Global EHR Satisfaction 2025

Healthcare organizations around the world have become more digitally mature since implementing their go-forward EHR, and now, they are prioritizing EHR optimization (see KLAS’ 2024 and 2025 reports sharing global healthcare IT trends). As momentum around EHR optimization continues, the KLAS Arch Collaborative aims to help organizations worldwide fully support their clinicians in their EHR experience. This report uses data gathered over the last three years from 38 organizations—located across Canada, Europe, the Middle East, and Oceania—to examine how EHR satisfaction compares worldwide. Organizations that are running an EHR without measuring its impacts are inadvertently missing opportunities for greater organizational alignment and clinician satisfaction—the universal best practices in this report can help these organizations know where to focus to improve the EHR experience.

Note: Though the nomenclature used to describe the core patient record used throughout a hospital varies from region to region or language to language (EHR, EPR, EMR, etc.), the term that will be used in this report is EHR (electronic health record).

The Middle East Sets a High Bar for Clinician EHR Experience; Stable Infrastructure, Exceptional Training & Effective Governance Drive Their Success

Healthcare organizations in the Middle East are a model of success for clinician EHR satisfaction thanks to their strategic investments in three areas: foundational infrastructure, sustained training programs, and effective governance with organizational support. Regarding infrastructure, the organizations prioritize system reliability and speed, and they ensure that their clinicians can access the tools they need without disruption. For training, many organizations have adopted a proactive approach, offering ongoing, role-specific education that helps users get the most from their systems. And finally, the organizations have governance structures that include clinician input, which further ensures that the EHR evolves with users’ needs.

In comparison, other regions (including the US) struggle with infrastructure, training, and governance. Their infrastructures are often outdated or inconsistent, leading to slow system performance and connectivity issues. While most regions provide basic onboarding, they often lack the ongoing, role-specific education that is necessary to increase clinicians’ efficiency and confidence with the EHR. Furthermore, clinicians in these regions often feel left out of their organizations’ decision-making process, so they don’t feel supported in optimizing their workflows to meet their needs. These issues create an environment where EHRs are seen as burdensome, leading to higher clinician burnout and dissatisfaction.

Voice of the Clinician: EHR Experience

“I am highly satisfied with our EHR system in terms of patient safety, ease of use, efficiency, and team communication around patient care.” —Nurse (The Middle East)

“Using the EPR has massively slowed down my workflow and had a direct impact on patients. Most of my time is now spent looking at a computer and trying to find where to log information. From a nursing perspective, I feel that the EPR has harmed nursing care and detracted from person-centred care. Our bandwidth is taken up by trying to navigate and use the EPR and other systems, and our time is being allocated away from patients.” —Nurse (Europe)

Burnout Continues to Be a Global Issue; EHR Plays a Role

Clinician burnout is not confined to any one region or country—it is a universal challenge affecting healthcare organizations globally. Across most regions, including the US, about one-third of interviewed clinicians experience burnout; the exception is the Middle East. Common contributors to burnout are staffing shortages, stressful work environment, and lack of control over workload. In addition, the EHR is frequently cited as a top contributor to clinician burnout and can exacerbate other contributors. Clinicians in Oceania cite the EHR as a contributor the most, and clinicians in the Middle East cite it the least. When organizations understand the extent of their clinicians’ burnout and its connection to the EHR experience, they can be more strategic about organizational priorities that would reduce burnout (see this KLAS report for more about addressing burnout). Notably, improving EHR efficiency is key to boosting EHR satisfaction and consequently reducing burnout (see this KLAS report for more satisfaction drivers).

Voice of the Clinician: Burnout

“The number-one factor that has influenced my current negative feelings toward my organization is the EPR. It has caused so much frustration and dislike of my job that I literally have no joy in being here. I am considering resigning from my position because of this system. It has made my job harder. It is dangerous and takes time away from my patients.” —Nurse (Oceania)

“Our product is a terrible system that is designed to demoralize and waste the time of healthcare practitioners. It is not intuitive, there are too many ways to go wrong, there is no teaching or support, and there are many internal tricks that can only be learned by spending many hours trying to figure things out or begging people to help, despite them being too busy to help because they have their own issues and workload. Our system should be abandoned immediately before it collapses the whole system, causes mass physician burnout, and decreases quality of care for patients.” —Physician (Canada)

THE EHR HOUSE OF SUCCESS

A Stable EHR Infrastructure Is Nonnegotiable & Should Be Organizations’ First Priority When Looking to Improve EHR Satisfaction

For clinicians, a strong infrastructure—i.e., a reliable system with fast system response time—is essential for delivering safe, effective care. Frequent system slowdowns or crashes disrupt clinical workflows, leading to greater likelihood of clinician burnout and diminished care quality. In contrast, when the basics are in place, clinicians can focus on what matters most: their patients.

