Epic EHR Initiatives 2023

The Impact on Clinician Satisfaction

Authored by: Anna Beyer, 08/21/2023 | Read Time: 4 minutes

With limited budgets and resources, Arch Collaborative members frequently ask KLAS which of their EHR vendor’s education initiatives and system features are most effective at improving EHR efficiency and satisfaction. Because Epic users make up over 60% of respondents in the Arch Collaborative’s data sample, this report evaluates several Epic-specific initiatives and features to help Epic customers determine whether they are worth the investment. While not an exhaustive list of all Epic offerings capable of improving EHR efficiency and satisfaction, the initiatives and features examined in this report are those that Epic users have identified as top of mind.

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<div class="row" style="margin-top:40px; background-color:#c18654; padding:15px; border-radius: 15px;"><p style="padding:0; margin:0; color:#ffffff; font-size:.85em;"><strong>There is no one-size-fits-all solution when it comes to improving clinician EHR efficiency and satisfaction. The data and findings below are intended to spark conversations within your organization. As you read the report, consider the following: Are you fully leveraging the EHR education initiatives and system features available to Epic customers? Have you left offerings on the table that could set your clinicians up for greater EHR success?</strong></p></div><div class="row" style="margin-top: 40px;"><h3 style="color:#c18654;"><strong>Epic Physician Power Users and Physician Builders Report Enhanced Clinical Practice but Want More Opportunities to Put Their Training to Use</strong></h3><div class="col-sm-8"><p>Overall, providers who have participated in Epic’s Physician Power User courses or Physician Builders program feel the initiatives are valuable. Compared to peers who have not participated, these providers report higher Net EHR Experience Scores (NEES)<sup>†</sup> and higher agreement that the EHR enhances their clinical practice. Agreement that the EHR enables efficiency and quality care is also notably higher. Unfortunately, a common sentiment among these providers is that they aren’t always given the opportunity or system access needed to share their efficiency learnings with peers or put their enhanced EHR knowledge into practice. These individuals recognize that the system could be better leveraged but don’t feel empowered to help their organization actualize its potential.</p><p style="margin-bottom:20px; font-size:.85em; color:#858d96;">† 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).</p></div><div class="col-sm-4" style="margin-bottom: 30px; background-color:#2b333a; padding:15px; border-radius: 0 0 0 15px;"><p><strong style="color:#c18654; font-size:.85em;">Case Studies: Making the Most of Physician Power Users and Physician Builders</strong><br /><span style="color:#ffffff; font-size:.85em;">Explore the case studies below for details on how other Arch Collaborative members have found success with Physician Power Users and Physician Builders.</span></p><ul style="color:#ffffff;"><li>Physician Power Users: <a data-id="380" data-itemtypeid="15" href="/archcollaborative/casestudy/decreasing-turnover-rate-by-enhancing-training/380" target="_blank"><u style="color:#4c8bc9;">Guthrie Clinic</u></a></li><li>Physician Builders: <a data-id="68" data-itemtypeid="15" href="/archcollaborative/casestudy/physician-builders-with-a-holistic-view-of-the-ehr/68" target="_blank"><u style="color:#4c8bc9;">Tower Health</u></a>, <a data-id="140" data-itemtypeid="15" href="/archcollaborative/casestudy/collaborate-then-build/140" target="_blank"><u style="color:#4c8bc9;">Heart of Texas</u></a>, <a data-id="342" data-itemtypeid="15" href="/archcollaborative/casestudy/8-week-sprints/342" target="_blank"><u style="color:#4c8bc9;">MD Anderson</u></a></li></ul></div><img src="/images/report-images/2023/epic_ehr_initiatives-agreement_that_respondents_clinical_practice_is_enhanced_through_ehr_use.svg" alt="agreement that respondent's clinical practice is enhanced through ehr use" style="max-width: 1440px; max-height: 492px; width: 100%;" class="fr-fil fr-dib" /> <img src="/images/report-images/2023/epic_ehr_initiatives-net_ehr_experience_score_by_participation_in_epic_ehr_education_initiatives.svg" alt="net ehr experience score by participation in epic ehr education initiatives" style="max-width: 1440px; max-height: 295px; width: 100%;" class="fr-fil fr-dib" /></div><div class="row" style="margin-top:40px;"><h4><strong>Other Notable Findings</strong></h4><div class="col-sm-6"><p style="background-color:#2b333a; padding:5px 10px; color:#ffffff;"><strong>Epic Physician Power Users</strong></p><ul><li>Agreement that EHR enables quality care: 9 percentage points higher compared to peers</li><li>Agreement that EHR enables efficiency: 6 percentage points higher compared to peers</li><li>Agreement that EHR has needed functionality: 8 