environment and because of the lack of shared values from leadership. There has been inconsistent, poor, and sometimes even a complete lack of communication from leadership. I love my job, the nurses, and the interdisciplinary relationships with other medical professionals; however, leadership is what has driven me away.” “I am seeking opportunities that offer more competitive overall compensation that reflects the education, skills and experience I have acquired. Despite earning an advanced degree, desired advancement opportunities do not exist within my current role or organization. The current workplace culture does not align with my values. My workload continues to increase without leadership discussing the potential impact on my current workflow , which creates unclear expectations.” Physicians “The current leadership has no interest in our input and only wants control of how we practice , our hours, and every other aspect of our job through the EHR. I feel like we are being watched and documented and like we are just hamsters on a wheel for this organization.” “The leadership does not care about clinicians anymore; for them, it is all about the bottom dollar. Workloads constantly increase across multiple hospitals, but the pay never does, which is why everyone is leaving. This hospital system no longer meets any of their goals and certainly does not put the patient or the clinician first. The fact that our CEO wants this to be a hospitality service shows how far off the goals are. We are drowning constantly and begging for help.”  “I have lost confidence in my organization’s administration. What was once a culture of speaking up and influencing change has shifted into one of silence and suppression. After more than a decade here, I can no longer recognize the organization I once believed in. Administrators should be supporting us, not abusing or dismissing us.” “I am leaving because this organization no longer aligns with my values. Despite my dedication and expertise, I feel unrecognized ; my skills are unique, yet administration has chosen to hire locums at three times my salary.” Defining “At-Risk” Clinicians KLAS asked clinicians how likely they are to leave their organization in the next two years. Clinicians could choose from the following options: very unlikely, unlikely, neither unlikely nor likely , likely , or very likely . Arch Collaborative data shows that clinicians in the latter three groups (bolded) are the most likely to leave their organization. They are referred to collectively as “at risk.” Note that since KLAS’ last report on clinician turnover, the number of at-risk clinicians has remained stagnant. THE IMPERATIVE: LEADERS MUST IMPROVE THE EHR EXPERIENCE EHR Experience Is Strongly Linked with Clinician Turnover; Healthcare Leaders Must Invest in EHR Experience to Better Align with Clinicians—but Urgency Is Needed Rebuilding bridges with clinicians and stemming the tide of turnover is critical, yet it can seem a daunting undertaking, especially when attempted through broad initiatives such as improving organizational culture (a slow process) or increasing staff reimbursement (an option that may be financially unfeasible). The good news is that investing in the EHR experience is a concrete method that healthcare leaders can—and must—use to align with clinicians , which naturally leads to a better organizational culture. However, time is of the essence, as Arch Collaborative data shows that at-risk clinicians today are even more dissatisfied with the EHR than those who have already left. At the time of their Arch Collaborative measurement, at-risk physicians who have since left their organization had an average NEES 10.2 points lower than physicians who reported plans to stay; for nurses, the NEES is 5.1 points lower (see “Past Attrition” chart below). Today, the disparity in EHR satisfaction between clinicians who plan to stay and those who plan to leave the healthcare industry is even greater; the disparity for physicians is 47.4 points (see “Future Outlook” chart below). Given the predicted workforce shortages, this trend is distressing both for individual healthcare organizations working to retain clinical talent and for the healthcare industry as a whole. Past Attrition Future Outlook Voice of Clinicians: What Do Clinicians Want from Leadership When It Comes to the EHR? Clinicians with a poor EHR experience want leaders to have a patient-first mentality and to value clinicians’ perspectives on the EHR’s impact across departments. They want to be key players in their organization’s strategy to improve clinical workflows and optimize EHR functionality but currently feel dismissed, underappreciated, or left out of decision-making. They feel that the visibility that EHR data provides to leadership is sometimes weaponized, and some clinicians report being micromanaged by leaders who value the bottom line above clinician and patient experiences. “ Fix the EHR, now. My job is tied to patient satisfaction. Why isn’t the pay of the head of IT tied to provider satisfaction? That might fix the EHR problem.” —Physician “ The EHR should be a collaborative effort between IT and providers. At best, IT is very protective of their privileges and little fiefdom. Sometimes, it seems as if they think providers are here to make their work smooth and efficient. IT management, as opposed to the trainers and helpers, really doesn’t understand our needs or even seem interested in what they are. ” —Advanced practice provider “I like my job and organization, but I will likely leave if the organization continues to make top-down decisions, not include direct service staff in decision-making, and not improve communication about decisions before they are implemented. The EHR training we got was incredibly insufficient, and leadership hasn’t taken any accountability for that, nor is my voice taken seriously when I ask for support to understand an EHR function or share an issue related to the EHR.” —Allied health professional Note: While this report focuses on physicians and nurses, the same trends are seen among allied health professionals and APPs. Organizations That Have Focused on the EHR Experience as a Retention Strategy Are Seeing ROIs Several organizations that actively