In Canada, Europe, and Oceania, less than two-thirds of clinicians agree that their EHR infrastructure is effective. To boost EHR satisfaction, organizations in all regions must address issues with system reliability and response time (e.g., login time, load times, downtime, connectivity, consistent system performance) either before or in conjunction with extensive initiatives around education, governance, or personalization. If infrastructure issues are not addressed, the effectiveness of other initiatives will be diminished by persistent technological problems.

Voice of the Clinician: EHR Infrastructure

“Sometimes the system is slow to load, especially during time-sensitive, emergent situations.” —Nurse (Canada)

“It takes very long to start a workstation computer and log in to the system. I have had to wait for up to 5-10 minutes, which doesn’t sound like a lot, but the minutes add up when I am looking after 5-10 surgical patients in a day. The process for opening and logging in to the system should be faster.” —Physician (Canada)

“Wi-Fi connectivity drops out on regular basis, making me lose my work unless it is saved.” —Physician (Europe)

“I don’t know whether the issue is the EPR or the hardware we use, but the system freezes far too often. This delays the clinics and adds a huge amount of stress for both clinicians and patients.” —Physician (Europe)

To evaluate your organization’s infrastructure maturity, answer the self-examination questions in the KLAS Arch Collaborative Success Pathway—EHR Reliability & System Speed.

EHR Education & Training Are Essential for Clinician Success

In Canada, Europe, and Oceania, clinician satisfaction with EHR education is lower. EHR education is often not as much of a priority as other projects and thus isn’t allocated sufficient resources, sometimes due to financial constraints. While cutting back on training may help reduce short-term expenditures, it can have long-term negative impacts—for example, lower EHR satisfaction results in increased clinician burnout and a higher likelihood of clinicians leaving their organization. Additionally, poor initial training can lead to greater skepticism around ongoing training.

Onboarding and ongoing training are essential for building user confidence and boosting efficiency. Regarding onboarding training, clinicians need at least three hours of training but greatly benefit from receiving more; clinicians with the highest EHR satisfaction receive at least eleven hours of onboarding training (see chart below). When possible, onboarding training should include workflow-specific training.

After onboarding, clinicians should receive ongoing training—in particular, training tailored to specific clinical workflows—to become more proficient, learn time-saving features, and adapt to system updates. Clinicians should receive between three and five hours of training annually so they can maintain EHR proficiency and feel empowered rather than hindered by the technology. Also, ongoing training can help retain clinicians; the Clinician Turnover 2024 report notes that enhanced ongoing EHR education is a top factor that prevents clinicians from leaving their organization.

Note: The data in these charts comes from providers only and represents all provider feedback collected by the Arch Collaborative, not just that of the 38 non-US organizations examined in this report. Best practices for nurses can be found in the 2024 Nursing Guidebook.

Voice of the Clinician: EHR Education

“I want someone to sit with me as I go through my usual outpatient clinic day and point out improvements I could make; I would need only an hour of someone’s time, and I would be so much happier.” —Physician (Canada)

“We need thorough training for staff on how to use the system.” —Nurse (Canada)

To evaluate your organization’s education maturity, answer the self-examination questions in the KLAS Arch Collaborative Success Pathways for onboarding EHR education and ongoing EHR education..

Effective EHR Governance Is Key to Driving Organizational Alignment & Clinician Empowerment

EHR governance is defined as a healthcare organization’s strategic and operational framework for overseeing EHR management, usage, and optimization. Organizations with effective governance involve and listen to clinicians, communicate changes, and seek to optimize clinician workflows based on feedback. A key indicator of how well an organization does these things is clinicians’ agreement on whether their organization/IT leadership does a good job of implementing, training on, and supporting the EHR. In this way, the Middle East surpasses other regions, with clinicians highlighting strong leadership, clear communication and accountability, and a culture of clinician engagement. Clinicians in the other regions, in contrast, experience an us-versus-them culture with their IT team; they express frustration around not having a voice in EHR changes and say EHR changes aren’t communicated well.

In Arch Collaborative data generally, clinicians who strongly agree that their organization/IT leadership delivers well report higher EHR satisfaction (see this KLAS report). Organizations can foster effective EHR governance when there is shared ownership between organizational leaders and frontline clinicians. When clinicians have a voice in how the EHR is managed, updated, and optimized, they are more likely to feel invested in its success.

Voice of the Clinician: EHR Governance

“At the beginning, I was keen to give feedback on the EMR to correct some issues and improve functionality. However, the lack of receptiveness from the staff demoralized me, so until now, I have not provided feedback.” —Nurse (Oceania)

“IT support needs to be available on-site at all times. Every time we have an issue, it is impossible to get in-person support, especially when things are time sensitive. When there is an issue with IT, it directly impacts patient care, so it should be an organizational priority to ensure support is on-site and available.” —Nurse (Canada)

“Before the design and implementation of a new process, talk to the actual users of the system to ascertain how they work, what they want, and what will help. Prioritize the users and their needs above target-driven changes.” —Nurse (Europe)

Read the Arch Collaborative Learning Summit 2023 overview for more information.

