USE DATA TO UNLOCK THE POWER OF THE EHR

Arch Collaborative


Join hundreds of healthcare providers working together to revolutionize healthcare quality by improving the EHR experience



 



The Arch Collaborative is a group of healthcare organizations committed to improving the EHR experience.



Maximize Your EHR Experience

KLAS works with each member to improve their EHR experience by uncovering opportunities for change through standardized surveys and benchmarking.
KLAS meets with members regularly, and the whole Collaborative meets annually to facilitate learning from other healthcare organizations.
 
Satisfaction ratings for the Acute Care EMR market segment have been lower than the software average for over five years. The Arch Collaborative is working to change this.
Best in KLAS Rankings, 2014-2021


EHR SATISFACTION RESEARCH
Where It All Started


While sifting through our initial Collaborative data, we noticed a pattern that caused us to ask:
How can two organizations using the same EHR report such disparate satisfaction with the user experience?


Percent of Surveyed Clinicians Who Are Satisfied with Their EHR

PercentGoodWithTheirEHR

 
Why is there a 62 percentage points difference between different organizations using the same EHR?


Conclusion

“The truth? All EHRs see a wide spread in user experience from organization to organization. Benchmarking your organization against similiar organizations allows you to find out if you have truly maximized your investment.
This insight led us to dig deeper into what factors are most likely to create satisfied EHR users.
Over and over, the data revealed that satisfied users:
  • Are able to personalize their EHR experience
  • Share ownership for EHR governance
  • Are expert users of their EHR solution
More insights like these continue to be uncovered as additional organizations decide to measure and collaborate. Benchmark against your peers to determine whether you have truly maximized your EHR investment.
StatisfiedUser

quote "Without data, you're just another person with an opinion."

— W. Edwards Deming


Benefits of the Arch Collaborative
For Healthcare Providers


Become a member of the Arch Collaborative to:


  • Benchmark EHR satisfaction against similar organizations
  • Connect with and learn from other healthcare organizations
  • Improve clinician satisfaction with your EHR
  • Fine-tune your clinician education
  • Alleviate technology-related burnout
  • Deliver better care
98% of organizations see an improvement in EHR satisfaction when remeasured.

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The Science of Improving the EHR Experience 2021, July 2021
Photo by Christina @wocintechchat.com on Unsplash

success stories
From the Members Themselves
Real stories from the front-lines. See how the Arch Collaborative made an impact with these provider organizations.


how to participate
Become a Member
Real leadership requires data. Put the insights of over 200,000 clinician respondents at 250+ provider organizations to use.


Number 1
Express your interest. Discuss membership options.

Number 2
Pick the membership that fits your needs.

View Plans & Pricing
 
hr See Sample Benchmark Survey
Number 3
Dive deeper into the research. Start seeing value.

Visit the Learning Center


250+
Provider organizations
and counting
14+
Healthcare IT companies
and counting
Become a Collaborative member. Start your EHR improvement journey today.
Benefits of the arch collaborative
For Healthcare IT Companies (Vendors)
Use Arch Collaborative findings to give your solutions the edge they need to excel.


Get Crucial Information

  • Key pain points using the EHR
  • Best practices that drive high user satisfaction
  • Tips for improving clinician efficiency

Proactively Optimize

  • Fix problems before they become detrimental
  • Help customers deliver better healthcare

Express Interest

  • Reach out to our vendor specialist if you have any questions or would like to participate.




Vendor Participation
By participating in the Collaborative, healthcare IT companies can dramatically reduce the time it takes to implement changes based on end-user feedback.

3M
Ancile Solutions
Aquity Solutions
athenahealth
Cerner
Chartis Group
Divurgent
Epic
ettain health
Greenway Health
InterSystems
Medix
Tegria