percentage points compared to peers</li><li>Organizational NEES: 6 points higher at organizations that have Power Users compared to those that do not</li></ul></div><div class="col-sm-6"><p style="background-color:#2b333a; padding:5px 10px; color:#ffffff;"><strong>Epic Physician Builders</strong></p><ul><li>Agreement that EHR enables patient-centered care: 17 percentage points higher compared to peers</li><li>Agreement that EHR enables efficiency: 16 percentage points higher compared to peers</li><li>Agreement that EHR enables patient safety: 14 percentage points higher compared to peers</li><li>Agreement that EHR enables quality care: 12 percentage points higher compared to peers</li><li>Agreement that EHR is easy to learn: 10 percentage points higher compared to peers</li></ul></div></div><div class="row" style="margin-top:20px; background-color:#f2f3f4; padding:15px; border-radius: 15px;"><h4 style="padding:0;"><strong>Epic Physician Power Users and Physician Builders Defined</strong></h4><div class="col-sm-6" style="margin-bottom: 20px; border-left: 5px solid #2b333a; padding:0 10px;"><p><a href="https://galaxy.epic.com/Redirect.aspx?DocumentID=100097842&PrefDocID=137333" rel="noopener" target="_blank"><u style="color:#4c8bc9;">Epic Physician Power Users</u></a><br /><em style="font-weight:400; color:#858d96;">Available to all providers (i.e., physicians and advanced practice providers)</em></p><p><strong>Description provided by Epic:</strong> Individuals who have taken efficiency courses in Epic’s user setting tools and optimizations to understand the avenues by which they and their colleagues can become more effective. Can be a stepping stone to the Physician Builder program.</p><p><strong>Report sample:</strong> Respondents are included in the Physician Power User sample if they have completed at least one of Epic’s official Physician Power User courses (though the majority have taken multiple courses).</p></div><div class="col-sm-6" style="margin-bottom: 20px; border-left: 5px solid #2b333a; padding:0 10px;"><p><a href="https://galaxy.epic.com/Redirect.aspx?DocumentID=1864268&PrefDocID=111084" rel="noopener" target="_blank"><u style="color:#4c8bc9;">Epic Physician Builders</u></a><br /><em style="font-weight:400; color:#858d96;">Available to all providers (i.e., physicians and advanced practice providers)</em></p><p><strong>Description provided by Epic:</strong> Providers can complete additional Epic training and certification covering more advanced build tools, particularly focused around more “technical” builds that can be deployed system wide or by specialty. Many organizations grant physician builders additional access to complete builds that benefit the larger organization.</p><p><strong>Report sample:</strong> Respondents are included in the Physician Builders sample if they have been certified or accredited as Epic Physician Builders and if that certification/accreditation occurred <em style="font-weight:400;">before</em> their Arch Collaborative measurement.</p></div><p style="padding:0; font-size:.85em; color:#858d96;">Note: For more details on either of these education initiatives, click the links above to be transferred to Epic’s UserWeb.</p></div><div class="row" style="margin-top: 40px;"><h3 style="color:#c18654;"><strong>Several Epic System Features Shown to Improve Clinician Efficiency</strong></h3><div class="col-sm-8" style="margin-bottom:20px;"><p>Regardless of EHR vendor, efficiency is one of the lowest rated NEES metrics—among Epic respondents specifically, only 53% agree the EHR enables them to be efficient. Additionally, though staffing shortages, bureaucratic tasks, and chaotic work environments are the most common drivers of burnout, the individual NEES metric most closely tied to burnout is the EHR’s efficiency. Given this correlation, EHR efficiency should be a top focus of organizations wishing to reduce burnout and avoid turnover. Epic offers a variety of modules and system features that have the potential to help clinicians more quickly care for patients without sacrificing quality. Brain, Hey Epic!, Rover, and Secure Chat are among the modules or features that Arch Collaborative members most commonly ask KLAS about. As shown in the chart below, individuals measured both before and after the implementation of these features report above average increases in satisfaction. Organizations struggling with burnout may do well to ask themselves whether any of these features could help improve efficiency for their clinicians.