Personalization Leads to Enhanced EHR Usability

Personalization allows users to tailor the EHR to their specific needs and workflows, including around order sets, shortcuts, and documentation templates. These seemingly small adjustments can streamline routine tasks and boost overall efficiency. Of note, Arch Collaborative data shows that any adoption of personalization tools helps increase EHR satisfaction (for more information, see this KLAS report). Clinicians in the Middle East report the highest adoption of EHR personalization, likely due to educational resources and organizational governance that incorporates clinicians’ feedback on EHR changes.

To evaluate your organization’s EHR personalization maturity, answer the self-examination questions in the KLAS Arch Collaborative Success Pathway—EHR Personalization Tools.

Best Practices for EHR Personalization

Incorporate personalization capabilities into ongoing training or workflow training.

Monitor EHR data to identify potential EHR efficiency opportunities.

Calculate time and money saved from reduced clicks to generate buy-in and keep clinicians and leaders engaged in workflow optimization.

Voice of the Clinician: EHR Personalization

“Make document notes easy to read and have them flow better for each specialty.” —Physician (Europe)

“There is so much customization possible, but no one ever showed us the specific functionalities that are possible or what is efficient for outpatient clinics. We had to figure things out on our own, and I am sure that there are many other areas in which we could improve our efficiency, but I have no idea what is available.” —Nurse (Canada)

Partner with KLAS—Determine Next Steps for Improving EHR Satisfaction

If your organization wants to improve clinicians’ EHR experience and reduce burnout, KLAS can help you examine where your organization stands.

Measure current EHR satisfaction by collecting clinician feedback via the Arch Collaborative EHR Experience Survey.

Use survey results to identify key areas for improvement.

Draw on best practices and insights from high-performing organizations (like those in the Middle East) and prioritize targeted, sustainable changes.

Keep going—continue measuring your clinicians’ satisfaction and work to further optimize the EHR experience.

For more details about measuring clinician EHR satisfaction via the Arch Collaborative, see this document.

Leaders Worldwide Share Why Working with KLAS to Measure Clinicians’ Experience Is an Organizational Priority

“The bottom line is I don’t know where we would be today without joining the Arch Collaborative. It has been a key lever for me as a leader to be able to have that global voice to show where we are and where we need to be to truly be successful, and I can share that message in a way that has some weight behind it.” —CMIO (Canada)

Success Stories from Organizations Across the Globe 

EHR Infrastructure

Keys to Success:

Essentia Health has a robust network infrastructure. They have transparent communication, single-sign-on functionality to streamline logins, and a strong focus on uptime and resilience metrics. The organization’s success is further fueled by dialogue with clinical users, alignment between technological financial investments and patient care outcomes, and a consistent approach to hardware replacement. For more details, see case study.

EHR Education

Keys to Success:

Hamad Medical Corporation’s comprehensive approach to nurse onboarding education has resulted in their nurses reporting higher-than-average EHR satisfaction. The organization is in the 100th percentile for nurse agreement that (1) their initial and ongoing training is sufficient and (2) their training is workflow specific. For more details, see the case study.

EHR Governance

Keys to Success:

Dubai Health’s efforts around shared ownership, governance structure, and EHR support have contributed to high clinician EHR satisfaction. The organization’s NEES is among the highest ever achieved in the Arch Collaborative, and they are in the 100th percentile for respondent agreement that the organization has done well with implementing, training on, and supporting the EHR. For more details, see the case study.

EHR Personalization

Keys to Success:

UCI Health’s onboarding training goes beyond the basics by diving deep into workflow training and personalization. Simulations are used as part of the practical, hands-on experience so that nurses learn workflows rather than just basic system interactions. During classroom instruction, each nurse personalizes the look and feel of their system. For more details, see the case study.

What Is the KLAS Arch Collaborative?

The Arch Collaborative is a group of healthcare organizations committed to improving the EHR experience through standardized surveys and benchmarking. To date, over 300 healthcare organizations across 13 countries have surveyed their end users and over 600,000 clinicians have responded. Reports such as this one seek to synthesize the feedback from these clinicians into actionable insights that organizations can use to revolutionize patient care by unlocking the potential of the EHR.

This report acknowledges organizations that have won KLAS Arch Collaborative Awards. The Arch Collaborative EHR Experience Pinnacle Award honors members of the Arch Collaborative who have demonstrated that success is possible with the EHR. Qualifying organizations must have a NEES of at least 75.0 for nurses or a NEES of at least 60.0 for physicians. To put this in context, the average nurse NEES is 47.3 (n=113,045), and the average physician NEES is 23.4 (n=53,037).

The Arch Collaborative EHR Experience Breakthrough Recognition honors any participating organization whose NEES has increased by at least 15 points between measurements. This can be earned for physician or nurse scores.