measure the clinician experience via the Arch Collaborative are starting to lean into EHR measurement, benchmarking, and improvement as a retention strategy. KLAS shares the ROIs that organizations have seen in this panel and this report . In the former, four panelists touch on outcomes such as workforce stability, operational efficiency, positive organizational reputation and recognition, and improved staff morale and trust. The panelists note that the ROIs aren’t always purely financial—in particular, mission alignment and clinician well-being are critical but nonmonetary ROIs. Meanwhile, the report examines how prioritizing the clinician experience drives measurable ROI for organizations; the following comments are from the report’s data set. “We recognized that we needed to put more resources into clinical informatics support to improve the clinician experience. Post-pandemic, that focus on clinician wellness continues. If we want to provide the best possible patient care, we need well-trained and motivated clinical staff. In order to recruit and retain the best clinicians, we need to have an environment in which they are properly supported in providing care. This includes a commitment to making the EHR as efficient and effective for them as possible. ” —CMIO “We recognize the importance of addressing provider wellness and understanding the drivers behind burnout. About two to three years ago, we initiated intentional conversations around this topic, and we have been fortunate to have senior leaders who are committed to dedicating resources to this effort, despite budget constraints. Aligning clinician experience with organizational goals has been crucial in making the case for investment, especially in the context of recruitment and retention. ” —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.” —Physician leader and director of clinical informatics Clinicians Who Changed Their Mind About Leaving Say EHR Experience Has Improved Many at-risk clinicians are starting to feel the positive effects of their healthcare organizations’ efforts to improve the EHR. Over the last two years, 288 clinicians who reported plans to leave when initially surveyed in 2023 now say they plan to stay. The majority of these clinicians point to improved EHR technology and workflows, mentioning changes such as the implementation of macros, quick text, and ambient speech technology; an improved login experience; and enhanced clinical communication tools. Importantly, the success of these advancements is not tied to functionality alone; organizations that pair technology changes with ongoing education and effective support help clinicians understand how new tools fit into their broader workflows, making adoption smoother, quicker, and more sustainable. This aligns with findings from KLAS’ previous clinician turnover report , which shows that reduced burnout, enhanced EHR education, and enhanced IT support were the top factors that altered the future plans of at-risk clinicians. Together, these areas not only streamline daily tasks but also have meaningful ripple effects on clinician satisfaction and retention. One CMIO expressed, “We think there will be a doctor shortage, which will be a huge problem, so I pitched to our executive team that we needed to use technology to make our organization the place where people would want to come and work. That was how we started looking at ambient dictation.” 73% of clinicians who changed their mind and now plan to stay with their organization cite EHR improvements THE NEXT STEP: IMPLEMENT STRATEGIES FOR EHR EXCELLENCE To make their organization a place where clinicians love to work, healthcare leaders must work to improve the EHR experience. However, KLAS recognizes that leaders are being asked to do more with less. To support them in this effort, KLAS offers the following resources that can help leaders assess their organization’s current state and identify practical starting points for improvement. KLAS Arch Collaborative Resources Each year, the KLAS Arch Collaborative identifies EHR best practices validated by healthcare organizations and compiles them into guidebooks intended to be a one-stop shop for organizations looking to improve. The physician and nurse guidebooks outline how organizations can be successful with their EHR infrastructure, EHR education, EHR personalization, and EHR governance. KLAS Arch Collaborative Physician Guidebook 2025 KLAS Arch Collaborative Nursing Guidebook 2024 KLAS Arch Collaborative Award Winners  The following healthcare organizations have demonstrated great leadership and an ability to deliver an exceptional EHR experience. We hope their stories inspire your organization to prioritize clinicians by supporting their use of the EHR (click the logos for more information). EHR Experience Pinnacle Award Celebrates outstanding achievement and is awarded to member organizations with a NEES of 75.0 or greater for nurses, or 60.0 or greater for physicians EHR Experience Breakthrough Recognition Honors significant improvement and is given to member organizations whose NEES (for physicians, nurses, or both) has increased by at least 15 points between measurements Another Valuable Resource for Improving the Clinician Experience & Retention Addressing Health Worker Burnout:  The US Surgeon General’s Advisory on Building a Thriving Health Workforce “We have a moral obligation to address the long-standing crisis of burnout, exhaustion, and moral distress across the health community. We owe health workers far more than our gratitude. We owe them an urgent debt of action. This Surgeon General’s Advisory helps show what’s needed, and how we can do it. The stakes are high. If we fail to act, we will place our nation’s health at increasing risk. ” Vivek H. Murthy, MD, MBA Vice Admiral, US Public Health Service  Surgeon General of the United States 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 650,000 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 UTHealth Houston Did How UTHealth Houston Did It What Is the KLAS Arch Collaborative?

Key Findings: Program Goals Keys to Success Organizational Outcomes What UC San Diego Health & Amplifire Did How UC San Diego Health & Amplifire Did It What Is the KLAS Arch Collaborative?