Case Study
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UW Health and AQuity Partnership
Program Goals Reduce burnout and time spent in the EHR for a group of 100 primary and specialty care physicians Organizational Outcomes 98% of surveyed participants would recommend a virtual scribe to their colleagues. 88% of surveyed participants felt their after-hours documentation was reduced. 28% increase in agreement that ongoing EHR education is helpful among AQuity users between measurements. Keys to Success Establishing primary and secondary virtual scribes allows for physicians to always have a scribe when needed during a patient visit. Building relationships is key to the long-term success of a virtual scribe program. What University of Wisconsin Health and AQuity Did Some of the top contributors to burnout are found to be related to the administrative burden inherent with the electronic health record. UW Health decided to add virtual scribes to a group of 100 primary and specialty care physicians to decrease burnout levels, improve documentation, and ultimately, improve how clinicians engage with patients during a care visit. Deployment of the scribe program focused on 100 clinicians to validate the efficacy of the program and to demonstrate the strength (or weakness) of virtual scribes over other documentation resources at UW Health. UW Health selected primary and specialty care physicians to receive the virtual scribes and initially required that they add one patient/session to fund the virtual scribe effort and other wellness initiatives at UW Health. This request was later removed, but over half of the participants indicated that it was easy for them to add the extra session with the help of a virtual scribe. Providers in the program are matched with a scribe from AQuity based on specialty, work schedule, and workflow style preferences. Providers only work with one to two different scribes per month. This consistency allows UW Health providers to develop a relationship with their scribes and optimize workflow efficiencies. While turnover is often a concern (as many scribes are pre-med students) AQuity’s virtual model allows for scribes to continue working in a variety of circumstances and the approach to have primary and secondary scribes creates a safety net so physicians never have to worry about a scribe not knowing the specialty or unique workflows of the provider. Primary scribes typically work with a provider for 90% of their encounters, with a secondary scribe covering when the primary scribe takes a day off. Scribes are used for the majority of patient encounters, leaving little to be done after a clinician is finished seeing a patient to complete and sign off documents. Virtual scribes also help with pre-charting and the in-basket messages, leading to much lower total time spent in the EHR. In addition to measuring the success of the program with the Arch Collaborative, UW Health surveyed participants regarding their symptoms of burnout and satisfaction with their virtual scribes and measured how clinicians perceived their after-hours work time change. Even with the measurements being conducted during COVID-19, a vast majority of those surveyed reported reduced burnout symptoms, 88% felt satisfied with their virtual scribe and felt their documentation burdens had been decreased during clinic hours and 88% felt their after-hours documentation was reduced. 98% of surveyed participants would recommend a virtual scribe to their colleagues. More than half of the scribe supported physicians indicated it was easy for them to add extra patients per shift due to their scribe support.
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EHR Satisfaction in Providers with Complex Work Arrangements
Clinicians in the Most Complex Arrangements More Likely to Experience Stress or Burnout from EHR Issues More than one-third (36%) of providers who have the most complicated work arrangements and also report symptoms of burnout cite the EHR or other IT issues as factors in their burnout. In contrast, these factors are cited by only 20% of burned out providers with simpler work arrangements. Similar patterns appear among nurses and allied health professionals. Providers in the Most Complex Arrangements Spend More Non-Business Hours Charting Nearly 80% of providers who have the simplest work arrangements spend less than 5 hours per week charting outside of normal business hours. In contrast, that number is only 57% for those with the most complex arrangements. More than one-third of this group spends 6–15 hours per week on afterhours charting. Reasons for EHR Dissatisfaction in Complex Arrangements Different EHR systems across locations “The fact that the two locations are not integrated and are still on two different systems is a huge inconvenience for providers who are seeing patients in both places. It is also dangerous because it complicates patient care.” —Nurse practitioner, academic health system (2 locations, acute care & ambulatory) Different system configurations  (when using the same EHR) “We are using one system, but the different environments do not communicate with each other, so it is hard to find the information we need, and that can lead to miscommunication.” —Physician, academic health system (4 locations, acute care & ambulatory) Workflows not streamlined for multi-setting or multi-location providers “Portability is a problem for providers who practice in multiple locations. There are no adjustments in the system to improve workflows for anyone who isn’t a PCP doing simple work in one location.” —Physician, academic health system (3 locations, acute care & ambulatory) Varied levels of EHR support across settings and locations “The boots-on-the-ground clinical engineering people and IT support vary from facility to facility. [Location A] has a good response. [Location B] is decent. [Location C] is below average.” —Physician, large health system (4 locations, acute care & ambulatory) How to Achieve Strong EHR Satisfaction in Complex Work Arrangements Providers who work in multiple settings or locations aren’t all struggling with the EHR. 30% of those in the highest-complexity group (those working in acute care and other settings across multiple locations) are considered highly satisfied with their EHR experience. How can organizations improve the EHR satisfaction for all providers in complex work arrangements? 