</p></div><div class="col-sm-4" style="margin-bottom: 20px; background-color:#2b333a; padding:15px; border-radius: 0 0 0 15px;"><p><strong style="color:#c18654; font-size:.85em;">Case Studies: Making the Most of Brain, Rover, Hey Epic!, and Secure Chat</strong><br /><span style="color:#ffffff; font-size:.85em;">Explore the case studies below for details on how other Arch Collaborative members have found success with the system features examined in this report:</span></p><ul style="color:#ffffff;"><li>Brain: <a data-id="368" data-itemtypeid="15" href="/archcollaborative/casestudy/nurse-ehr-training-booster-shot/368" target="_blank"><u style="color:#4c8bc9;">Henry Ford Health System</u></a></li><li>Rover: <a data-id="371" data-itemtypeid="15" href="/archcollaborative/casestudy/collaborative-involvement-leads-to-high-nurse-satisfaction/371" target="_blank"><u style="color:#4c8bc9;">Bellin Health</u></a></li><li>Hey Epic!: <a data-id="468" data-itemtypeid="15" href="/archcollaborative/casestudy/mayo-clinic-and-3m-the-path-to-automation-and-ambient-documentation/468" target="_blank"><u style="color:#4c8bc9;">Mayo Clinic</u></a></li><li>Secure Chat: <a data-id="490" data-itemtypeid="15" href="/archcollaborative/casestudy/tailored-provider-onboarding-with-a-focus-on-follow-up/490" target="_blank"><u style="color:#4c8bc9;">Lee Health</u></a></li></ul></div><img src="/images/report-images/2023/epic_ehr_initiatives-net_ehr_experience_score_before_vs_after_implementation_of_epic_features.svg" alt="net ehr experience score before vs. after implementation of epic features" style="max-width: 1440px; max-height: 406px; width: 100%;" class="fr-fil fr-dib" /></div><div class="row" style="margin-top:40px;"><h4><strong>Other Notable Findings</strong></h4><p style="font-size:.85em; color:#858d96;">Percentage point changes represent increases measured in same individuals before and after implementation. Items ordered high to low by percentage point change.</p><div class="col-sm-6"><p style="background-color:#2b333a; padding:5px 10px; color:#ffffff;"><strong>Brain</strong></p><ul><li>Agreement that alerts prevent mistakes: 6 percentage points</li><li>Agreement that EHR has needed functionality: 6 percentage points</li><li>Agreement that EHR enables efficiency: 5 percentage points</li><li>Agreement that EHR enables quality care: 5 percentage points</li></ul></div><div class="col-sm-6"><p style="background-color:#2b333a; padding:5px 10px; color:#ffffff;"><strong>Rover</strong></p><ul><li>Agreement that EHR enables efficiency: 4 percentage points</li><li>Agreement that EHR enables quality care: 4 percentage points</li><li>Agreement that EHR has needed functionality: 4 percentage points</li></ul></div><div class="col-sm-6"><p style="background-color:#2b333a; padding:5px 10px; color:#ffffff;"><strong>Hey Epic!</strong></p><ul><li>Agreement that EHR enables quality care: 9 percentage points</li><li>Agreement that EHR enables efficiency: 4 percentage points</li><li>Agreement that EHR enables patient-centered care: 4 percentage points</li><li>Agreement that EHR enables patient safety: 4 percentage points</li></ul></div><div class="col-sm-6"><p style="background-color:#2b333a; padding:5px 10px; color:#ffffff;"><strong>Secure Chat</strong></p><ul><li>Agreement that EHR enables quality care: 9 percentage points</li><li>Agreement that EHR enables efficiency: 5 percentage points</li><li>Agreement that EHR enables patient-centered care: 3 percentage points</li></ul></div></div><div class="row" style="margin-top:20px; background-color:#f2f3f4; padding:15px; border-radius: 15px;"><h4 style="padding:0;"><strong>Epic System Features Defined</strong></h4><div class="col-sm-6" style="margin-bottom: 20px; border-left: 5px solid #2b333a; padding:0 10px;"><p><a href="https://galaxy.epic.com/Redirect.aspx?DocumentID=100152064&PrefDocID=149346" rel="noopener" target="_blank"><u style="color:#4c8bc9;">Brain</u></a><br /><em style="font-weight:400; color:#858d96;">For inpatient nurses</em></p><p><strong>Description provided by Epic: </strong>Home activity that helps inpatient nurses and other roles plan their day. Inspired by the paper “brains” that nurses typically jot down at the start of their shifts, the Brain presents a timeline view of the orders, events, and requirements for each assigned patient. Without leaving the Brain, nurses can record flowsheet values and scan patient and medication barcodes to document medication administration.</p><p><strong>Report sample: </strong>Data above measures the change in satisfaction of repeat respondents before and after their organization implemented Brain.</p></div><div class="col-sm-6" style="margin-bottom: 20px; border-left: 5px solid #2b333a; padding:0 10px;"><p><a href="https://galaxy.epic.com/Redirect.aspx?DocumentID=100152050&PrefDocID=149346" rel="noopener" target="_blank"><u style="color:#4c8bc9;">Rover</u></a><br /><em style="font-weight:400; color:#858d96;">For inpatient nurses</em></p><p><strong>Description provided by Epic: </strong>Mobile app for iPhones and Android devices that supports hospital-based nursing workflows, giving nurses access to patient information on the go and increasing nurse efficiency. Features include flowsheet documentation, MAR documentation, real-time push notifications for time-sensitive updates, and clinical image capture using the mobile device’s camera.</p><p><strong>Report sample: </strong>Data above measures the change in satisfaction of repeat respondents before and after their organization implemented Rover.