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

Key Findings: Program Goals Keys to Success Organizational Outcomes What Seattle Children’s Did How Seattle Children’s Did It What Is the KLAS Arch Collaborative? About Seattle Children’s

Using a track-and-field analogy, this report clarifies how to leverage your EHR Experience Level to focus on the areas that will be most impactful for your organization. It also explores how the EHR House of Success correlates with this framework to guide leaders on how to achieve their set goals. Voices of Healthcare Organizations “We already get the data review report, and it highlights the things we need to work on. It just feels like generic information, and we want more information and direction on the route we should take to address and improve the gaps.” —Healthcare executive “ It can be hard to make a decision on what to do first , and sometimes getting a few of those easy wins launches us into a mindset that we can do some of these things.” —Healthcare executive Setting Your Starting Line The first step to improving EHR satisfaction is understanding your starting point. Your organization’s Arch Collaborative measurements—including your overall Net EHR Experience Score (NEES), † the 11 equally weighted metrics, and benchmarking percentiles—let you know where your clinicians’ satisfaction stands today. The recently introduced EHR Experience Levels framework builds on these metrics, ultimately providing a clear starting point for organizations looking to improve. For a full explanation of the levels, see the recent KLAS Arch Collaborative Executive Scorecard report. † Each individual clinician’s responses to the Arch Collaborative EHR Experience Survey regarding core factors such as the EHR’s efficiency, functionality, impact on care, and so on are aggregated into an overall Net EHR Experience Score (NEES), which represents a snapshot of the clinician’s overall satisfaction with the EHR environment at their organization. A NEES can range from -100 (all negative feedback) to 100 (all positive feedback). Setting Targets for Progress Visualizing the Levels: From Hurdles to Vaults Think of this journey like a track-and-field competition: At any given time, many events are taking place, each demanding something different of the athlete—precise technique, targeted training, and sometimes collaboration or specialized equipment. Through it all, athletes work toward their own goals and personal records, whether measured in speed, distance, or height. Just as a coach surveys the field to decide how best to train their athletes for success, a healthcare organization seeking to improve clinician EHR satisfaction can take a similar approach. Without first assessing your current position, it can be overwhelming to look at the data and know where to begin or how much improvement is needed. Standard benchmarks can show where you stand among peers, but each organization faces different hurdles and heights that they must clear. The EHR Experience Levels provide additional clarity by showing you how your own metrics compare to those at the next level—revealing where you should focus your energy and how far you need to stretch to progress. By examining where the largest gaps in satisfaction exist, you can pinpoint the metrics that will most help your organization advance and make the greatest impact on clinician satisfaction. To illustrate how metrics tend to vary in impact and what effort is required to improve them, we have grouped them into three categories—hurdles, relay races, and pole vaults. Framework for EHR Progress: A Track-and-Field Comparison When running hurdles, you cannot quickly finish the race unless you cleanly clear them. They are essential barriers that no organization can skip when seeking to improve the EHR experience. These metrics often show the largest gaps between below-average (Level 1) and exceptional (Level 6) performers, so focusing here can have the greatest impact on overall satisfaction. Success in relay races requires teamwork and timing, hinging on both individual performance and seamless handoffs. Efforts here may require preparation and collaboration across multiple teams and infrastructure (e.g., servers, badges, Wi-Fi) but are achievable with the right coordination and focus. The pole vault is a technically demanding event, requiring a combination of speed, strength, agility, timing, and balance. These are challenges the entire industry is still working to solve. The pole vault isn’t impossible to clear, but success requires broad external collaboration and remains a pain point even for Level 6 organizations. Some organizations may find value in cross-training for multiple events—tackling several EHR initiatives at once—while others may choose to focus their energy on a single priority. In either case, the EHR Experience Levels help clarify where those efforts will have the greatest impact. The Metrics That Matter Most for Physicians & Nurses Across Arch measurements, three NEES metrics consistently emerge as the hurdles, relay races, and pole vaults that organizations should work on to make meaningful EHR improvement. For both physicians and nurses, efficiency is often the first hurdle to clear, and external integration is the pole vault that remains most difficult to solve. The relay race differs between clinical roles—for physicians, it is response time, and for nurses, it is patient-centered care. Key Metrics for EHR Improvement Hurdle: Efficiency Agreement that the EHR enables efficiency is the lowest NEES metric for physicians—and the first hurdle organizations need to overcome. Only 26% at Levels 1–3 agree their EHR enables efficiency, compared to 70% at Level 6, a 44-point gap. Closing this gap (often done through training and workflow optimization) has one of the greatest impacts on overall EHR satisfaction. A health system cannot move from Level 1 to Level 6 unless their physicians and nurses believe their EHR enables efficiency. Relay race: Response time & patient-centered care Physicians: In the relay race for physicians—improving system response time—everything depends on a strong start; a false start or dropped baton can derail any other efforts. Likewise, no amount of training or workflow optimization can compensate for a slow login for users. Physicians can identify where speed is lagging but need IT teams and vendors to join the race to diagnose root causes and make workflow/technical upgrades (e.g., reducing load times; investing in servers, Wi-Fi, or badge logins). Because EHR vendors play a significant role in system response time, adhering to their best practices (e.g., hardware inventory schedule) and requirements is crucial. Nurses: Patient-centered care is the relay race for nurses; their agreement that the EHR enables patient-centered care rises from 49% at Levels 1–3 to 87% at Level 6—a 38-point gain, including a 21-point leap between Levels 3 and 4. Cross-team collaboration is vital to improve nurses’ perception. Improved training, strong governance, and reduced duplicative charting help nurses connect documentation to patient outcomes rather than just reporting. Pole vault: External integration External integration remains the most difficult perception to change. Even at Level 6, only 63% of physicians and 67% of nurses agree their EHR provides seamless access to outside information. Training and governance can improve perceptions of integration, but true interoperability requires technical proficiency and