1. Provide training that targets workflow and location differences In the Arch Collaborative survey, participants are asked to share the top three things they want addressed to improve their EHR experience. The need for better or more EHR training is cited about 27% more often by dissatisfied users in the most complex arrangements compared to those with simpler work arrangements. Vidant Health is an example of how to provide successful EHR training. They specifically target clinicians who work in multiple locations by requiring them to receive video instruction specific to their workflows before the standard classes. Clinicians also attend a three-hour, setting-specific class (inpatient, ambulatory, or ED), and those who work in multiple settings are required to go to each related class. 2. Encourage use of personalization tools Clinicians that work in multiple settings see bigger satisfaction gains from use of personalization tools than those that work in a single setting. Personalization tools are cited as a reason for high EHR satisfaction about four times as often by clinicians in complex arrangements compared to clinicians with simpler work arrangements. Kaiser Permanente Northwest has developed their own method to improve personalization use. They noticed that some EHR users find it more difficult to invest time and energy on their own into learning and using personalization tools, and these users are typically the ones who struggle with EHR efficiency. Kaiser Permanente Northwest built tools tailored to all providers in a given department, with the philosophy that similar providers will benefit from similar tools, improving efficiency and workflows across the department. 3. Ensure the voices of clinicians in complex arrangements are heard when it comes to workflow differences Different providers have different support and communication needs, and improving the EHR requires input from diverse clinical backgrounds and settings. This is especially true with providers who work in multiple settings as the effects of setting-specific issues will be compounded for them. One provider from an academic health system illustrated this concept, explaining, “Too many of the doctors that assist the IT folks don’t actually practice in locations or care settings that well represent the others. They are not good representatives of the masses. . . . Rarely do they deliver any resolution or true improvement.” MemorialCare designed their training programs to cover multiple service lines for clinicians of various backgrounds. In 1997, they established their best-practice team, which includes members from multiple hospitals, physician groups, and offices who come together to share diverse ideas for enhancing care and improving patient safety. This team obtains feedback from a variety of clinicians so every service line has a voice in the EHR changes. As an example, the critical care team recently updated over 100 order sets by removing benzodiazepine in response to the FDA’s warning about it increasing fall risks for elderly patients. Among Collaborative organizations, MemorialCare ranks in the 99th percentile for provider EHR efficiency and in the 97th percentile for the EHR’s support of quality care. 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 250 healthcare organizations have surveyed their end users and over 240,000 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. To participate in the Arch Collaborative, go to klasresearch.com/arch-collaborative .
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Allied Health Professionals
A Wide Spectrum of Allied Health Roles The main allied health roles represented in this data are pharmacists, followed by physical therapists and technologists. Social workers, technicians, occupational therapists, dietitians/nutritionists, respiratory therapists, counselors, speech therapists, and clinical laboratory scientists each make up less than 10% of surveyed allied health professionals. At least a dozen organizations are represented in each role type. Other allied health roles with very small numbers of respondents (e.g., audiologist, chaplain) appear in other Collaborative data but are not represented here. Technicians Are Most Satisfied with the EHR; Counselors Are Least Satisfied Of these allied health role types, technicians have the highest average Net EHR Experience Score † (NEES), followed by technologists and pharmacists. Counselors have the lowest NEES; speech therapists, occupational therapists, and physical therapists also have an average NEES of less than 20.0. Physical therapists are the second-largest allied health group within the Arch Collaborative’s data, so targeting them for EHR satisfaction improvement could have a high impact. In aggregate, allied health professionals have an average EHR experience compared to other user types, with an NEES a few points behind nurses and advanced practice providers (APPs). However, they score more than 20 points higher than physicians, who are the least satisfied EHR users in Arch Collaborative data. † The Net EHR Experience Score is a snapshot of clinicians’ overall satisfaction with the EHR environment(s) at their organization. The