Key Drivers of Clinician EHR Satisfaction 2023

Efficiency and Fast System Response Time Impact EHR Satisfaction the Most

Similar to a net promoter score, the NEES represents the overall landscape of clinician satisfaction with the EHR. The NEES is calculated by subtracting the percent of negative user feedback (strongly disagree or strongly agree) from the percent of positive user feedback (strongly agree or agree); it excludes indifferent feedback (neither agree nor disagree). A NEES can range from -100 (all negative feedback) to 100 (all positive feedback). The table to the right shows the 11 metrics (and their associated questions) that make up the NEES.

The metrics most closely correlated with the overall NEES are the EHR’s ability to enable efficiency and the system response time (learn more about the latter in this Arch Collaborative report); low scores in these two areas indicate that larger issues (e.g., lag time or too many clicks) are preventing clinicians from leveraging the EHR’s full potential.

Some metrics tend to generate higher satisfaction than others. For example, across Collaborative organizations, 75% of responding clinicians agree or strongly agree their EHR is reliable; however, only 55% agree the system response time meets their expectations. A few metrics see low average satisfaction scores, even from organizations with a high NEES. The metric with the lowest average score is integration with outside organizations (i.e., external integration), followed closely by agreement the EHR enables efficiency. For both metrics, only 56% of respondents with a NEES in the highest quartile are satisfied. This demonstrates that the industry is lagging far behind end users’ expectations for things like integration and efficiency. To raise the bar and improve clinician satisfaction, healthcare organizations will need to collaborate with their peers, learn from high-performing organizations, and work with vendors.

The table to the right is meant as a reference tool to help organizations know how to target specific improvements to the EHR experience. For example, organizations with low scores for system reliability may want to focus on improvements in areas most correlated with that metric, such as system response time, internal integration, external integration, and enables patient-centered care. Some metrics are more closely connected to multiple other metrics. Others, like agreement the EHR enables patient-centered care, can be difficult to address directly; organizations can improve these areas indirectly by making improvements to other, highly correlated areas. While training is less directly correlated with NEES metrics, it is still critical and represents one of the Arch Collaborative’s foundational pillars to success with the EHR.

The following sections detail what metrics are most important for healthcare organizations, individual end users, and EHR vendors to focus on due to those metrics’ high correlation to EHR success. Further recommendations for strategies to improve these metrics can be found in the Expanded Insights section of the full report.

Recommendations for Success—Healthcare Organizations and End Users

Recommendations for Success—EHR Vendors

System reliability & response time

• Clearly communicate recommendations or best practices for how healthcare organizations should set up and use the EHR.
• Be transparent about which technology works best with the EHR, including single sign-on options, other software solutions, hardware, and internet options.
• Work with customer organizations to ensure they are following recommendations and best practices.

Internal and external integration

• Develop connections among your own systems and with other vendors’ systems.
• Train customer organizations on how to best to utilize existing integration.

Alerts

• Do not assume customer organizations are using alerts in the most effective way. Recommend a strategy for implementing and using alerts that helps avoid alert fatigue.
• Be actively involved in improving the alerts process for end users by providing guidance and support, along with ensuring alert functionality is strong.

Quality care

• Provide the functionality organizations are asking for, along with awareness and education about existing functionality. This can help end users feel more assured that the EHR is helping them care for their patients effectively.
• Help ensure alerts are accurate and effective to help prevent care-delivery mistakes, thereby increasing confidence in the EHR’s ability to enable 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, almost 300 healthcare organizations have surveyed their end users and over 370,000 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. To participate in the Arch Collaborative, go to https://engage.klasresearch.com/klas-arch-collaborative/.