cross-entity alignment among vendors, governments, and health systems , making this one of the hardest challenges to solve. Taking the Next Steps Few athletes begin with the pole vault, and few healthcare organizations start at Level 6. Progress comes from identifying the metrics that will make the most impact to your organization through your EHR Experience Level and then making consistent, intentional efforts to improve those areas. Luckily, no organization has to make this journey alone. While this report focuses on goal setting, the Arch Collaborative offers a range of resources with both strategic guidance and practical tools to help leaders tackle the metrics they have decided on and reach new EHR Experience Levels. Some of these resources include: Guidebooks Physician Guidebook 2025 Nursing Guidebook 2024 Learning tracks Success Pathways EHR education: onboarding and ongoing Interoperability Governance & support Award winners KLAS Arch Collaborative Award winners Pinnacle Award Winners Case Studies Sustaining Progress: Leadership & the EHR House of Success While an organization works to improve their highest-impact metrics, the pillars of the EHR House of Success —education, governance, and personalization—remain essential. The metrics in the previous section show an organization where to focus; the EHR House of Success guides leaders on how to achieve those goals, whether through technical upgrades, workflow optimization, or cultural alignment. Healthcare leaders play the role of coach on this journey. Their job is to provide both strategy and support—setting clear targets, ensuring accountability, and reinforcing the pillars of the EHR House of Success. When leaders consistently emphasize education, governance, and personalization, they create conditions where their clinicians can thrive. The following charts illustrate how these pillars correlate with the EHR Experience Levels. As organizations progress from Level 1 to Level 6, consistent gains can be seen in each area, reinforcing that these principles—and the leaders who sustain them—are critical to sustaining improvement. The Pace of Improvement Varies Improvement looks different for every organization, and both steady and rapid progress can lead to meaningful results. At the 2025 Arch Collaborative Learning Summit, Franciscan Health shared how intentional, incremental work over multiple years led to lasting gains in satisfaction, climbing three EHR Experience Levels and representing one of the most substantial improvements observed in the Collaborative. With a different approach, UTHealth Houston showed that focused initiatives with nurses can drive measurable improvements, rapidly elevating their NEES and EHR Experience Level over just two years. Together, these examples highlight that there is no single timeline for success. What matters most is committing to the work—whether through steady refinement or rapid, focused change—and using the Levels and House of Success as guides along the way. Practice & Perfection: Steps to Take Examples of Setting Effective Goals with EHR Experience Levels  To tangibly illustrate the principles in this report, the following exercises demonstrate the potential benefits of using your EHR Experience Level in conjunction with standard benchmarking when setting goals. Better Care Health is a real Arch Collaborative member organization that has been anonymized for use in data visualizations. This proxy organization serves as an example to illustrate how organizations can interpret and act on their EHR satisfaction data. Better Care Health Physicians—NEES 42.5, Level 4 At first glance, Better Care Health’s benchmarking results for physicians suggest that “enables quality care” should be the primary focus for improvement, as it is the only metric below the upper quartiles. While that insight is valuable, the organization’s EHR Experience Level provides a clearer picture of where improvement will have the most impact. When comparing their current Level 4 results to the average Level 5 organization, quality care remains an area of opportunity (9% gap), but the largest differences appear in external integration (17%) and patient-centered care (12%). Continued efforts in areas like quality care will support progress toward Level 6, but focusing on external integration and patient-centered care will drive the most significant gains. Better Care Health Nurses—NEES 67.2, Level 5 Better Care Health can perform a similar exercise for their nurses, who report higher overall satisfaction than the physicians. The nurses benchmark in the upper quartiles across all metrics, making it less clear at first where the organization should focus on improvement. Comparing their Level 5 results to the average Level 6 organization reveals the largest opportunities: efficiency (16% gap), patient-centered care (13% gap), and quality care (12% gap). While maintaining high-performing metrics such as reliability—already on par with Level 6—will support ongoing progress, concentrating on these three areas is most likely to accelerate the nurses’ advancement to Level 6. About This Report The Arch Collaborative is a group of healthcare organizations committed to improving the EHR experience through standardized surveys and benchmarking. To date, more than 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.

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

Key Findings: Program Goals Keys to Success Organizational Outcomes What Parkview Health Did How Parkview Health Did It What Is the KLAS Arch Collaborative? About Parkview Health

Key Findings: Program Goals Keys to Success Organizational Outcomes What OU Health Did How OU Health Did It What Is the KLAS Arch Collaborative? About OU Health

In July 2025, KLAS hosted the eighth annual Arch Collaborative Learning Summit to support this community, inviting 311 leaders from 102 organizations to be vulnerable and share expertise and best practices. To help other organizations on their journey to EHR improvement, this overview provides summaries of the discussions and sessions that occurred during the summit (to view full presentations, click here ). Save the Date: Arch Collaborative Learning Summit 2026 KLAS is excited to announce that the next Arch Collaborative Learning Summit will be July 28–30, 2026, in Salt Lake City, Utah . This event is for Arch Collaborative members only. Please reach out to your KLAS client success manager for more information on the summit and how to register for the event. Arch Collaborative Awards During the summit, KLAS was able to celebrate the 2025 Arch Collaborative Award winners , who are listed below. For more information on how to qualify for an EHR Experience Pinnacle Award or Breakthrough Recognition, click here . EHR Experience Pinnacle Award Winners The EHR Experience Pinnacle Award is given to Arch Collaborative members who have attained the highest Net EHR Experience Scores (NEES) † for nurses or physicians of all Arch Collaborative organizations. KLAS congratulates the 2025 award winners. † Each individual clinician’s responses to the Arch Collaborative EHR Experience Survey regarding core factors such as the EHR’s efficiency, functionality, impact on care, and so on are aggregated into an overall Net EHR Experience Score (NEES), which represents a snapshot of the clinician’s overall satisfaction with the EHR environment at their organization. A NEES can range from -100 (all negative feedback) to 100 (all positive feedback). Nurses Organizations