survey asks respondents to rate factors such as the EHR’s efficiency, functionality, impact on care, and so on. The Net EHR Experience Score is calculated by subtracting the percent of negative user feedback from the percent of positive user feedback. Net EHR Experience Scores can range from -100 (all negative feedback) to 100 (all positive feedback). Across Specialties, Allied Health Professionals in Pediatrics Struggle the Most with the EHR The EHR Experience Survey also asks allied health professionals to share their specialty or focus area. Those in radiology have the highest NEES on average, followed by those in hospital medicine and gynecology & obstetrics. Allied health professionals in pediatrics have the lowest NEES—almost 9 points lower than the next-most-satisfied specialties (general surgery, physical rehabilitation, and critical care). For additional analysis that looks at allied health professionals through the lenses of training, governance, EHR personalization, and wellness, please see the Expanded Insights section in the full report. 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 250 healthcare organizations have surveyed their end users and over 240,000 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. To participate in the Arch Collaborative, go to https://klasresearch.com/arch-collaborative .
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EHR Vendor Initiatives
Arch Collaborative data on EHR stakeholders shows that about 33% of the variation in the EHR experience from user to user can be attributed to the EHR vendor in use; the organization and the individual user account for the rest of the variation. While not the most important factor, the EHR vendor still has a big impact. EHR vendors have close relationships with their customer organizations, so they can apply needed solutions to improve end user satisfaction. Clinicians who strongly disagree that their EHR vendor delivers well are much less satisfied with the EHR experience overall than those who strongly agree (a difference in Net EHR Experience Score of 145.7 points—see below). EHR Vendor Programs Can Make a Big Difference To better understand the potential impact of the EHR vendor on end-user satisfaction, KLAS asked Cerner and Epic (the two vendors with the largest samples of Arch Collaborative member customers) to share what new tools, programs, or initiatives they have recently begun offering. The following descriptions come from the vendors and have not been validated by KLAS. Blueprint: Initiative by which Cerner works with clients to leverage the Blueprint tool to identify functionality that is owned but not yet implemented, fully configure existing capabilities to Cerner’s Model Experience, and provide guidance on adopting/using functionality in line with best practice recommendations. Brain: Inspired by what nurses commonly jot down on paper “nurse brains” at the start of their shifts, the Brain presents a timeline view of the orders, events, and requirements for each patient the user is assigned to. Hey Epic!: Voice assistant tool to help providers with documentation and information searches. Rover: A mobile app designed to improve productivity by allowing nurses and other clinicians to review, document, communicate, and complete other key workflows on the go. A number of organizations in the Arch Collaborative have recently implemented these tools or programs. The chart below compares these organizations’ Net EHR Experience Scores before and after implementing. Overall, these initiatives are correlated with higher EHR satisfaction. (It should be acknowledged that Collaborative members who re-measure tend to see some improvement in general, but the improvements shown below are still significant.) Overall, clinician feedback shows organizations who implement one of these initiatives and re-measure see an improved EHR experience. Though the extent of the impact can vary across initiatives and in specific metrics, and results are early, all initiatives highlighted in this report have a positive correlation overall with satisfaction improvement.
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Improving EHR Satisfaction in Ambulatory Settings
† As championed by Dr. CT Lin, CMIO at UCHealth, EHR optimization sprints aim to quickly optimize EHR efficiency through a three-pronged, team-based approach that includes (1) clinician training, (2) workflow redesign, and (3) the creation of specialty-specific tools. Dr. Lin—a longtime friend of the Collaborative and an early advisor to its members—graciously shared details of his EHR 2.0 optimization sprints at the Eastern US Arch Collaborative Workshop, held in January 2020. Additional details about UCHealth’s sprints can be found in this article by Mayo Clinic. Across Clinical Roles, Optimization Sprints Dramatically Improve EHR Satisfaction On average, providers, nurses, and allied health professionals all saw large increases in their Net EHR Experience Score (NEES) ‡ following an optimization sprint, and each group also reported improved satisfaction with how their organization has implemented, supported, and trained on the EHR. As IT and operational departments invest in reaching out to their clinics, they can dramatically change how clinicians view the EHR. ‡ 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. The NEES is calculated by subtracting the percent of negative user feedback from the percent of positive user feedback. An NEES can range from -100 (all negative feedback) to 100 (all positive feedback). Increased Efficiency > Decreased Burnout for Providers On average, the percentage of providers reporting at least some degree of burnout dropped by nine percentage points following an optimization sprint. Several factors likely contribute to this reduction