</p></div><div class="col-sm-6" style="margin-bottom: 20px; border-left: 5px solid #2b333a; padding:0 10px;"><p><a href="https://galaxy.epic.com/Redirect.aspx?DocumentID=100064112&PrefDocID=128009" rel="noopener" target="_blank"><u style="color:#4c8bc9;">Hey Epic!</u></a><br /><em style="font-weight:400; color:#858d96;">For all clinicians</em></p><p><strong>Description provided by Epic: </strong> To save time and get more quality face time with patients, clinicians can use voice commands to take actions in Epic. With the help of Hey Epic! voice assistant, clinicians can quickly retrieve specific pieces of information that they need before seeing a patient. Additionally, in Rover, Hey Epic! supports the use of voice to create reminders by adding patient-specific tasks to the Brain. Uses a natural language understanding service from Nuance or 3M MModal.</p><p><strong>Report sample: </strong>Data above measures the change in satisfaction of repeat respondents before and after their organization implemented Hey Epic! Data sample was limited to providers who report using speech recognition as their documentation method (providers using other documentation methods would not be utilizing Hey Epic!).</p></div><div class="col-sm-6" style="margin-bottom: 20px; border-left: 5px solid #2b333a; padding:0 10px;"><p><a href="https://galaxy.epic.com/Redirect.aspx?DocumentID=3876926&PrefDocID=99048" rel="noopener" target="_blank"><u style="color:#4c8bc9;">Secure Chat</u></a><br /><em style="font-weight:400; color:#858d96;">For all clinicians</em></p><p><strong>Description provided by Epic: </strong>Providers, nurses, and other staff use Secure Chat to send secure messages to colleagues in real time from Epic’s mobile apps or from Hyperspace. Enables conversations with a single recipient or with a group of colleagues.</p><p><strong>Report sample: </strong>Data above measures the change in satisfaction of repeat respondents before and after their organization implemented Secure Chat.</p></div><p style="padding:0; font-size:.85em; color:#858d96;">Note: For more details on any of these system features, click the links above to be transferred to Epic’s UserWeb.</p></div><div class="row" style="margin-top: 40px;"><h3 style="color:#c18654;"><strong>Clinician Voices</strong></h3><h4><strong>On Epic Physician Power Users & Physician Builders</strong></h4><ul><li><em style="font-weight:400;">“We need physician builders. Epic requires them at new hospitals for a reason. It is impossible to talk to the Epic team and get what we need built into Epic without a translator, i.e., a physician builder.” </em>—Physician</li><li><em style="font-weight:400;">“I am a Physician Builder and have also completed additional Epic superuser training to improve my efficiency with charting. I feel that the superuser training in particular was very practical and should be actively offered to engaged providers, or my organization should offer similar training.” </em>—Physician</li><li><em style="font-weight:400;">“I have personally taken and completed the Epic Physician Builder course at Epic. I offered to build things myself in a playground environment and then hand them over for testing before placing them in the live environment. I was told that was not an option at our institution.” </em>—Physician</li><li><em style="font-weight:400;">“I am an Epic Physician Builder, and the system could do so much more than we use it for.” </em>—Physician</li><li><em style="font-weight:400;">“There seems to be a lack of Power Users who can help teach peers the tricks of the technology.” </em>—Advanced practice provider</li><li><em style="font-weight:400;">“I am a Power User, I am very Epic savvy, and I do informatics work. I would guess that most of my partners have far less satisfaction and less personalization than I do.” </em>—Physician</li></ul><h4><strong>On Brain</strong></h4><ul><li><em style="font-weight:400;">“I like the function of Brain and how it organizes all of the medications, labs, and treatments my patient needs per shift in one place.” </em>—Inpatient nurse</li><li><em style="font-weight:400;">“I do like to use Brain when on the floor. It does help make sure I stay on task, but it is strictly task oriented and just for checking off boxes.” </em>—Inpatient nurse</li><li><em style="font-weight:400;">“I think Brain provides a good overview of what to expect in upcoming patient care for things like medications, blood draws, diagnostic scans, and so forth. I think there are a lot of warnings and alerts that help keep patients safe. However, some can become repetitive, which creates a habit of dismissing them.” </em>—Inpatient nurse</li><li><em style="font-weight:400;">“The Brain function needs more work and fine-tuning. It should allow nurses to get what they need without opening the patient’s chart.” </em>—Inpatient nurse</li><li><em style="font-weight:400;">“In order to assign a patient to a nurse’s Brain, I have to right