qualified for a Nurse award by achieving a NEES of 75.0 or higher Physicians Organizations qualified for a Physician award by achieving a NEES of 60.0 or higher EHR Experience Breakthrough Recognition Winners This recognition is given to Arch Collaborative members who have improved their NEES by 15 points or more between measurements. Congratulations to the following organizations: Main Stage Summit Presentations & Panels Click on the headers to access recordings of the presentations and panels Summit Welcome Summary: There is an urgent need for the healthcare industry to accelerate change for clinicians: While Arch Collaborative data shows that self-reported burnout rates have decreased for both physicians and nurses, many clinicians still report levels of burnout. Among these clinicians, 30% of nurses and 32% of physicians cite staffing shortages as a contributor. If the clinician experience does not continue to improve, current staffing shortages will worsen, which will in turn worsen burnout. Based on projections from McKinsey , the US may face a critical shortage of 200,000–450,000 nurses and 38,000–120,000 physicians by 2034. The Arch Collaborative EHR Experience Levels and Executive Scorecard can help organizations drive change: The Arch Collaborative offers powerful benchmarking and insights, but sometimes translating those insights into action can feel overwhelming. The following offerings can help organizations as they seek to improve the clinician EHR experience. EHR Experience Levels: The Arch Collaborative has seen many organizations make significant improvements to the EHR experience over time. However, actually making improvements can seem daunting, and many organizations don’t know where to start. The new EHR Experience Levels provide a simpler look at Arch Collaborative data, helping organizations better understand where they stand today. Executive Scorecard: The Executive Scorecard works in tandem with the EHR Experience Levels, providing an overview of clinicians’ current experiences and breaking down information into four key areas—net EHR experience, EHR infrastructure, EHR education, and EHR support. The scorecard also highlights financial risk caused by EHR-related burnout and provides actionable insights to inform strategies for improvement. Looking Forward with Artificial Intelligence Summary: Ambient speech is propelling AI into the clinical workflow: Over the past 18 months, ambient speech technology has rapidly expanded and positively impacted clinician wellness, documentation efficiency, and patient interactions. Due to these early positive outcomes, many organizations are actively working to expand ambient speech pilots and establish enterprise adoption. (For more information on early outcomes being achieved, see KLAS’ Ambient Speech Outcomes 2025 report .) How should organizations prepare clinicians for an AI-driven future? While most clinicians report that ambient speech and other AI tools are intuitive, summit attendees emphasized that long-term AI success will hinge on clinicians’ ability to critically evaluate and effectively leverage AI-generated content during care delivery. Now is a critical time for organizations to (1) establish a deliberate AI strategy and (2) build a foundation of AI literacy and trust among clinicians. Key focus areas include: Baseline AI literacy: All clinicians, regardless of specialty or role, should have a foundational understanding of AI. Training should use clear, accessible language about AI’s strengths and limitations and address data quality, prompt creation, hallucination risks, and AI’s ability to support (but not replace) clinical judgment. Consistent change management: Carefully consider the mindset and workflow changes that accompany AI adoption. Maintain transparency regarding expectations, goals, and progress. Focus on communicating benefits to clinicians and patients and celebrate wins. Engage non-IT clinician champions. Understand that different individuals will require different approaches. Real-world training: Offer role-based training within clinical workflows, and emphasize the transparency and explainability of AI output and how to personalize it to clinician needs. Ongoing training and support resources should be available to clinicians. Governance that involves clinicians: Create cross-functional AI governance structures that include clinical, IT, and legal/privacy teams. These structures will oversee selection of AI tools based on organization standards, data usage, appropriate clinical use, and ongoing evaluations. Feedback channels: Ensure clinicians have an accessible structure to flag issues and suggest improvements. Health systems should close the loop and provide transparency regarding the performance of AI tools. Where will AI move the needle next for clinicians? Most healthcare organizations are still early in their AI journey, and many summit attendees expressed optimism that AI solutions will quickly evolve in the coming months and years and help drive a better clinician experience. Near-term opportunities include: Auto-generated orders and coding (via ambient speech) to streamline downstream workflows. Reduced nursing documentation burden via AI-powered end-of-shift summaries, handoff notes, care plans, and flowsheet optimization. Consolidation and summarization of patient records (especially from outside organizations) to reduce manual review time and improve clinical accuracy. Generated drafts for patient and care team messages to reduce the administrative burden and enhance clarity/empathy of communications. Real-time training and support via AI chatbots and assistants. Predictive analytics that forecast clinical risks and operational needs to support proactive planning. ROI of Clinician Experience Summary: What factors are driving technology investments? Internal champions: Initiatives often begin from within—especially from CMIOs who are frustrated with EHR usability. Competitive advantage: Systems see their focus on the clinician experience as a recruitment differentiator. Implementation pains: Large-scale rollouts can expose gaps in clinician support. Transparency & evidence: Arch Collaborative benchmarks can validate concerns and identify areas for focused improvement efforts. How can organizations secure executive support and budget? Tailor messages to executive priorities: CEOs are often persuaded by performance improvements, and CFOs respond to potential reductions in denials and improvements to documentation and risk mitigation. Access grants: Grants can be leveraged to pilot support roles and secure future funding. Measure with the Arch Collaborative: Having the external validation from Arch Collaborative data can support board-level conversations. How do organizations demonstrate ROI? Define ROI metrics early: Before implementation, be sure to define ROI metrics so that stakeholder expectations are aligned. Look for key outcomes: These include workforce stability, operational efficiency, reputation and recognition, and staff morale and trust. Remember that ROI isn’t purely financial—mission alignment and clinician well-being are critical but non-monetary ROI factors. For more insights, see The ROI for Improving Your Clinicians’ Experience 2025 . Navigating Today’s Challenges to Accelerate Tomorrow’s Innovation Summary: This session provided a candid look at how healthcare organizations, vendors/firms, and payer organizations feel about today’s challenges—from regulatory and funding shifts