in burnout. However, of particular note is that pre-intervention, less than half of participating providers viewed their EHR as a tool that enables efficiency; post-intervention, that number rose to almost two-thirds, with several organizations reporting a dramatic reduction in afterhours charting. Provider perceptions of the efficacy of their ongoing EHR training also saw a significant boost. Other Collaborative data has shown that providers who don’t agree that their ongoing training is sufficient are 3.0–4.5 times more likely to report plans to leave their organization within two years. Framework for Implementing a Successful EHR Optimization Sprint While the Arch Collaborative organizations that have completed an optimization sprint offered a variety of helpful advice for their peers, the following two overarching guidelines were mentioned by all four organizations: Leadership matters —The individuals chosen to lead the sprint and the specific clinics chosen for the pilot will make or break the project. Look for leaders who are excited to champion operational improvements and increased clinician engagement. Utilize a pilot and then grow organically as you achieve success —For the organizations in this report, optimization sprints have become a key element of their efforts to support the EHR. However, this broad investment was only made after pilot programs demonstrated that sprints were an effective way to improve satisfaction with the EHR. Steps of a Successful Sprint Step 1: Build your sprint team Team members should be highly competent in either training clinicians or understanding EHR workflows. These individuals should also be generous in how they work with others, as they will likely be working with many clinicians who have very negative perceptions of the IT team and the EHR. Step 2: Choose your pilot clinic Start with a clinic that has a pressing need to improve the EHR and whose leadership is already bought into the idea of a sprint. Step 3: Prepare for the sprint The preparation phase typically includes a kickoff meeting followed by several additional meetings to identify the build scope and establish relationships between the sprint team and the clinic. These preparations are key to being able to hit the ground running once the sprint team is on-site at the clinic. Step 4: Collect a pre-sprint measurement Several organizations have utilized their EHR’s native tracking of metrics like afterhours charting and chart-closure rates to set a pre-sprint benchmark. Additionally, three of the four Collaborative members in this research established a benchmark utilizing the Collaborative’s pre/post surveys, which are included in all Collaborative memberships (alternatively, a recently completed full Collaborative measurement can be used as the pre-sprint benchmark). Step 5: Complete the sprint Sprints generally have three components: clinician training, workflow redesign, and the creation of specialty-specific tools. The training is typically done one on one and focuses on helping clinicians become proficient with new and pre-existing functionality and tools as well as any newly developed workflows. For specific details on how to implement a sprint, please see this comprehensive article in the Mayo Clinic Proceedings . Step 6: Collect a post-sprint measurement Once the sprint is complete, use the same survey instrument leveraged for the pre-sprint measurement to capture any changes in clinician satisfaction. Step 7: Adjust and iterate Using feedback from clinician surveys and interviews with clinic leadership to identify any needed adjustments, select the next clinic to participate in the sprint.
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Individual Repeat Measurements
33% of Repeat Individuals Report Significant Improvement Changes in Net EHR Experience Score (NEES) † between a clinician’s first and second measurement have an almost perfect normal distribution, validating the accuracy of the survey in gauging EHR satisfaction. While the average clinician reports a 6.3-point improvement, approximately 33% of clinicians have seen highly significant improvement (i.e., an increase in NEES of at least 20 points). Analyzing the data from these “high-improvement” clinicians reveals the factors most commonly associated with improved EHR satisfaction (see below). † 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. The NEES is calculated by subtracting the percent of negative user feedback from the percent of positive user feedback. An NEES can range from -100 (all negative feedback) to 100 (all positive feedback). The Individual Metrics Most Commonly Associated to High Overall Improvement Almost all clinicians in the high-improvement group report an increase in their personal accountability for mastering the EHR. This validates a key finding of the Collaborative, which is that—across metrics—users themselves can account for up to 40%–60% of the variation in their EHR satisfaction (see “Stakeholder” chart below). See the Intermountain Healthcare case study to learn how that organization’s focus on provider coaching led to improved perceptions of the EHR. Other common associated improvements include improved perceptions of the EHR vendor, increased satisfaction with the quality and frequency of ongoing training, and greater adoption of personalization. This validates the importance of two of the Arch Collaborative’s three pillars of EHR satisfaction: training (both initial and ongoing) is an important aspect of the user mastery pillar, while personalization is critical to the EHR “meeting unique user needs.” See full report for additional details on the three pillars. The Individual Metrics with Most Impactful Association to High Overall Improvement While personal accountability is the most common change, system