click and assign me rather than at the initial Epic logon. Also, I do not find the Brain feature as a sidebar beneficial. I cannot ever clear out of it when in a patient chart, and it makes the flowsheets even smaller to chart on.” </em>—Inpatient nurse</li></ul><h4><strong>On Rover</strong></h4><ul><li><em style="font-weight:400;">“I think using Rover provides the efficiency of having easily accessible information. Being able to scan patient barcodes provides that extra safety precaution when administering medications.” </em>—Inpatient nurse</li><li><em style="font-weight:400;">“It would be better if Rover could have more access to assessment charting. Charting for full head-to-toe assessment is needed. Rover is limited; it needs more assessment features.”</em>—Inpatient nurse</li><li><em style="font-weight:400;">“I love the addition of being able to take photos from Rover and attach them directly to a wound on the flowsheet.” </em>—Inpatient nurse</li><li><em style="font-weight:400;">“There are multiple little things that cause delays in charting. One of those is not having all flowsheets or documenting available from the Rover phones.” </em>—Inpatient nurse</li></ul><h4><strong>On Hey Epic!</strong></h4><ul><li><em style="font-weight:400;">“I would like the functionality of Hey Epic! to be improved. It should be as smart as Alexa or Siri, but it is a solid 10% of either of those.” </em>—Advanced practice provider</li></ul><p style="font-size:.85em; color:#858d96;">Note: This is the only comment from a Collaborative respondent that specifically mentions Hey Epic!</p><h4><strong>On Secure Chat</strong></h4><ul><li><em style="font-weight:400;">“I enjoy Secure Chat. It enables me to reach stakeholders immediately, which enhances my performance and care of patients.” </em>—Nurse</li><li><em style="font-weight:400;">“Secure Chat has made discharge planning and MD communication much better.” </em>—Allied health professional</li><li><em style="font-weight:400;">“I intensely dislike the inappropriate use of Secure Chat by ancillary staff. People don’t want to page someone for minor issues that can be addressed during rounds, but what used to require a page and some forethought as to the appropriateness of the question is now an inappropriate, bothersome, knee-jerk” secure chat message to medical staff. This happens even when medical staff are marked as unavailable. Secure chat has taken the critical thinking out of nursing care and has become a primary factor contributing to resident burnout.” </em>—Physician</li><li><em style="font-weight:400;">“I feel like Secure Chat has seriously worsened my Epic satisfaction. It is very intrusive and interrupts my other work, demanding my attention. It prevents my ability to have a no-distraction zone and to focus on the task. Between Secure Chat, notes, patient portal messages, staff messages, prescription refills, and other documentation, I have little time to actually see patients. It feels horrible.” </em>—Physician</li><li><em style="font-weight:400;">“Communication within the EHR is good overall, including via InBasket, Secure Chat, and so forth. However, there should be clearer expectations about when each method should be used.” </em>—Allied health professional</li><li><em style="font-weight:400;">“I love Secure Chat. It makes it so much easier to get ahold of specialists and not play phone tag.” </em>—Physician</li></ul><p style="margin-top:40px; background-color:#c18654; padding:15px; border-radius: 15px;color:#ffffff; font-size:.85em;"><strong>KLAS continues to validate which EHR programs, tools, and/or initiatives make a difference in EHR satisfaction. If you are an Arch Collaborative member and want to better understand the impact specific programs or initiatives are having on your clinicians, please contact your KLAS provider success manager.</strong></p></div><hr style="margin-top:40px;" /><div class="row" style="margin-top: 40px;"><h3 style="color:#c18654;"><strong>What Is the KLAS Arch Collaborative?</strong></h3><p>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 415,000 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.</p></div>

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Clinician Efficiency and Personalization, Nursing EHR Success, Ongoing EHR Education, Recognized Improvement

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This material is copyrighted. Any organization gaining unauthorized access to this report will be liable to compensate KLAS for the full retail price. Please see the KLAS DATA USE POLICY for information regarding use of this report. © 2019 KLAS Research, LLC. All Rights Reserved. NOTE: Performance scores may change significantly when including newly interviewed provider organizations, especially when added to a smaller sample size like in emerging markets with a small number of live clients. The findings presented are not meant to be conclusive data for an entire client base.

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