to operational pressures—and how leading organizations are responding to these challenges. Reimbursement fears aren’t freezing budgets but redrawing them: Reimbursement alignment is influencing overall strategic decision-making more than ever. Most organizations aren’t anticipating IT budget cuts. Instead, they are shifting spending to vendor partnerships and tools that can provide fast, measurable ROI. Budgeting prioritizes resilience and steady growth over big bets. Value-based alignment is evolving into true revenue strategy: Organizations are rethinking payer partnerships, MA growth, and contract performance. Smaller healthcare organizations are reacting like large health systems but lack large-system resources: Many underresourced organizations are trimming their capital spending and adjusting staffing; however, this leaves them with limited teams, sparse analytics, and no margin for error. Policy shifts are no longer theoretical and are driving hard choices: Payment reforms are triggering reconfigurations. Some organizations are scaling back services; others are expanding high-reimbursement lines. These survival strategies have major implications for patients’ access to care. Pilots are everywhere; few organizations know how to scale: Amid staffing cuts, organizations are betting on AI and digital tools to ease the administrative burden. However, most remain in the pilot phase and lack needed funding, standards, or readiness to scale. Franciscan Alliance Keynote Address Summary: Over the course of their engagement with the Arch Collaborative, Franciscan Alliance has improved from a NEES of 49.5 to 70.3 (on a -100 to 100 point scale)—and for physicians specifically, from a NEES of 32.2 to 71.3. Clinician participation in the health system’s annual survey has more than tripled since their initial survey thanks to ease of access and incentives. Franciscan’s trek has occurred over several years and been driven primarily by clinical and physician informaticists. Changes and interventions have been a combination of build and educational changes, along with better marketing to coworkers. Topic-Based Presentations Click on the headers to access recordings of the presentations and panels AI in Healthcare From Pilot to Enterprise: How Cleveland Clinic Selected and Scaled an Epic-Integrated Ambient AI Platform Summary: Cleveland Clinic rigorously evaluated five ambient speech vendors before selecting and scaling a solution enterprise wide and embedding it in Epic. In this session, clinical leaders from Cleveland Clinic outlined their selection rubric, success metrics, monitoring methods, and operational playbook. They also shared the impact of ambient AI on clinician efficiency and satisfaction, documentation quality, and revenue. Implementation of an Ambient AI Solution in an Academic Medical Center Summary: UVA Health is an integrated health system with a world-class academic medical center, three community hospitals, a specialty rehabilitation hospital, and a network of primary and specialty care clinics throughout Virginia. In response to ongoing concerns with the provider documentation burden, UVA Health embarked on a rapid implementation of Microsoft’s DAX Copilot ambient AI solution. Following a 10-provider pilot, UVA deployed the solution to over 600 primary and specialty care providers over a five-month period. This presentation focuses on key project decisions and early outcomes derived from qualitative and quantitative analysis. From Implementation to Integration—Strategies for Clinician Engagement and Widespread Conversational AI Adoption in Healthcare Summary: Conversational AI tools are transforming the clinician experience within EHR systems. During this session, Dr. Kush Gaur and Dr. Travis Bias explored the complex interplay between technological advancements and their effective adoption in clinical settings. Further, the leaders shared how Sutter Health’s informatics teams, in collaboration with Solventum’s experts, are pioneering a more efficient and user-friendly EHR environment that significantly enhances the clinician experience. An Ambient Conversation: University of Iowa Health Care and Nabla’s Approach Summary: As the EHR has evolved, provider burden has generally increased. However, the University of Iowa Health Care (UIHC) saw a notable increase in their NEES between 2023 and 2025, increasing from 54.2 to 65.1 (on a -100 to 100 point scale). The adoption of ambient AI via Nabla has been identified as one of the leading contributors to this improvement, with documented higher levels of user satisfaction for several EHR experience metrics. This session explores how Nabla’s ambient AI technology helped the UIHC improve EHR satisfaction and reduce burnout among clinicians. Ambient AI Adoption at One Year in a Rural Academic Health Network Summary: The University of Vermont Health Network evaluated a pilot study of two ambient AI vendors and later selected Abridge as their go-forward partner. After a rapid rollout within primary care over the summer of 2024, the technology was rolled out in waves to understand and maximize specialty adoption and usage rates. The initial pilot cohort of 50 primary care providers was followed for one year via a survey, which showed a sustained reduction in burnout and an improvement in professional fulfillment. Two smaller studies demonstrated non-inferior note quality and positive patient feedback on note quality. An area of continued exploration includes learners and the impact this technology will have on their competence, confidence, and capacity for learning. The Role of AI in Advancing Physician Well-Being Summary: AI is rapidly transforming healthcare and has the potential to alleviate the administrative burden, reduce cognitive overload, and enhance clinical decision-making. How can these advancements be harnessed to support, rather than strain, the well-being of physicians? This session explores the evolving role of AI in addressing key drivers of physician burnout and promoting sustainable, satisfying clinical practice. Additionally, it shares insights into designing, implementing, and advocating for AI solutions that prioritize physician needs, elevate professional satisfaction, and build a more resilient healthcare workforce. EHR Education The Provider Efficiency Program—A Multimodal, Multidisciplinary Strategy for Optimizing EHR Usability Summary: LifeBridge Health’s informatics teams used data from both the Arch Collaborative EHR Experience Survey and the Oracle Health Lights On Network performance metrics to design a multimodal, multidisciplinary Provider Efficiency Program (PEP). Incorporating direct observations during patient care with personalized training, PEP targeted optimized workflows and effective use of existing tools. Significant qualitative and quantitative improvements have been sustained for all participants, and the program has been adapted based on lessons learned. Enhancing Provider EHR Satisfaction Through Targeted, Engaging Training Summary: At a time when provider burnout is real, Parkview Health’s approach to EHR training is anything but business as usual. They have embraced a model rooted in personalization, active learning, and continuous support because one-off training doesn’t cut it anymore. This session shows how signal-driven coaching, note-bloat–busting documentation sessions, interactive escape room challenges, and even music and humor have helped providers engage, retain, and thrive. Empowering Clinicians: Navigating EHR Changes and Upgrades with Confidence at M Health Fairview Summary: With the flurry and frequency of technology upgrades and changes, many health systems struggle to deliver high-quality education programs that support clinicians using the technology. However, when done well, self-directed training has proven to be a scalable solution that can help standardize and even improve the effective delivery of EHR training, enabling clinician proficiency and satisfaction. M Health Fairview, a pioneer in virtual learning, shared the benefits they have witnessed by using uPerform’s self-directed learning, including expedited onboarding, smooth go-lives and upgrades, digital at-the-elbow support, effective communication, and increased provider EHR satisfaction. The Human Side of the EHR: Training, Tools, and Trust in Rural Healthcare Summary: During this presentation, leaders from Frances Mahon Deaconess Hospital discussed the journey their organization took to vastly improve their clinician satisfaction, starting with a NEES of 14.0 and increasing to 51.0 in just three years. Part of this journey involved better strategizing their initial onboarding education and ongoing education, which is an important factor in maintaining clinical efficiency, compliance, and provider engagement within a rural healthcare setting. This session helps identify key strategies for tailoring the EHR to the unique workflows and resource limitations of small rural healthcare organizations and also examines the relationship between EHR usability and end-user satisfaction. From Off-The-Rack to Custom Fit: Transforming Physician Training with Amplifire Summary: UC San Diego Health (UCSD) onboards approximately 1,000 new clinicians each year, and each must complete mandatory Epic training within two weeks of their start date. Due to limited staff and a lack of personalization for training, UCSD partnered with Amplifire to implement a high-quality, customized Epic training solution that could meet individual needs and scale efficiently. This presentation examines the data collected from UCSD’s Amplifire-based eLearning initiatives, providing a detailed look at EHR learner feedback and performance metrics and an understanding of how data-driven insights can inform and improve the design of self-directed learning programs. Breaking the Training Plateau: How Dayton Children’s Is Transforming EHR Education Summary: Despite notable gains in EHR satisfaction across multiple KLAS Arch Collaborative surveys, Dayton Children’s Hospital faced a persistent challenge—clinician satisfaction with training remained stagnant year over year. In response, the organization engaged a consultant to assess the root causes of this plateau. The outcome led to a series of recommendations, including the selection of technology solutions. In this session, leaders from Dayton Children’s and 314e shared the story of this transformation journey—from initial assessment to implementation to measurable impact—and explored how AI-driven microlearning has reshaped the clinician EHR experience. Making Change Real—Bridging the Readiness Gap in EHR Adoption Through Integration Device Training Summary: Baylor Scott & White Health, in partnership with Nordic, shared approaches and lessons learned in leveraging scenario-based learning and change management approaches to improve clinician readiness for and adoption of integrated real-time medical device data in the EHR clinical workflows. Shared Ownership Clinician-Centered by Design: How the Three Pillars of Success—Education, Governance, and Personalization—Led to Top 2% EHR Clinician Satisfaction Summary: At Reid Health, achieving top 2% performance in clinician EHR satisfaction wasn’t the result of reacting to survey data; it was the product of building internal alignment before measurement. This presentation details how Reid Health used a culture-first approach—anchored in the Arch Collaborative’s pillars of education, governance, and personalization—to transform the clinician-EHR relationship. Guided by physician-led governance and cross-functional collaboration, Reid implemented an agile-based Epic Refuel initiative, embedded personalization at scale, and adopted ambient AI to streamline workflows and reduce documentation burden. Training was reimagined to reflect real clinical use, while governance structures elevated clinician voices to guide decision-making and prioritization. Designed for organizations ready to move from insights to execution, this session provides practical strategies for leveraging governance, personalization, and training to drive measurable improvement in EHR satisfaction. Impactful Governance & Shared Ownership Drive Clinician EHR Success Summary: This presentation shares how St. Jude Children’s Research Hospital leveraged and continuously evolved their structured governance models to align clinical, operational, and IS stakeholders. The organization leveraged existing IT Service Management (ITSM) platforms for intake, tracking, and beyond, and they established sustained governance engagement and communication throughout the life cycle of the project. Shared Ownership in Action—Building a Culture of Engagement, Governance, and Operational Excellence Summary: In this session, UTHealth Houston shared how they built a culture rooted in shared ownership, driving sustainable improvement in EHR utilization and patient care. The organization outlined the foundational strategies they used to align stakeholders, foster accountability, and embed excellence into everyday operations. These strategies include establishing shared vision and urgency, creating a strong governance structure, having physicians lead engagement, maintaining accountability through data, simplifying the user experience, and sustaining momentum. Optimizing in Collaboration—A Path to Enduring Nursing EHR Satisfaction Summary: This presentation shares how Houston Methodist has used Arch Collaborative insights to improve their clinical end users’ experience. Unlocking the Magic of Specialty Sprints: How to Implement a Successful Program Summary: This presentation explores how to unlock the magic of Epic Specialty Sprints to drive measurable improvements in EHR engagement and satisfaction. Organization leaders discuss the foundational principles of Specialty Sprints, revealing the secrets to structuring and implementing them effectively. Key topics include identifying areas of low satisfaction, allocating resources strategically, and building the right teams to support each sprint. KLAS Sessions Click on the headers to access recordings of the presentations and panels Change Management—The Key to Guiding Organizations to EHR Success Summary: Expand your vision of change management as a critical tool for delivering the benefits of rapidly evolving technology to clinicians. Collaborate with peers and discover how organizations have successfully navigated complex changes—including EHR implementations, upgrades, AI deployments, and ongoing optimizations—by leveraging strong governance structures, informatics teams, and superusers to maximize impact and ensure clinicians aren’t left behind as healthcare IT surges forward. Nursing Best Practices Summary: Join us for a dynamic showcase of Arch Collaborative best practices and discover how top-performing health systems have transformed their nurses’ EHR experience. Gain actionable insights to streamline workflows, elevate efficiency, strengthen training programs, and alleviate nurse