integration is the core NEES metric associated with the largest increases in overall EHR satisfaction and represents a significant opportunity for organizations and vendors to completely shift their end users’ EHR perceptions. Regarding integration, respondents are asked to rate—on a five-point Likert scale—their level of agreement that the internal and external integration is sufficient. On average, respondents who increase by four levels of agreement (i.e., move from strongly disagree to strongly agree) see a corresponding NEES increase of 130.7 points. Even more modest shifts of one or two levels of agreement can still yield significant improvements. It is important to note that the core NEES metrics that are associated with the largest improvements in overall satisfaction—including integration as well as system speed and functionality—are actually the ones that individual clinicians have the least control over (see “Stakeholder” chart above). This highlights the fact that true EHR success does not depend on the user alone—it also requires collaboration from the vendor and organization to make meaningful changes that individuals cannot make themselves. Among the survey questions that don’t factor into a respondent’s NEES, the ones with the largest associated increases are the same metrics noted above as the most common—personal accountability, agreement that EHR vendor delivers well, and satisfaction with ongoing training. The strong association that exists between a respondent’s overall EHR satisfaction and their approval of the EHR vendor’s delivery again highlights the importance of provider organizations working closely with their vendors to hold them accountable for needed changes. Key Takeaways Changes across measurements show that a delicate balance must be achieved between three stakeholders: the individual, the provider organization, and the EHR vendor. When the three work together, it is possible to achieve significant improvement in EHR satisfaction. Individuals have the opportunity to improve their own satisfaction with the EHR by attending trainings, using tip sheets, and adopting more personalizations. Provider organizations and EHR vendors are responsible for making needed improvements to things such as integration, functionality, and system response time. Efforts in these areas can compound end-user efforts and transform EHR detractors into evangelists.
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Clinician Training 2021 Update
This report, an update to the 2019 Clinician Training report , dives into evidence-based findings on EHR training. It provides a refresh on past findings and shares insights from new questions (on telehealth, virtual training, etc.) and new views of Collaborative data. Ultimately, this report aims to help organizations elevate training to improve clinician EHR satisfaction, clinician wellness, and the quality of patient care. (See the full report for the complete insights on clinician training.) Keys to Successful EHR Training More than 20 organizations have participated in the Trainer Quality Benchmark survey, which collects responses from clinicians after they receive EHR training. Data from this survey reveals two aspects of training are highly correlated with satisfaction: type of training and length of training. Various types of training can be effective as long as an actual trainer is involved—self-directed e-Learning is much less effective. More than an hour of training is also likely to result in higher training satisfaction. Initial Training Has Consistently High Correlation with Satisfaction Clinicians who strongly agree that their initial EHR training prepared them well to use the EHR have an average Net EHR Experience Score (NEES) 89.7 points higher (on a -100 to 100 scale) than those who strongly disagree. This is the exact same spread reported in the 2019 Clinician Training report , even with 50,000 additional responses collected since then. (More insights on initial training can be found in the Expanded Insights and on the Arch Collaborative website in the form of webinars, case studies, and other reports.) Early Insights on the Use of Simulations A new question in the executive survey (conducted with executive leaders at member healthcare organizations) asks whether the organization uses simulations for initial EHR training. Preliminary results show that organizations that do use simulations have, on average, a higher NEES than organizations that don’t. ‡ The Net EHR Experience Score (NEES) is a snapshot of clinicians’ overall satisfaction with the EHR environment(s) at the organization. The survey asks respondents to rate factors such as the EHR’s efficiency, functionality, impact on care, and so on. The Net EHR Experience Score is calculated by subtracting the percent of negative user feedback from the percent of positive user feedback. Net EHR Experience Scores can range from -100 (all negative feedback) to +100 (all positive feedback). Strong Ongoing Training Associated with 100-Point Higher Satisfaction Arch Collaborative data shows a 101.2-point difference in NEES between clinicians who strongly agree ongoing training is sufficient and those who strongly disagree. KLAS’ 2019 report found a 102.7-point difference. The static nature of these results indicates the consistent importance of training satisfaction, even as Collaborative data has expanded to include more and more organizations. Telehealth Training and the EHR Experience In the last year, KLAS has added a question to our EHR Experience Survey about training on telehealth tools. Responses to this question show strong training on telehealth tools and processes is correlated with a better EHR experience overall. For deeper insights on the effects of telehealth training, see the Expanded Insights.