burnout with practical strategies you can deploy across your organization. Physician Best Practices Summary: The 2025 Arch Collaborative Physician Guidebook is based on the feedback of more than 35,000 physicians who have measured their EHR satisfaction via the KLAS Arch Collaborative from 2022 to 2025. This data has enabled the Arch Collaborative to validate best practices used by healthcare organizations to make notable improvements to their physicians’ EHR satisfaction. This session shares impactful strategies across key areas of EHR success—infrastructure, education, governance, and personalization—and highlights innovative opportunities, including AI-driven solutions. A Renewed Focus on Operational Efficiency and Workforce Management Summary: Healthcare organizations continue to face challenges like staffing shortages, narrowing margins, and operational challenges. In this session, KLAS shares data on how hospitals are facing these challenges and how innovative technology can lead to improvement in areas, including capacity optimization, workforce retention, advanced analytics, and patient workflows. Other Sessions EHR Vendor Presentations Several EHR vendors actively participate in the Arch Collaborative. At the summit, Epic, MEDITECH, and Oracle Health gave presentations on how they use Arch Collaborative learnings to help customers improve the clinicians’ EHR experiences. To access recordings of these sessions, please reach out to your KLAS client success manager. Product Demonstrations  Improving the EHR experience is a team effort—some healthcare organizations choose to rely on their internal teams, while others choose to seek external partners who can help them on their improvement journey. To make it convenient for healthcare leaders to assess and compare solutions targeted at improving the clinician experience, vendors who are Arch Collaborative members were able to purchase demo opportunities at the summit. The following vendors chose to host product demos at this year’s event: 314e Abridge Ambience Healthcare Evidently Nabla Onpoint Healthcare Partners Suki uPerform Wellsheet Summit Workshops During the summit, groups of attendees used what they had learned to design their ideal EHR education and governance structures within a realistic budget and without any preexisting limitations. What the attendees came up with will be used in KLAS’ iterative process to create frameworks for both EHR education and governance. The following sets of questions were used during these workshops, and readers can consider their own answers as they create strategies in these areas. (Note that the purpose of these questions isn’t to provide a checklist of everything an organization should do for EHR education or governance but rather to guide discussion.) EHR Education  Who delivers the training, and how? (e.g., peer trainers, IT trainers, superusers, virtual modules, 1:1 coaching, embedded informaticists) How many trainers would you need? Where would they report? How would you structure application and workflow expertise within your training team? Who updates training content? How often? What training methods or modalities would you use? (e.g., simulations, gamification, in-system tips, on-demand videos, mobile access, 1:1s, classrooms) Do you centralize training, or decentralize it? When, how often, and how long does training occur? (e.g., before go-live, at hire, at 90 days, in quarterly refreshers) How do you get clinicians engaged to attend? How is training personalized for different types of clinicians? (e.g., new hires vs. seasoned staff, inpatient vs. outpatient, tech-savvy users vs. hesitant users) How do you assess skill, knowledge, and confidence before and after training? What would evaluation or certification look like? EHR Governance How can your governance structure enable you to achieve your EHR goals? What do you consider governance structure essentials/best practices? What should representation look like at the C-level, director/manager level, and end-user level? How should committees and subcommittees be organized? (e.g., by topic, committee member clinical background, department/service line) How can you structure in a way that balances the solid vetting of plans with the ability to decide and act quickly? What items are essential to ensuring strong feedback loops between EHR leadership and clinical end users? How do you clarify your EHR road map to both leaders and end users? How proactive is your communication on coming changes/next steps in that road map? How do you most effectively gather end-user feedback? (e.g., surveys, rounding, ticketing systems, EHR-embedded feedback tools, regular time in governance meetings to address end-user concerns) What role are superusers playing? How do you ensure superusers are not only proficient EHR users but also essential champions in carrying out the overall EHR change management strategy? How do you get the right people involved? What have you seen be most successful in keeping engagement high outside of sporadic, intense events like major go-lives? What are key considerations with resource allocation? Do all aspects of EHR support need to be in-house, or can/should some be outsourced? Can technology augment or replace some elements of EHR support? Summit Attendees Healthcare Organizations Ascension Alberta Health Services Allegheny Health Network Baylor Scott & White Health Beacon Health System Children's Health Children's Hospital of Orange County Children's Hospital of Philadelphia Children's National Hospital Cleveland Clinic CommonSpirit Health CommUnityCare Health Centers Community Health Care Association of New York State Confluence Health Connecticut Children's Cook Children's Health Care System Dayton Children's Hospital Department of Veterans Affairs eHealth NSW Essentia Health Frances Mahon Deaconess Hospital Franciscan Health Froedtert & the Medical College of Wisconsin Gillette Children's Health Choice Network HealthLinc HonorHealth Houston Methodist Intermountain Health Jefferson Health Kettering Health LCMC Health LifeBridge Health Loma Linda University Health M Health Fairview Mayo Clinic MD Anderson Cancer Center Mercy Health Michigan Medicine Morris Hospital & Healthcare Center Mountainlands Community Health Center MultiCare Northern Arizona Healthcare Northfield Hospital + Clinics OCHIN OHSU Hospitals & Clinics Olmsted Medical Center Orlando Health OU Health Ozarks Healthcare Parkview Health Reid Health SouthEast Alaska Regional Health Consortium Stanford Medicine Children's Health St. Jude Children's Research Hospital St. Luke’s Health System SUNY Upstate Medical University Sutter Health UC San Diego Health University of Illinois Hospital & Health Sciences System University of Iowa Health Care University of Vermont Health Network UTHealth Houston UVA Health Valley Children's Hospital VCU Health WellStar Health System WVU Medicine Vendors/Services Firms 314e Abridge Ambience Healthcare Amplifire athenahealth AWS CSI Companies Eli Lilly and Company Epic Evidently Goliath Technologies Greenway Health IKS Health InterSystems MEDITECH MedPower Microsoft N4MATIX Nabla Nordic Onpoint Healthcare Partners Oracle Health Phrase Health ReMedi Health Solutions Solventum Suki Tegria uPerform Wellsheet Healthcare Associations & Media Scottsdale Institute American Medical Association HIMSS Healthcare IT Today 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. 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 Inova Did How Inova Did It