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Key Drivers of Clinician EHR Satisfaction 2023
Mar 2023

Key Drivers of Clinician EHR Satisfaction 2023


Exploring the EHR Experience Metrics

Authored by:  Lauren Manzione, 03/03/2023 | Read Time: 4 minutes

Since 2017, the Arch Collaborative has used the Net EHR Experience Score (NEES) to measure and benchmark clinicians’ EHR satisfaction. This report breaks down what this score means and how the metrics behind it can help organizations pinpoint ways to improve clinicians’ experience with the EHR, thereby improving healthcare delivery and reducing burnout. Efforts to improve may involve addressing areas of opportunity directly, but they can also include addressing issues indirectly by targeting related factors.


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Efficiency and Fast System Response Time Impact EHR Satisfaction the Most

Individual metrics behind the NEESSimilar 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.

percent of clinicians satisfied with nees metric
where to start to improve the ehr experience

 TEXTThe 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

Healthcare Organization/IT Leadership

System reliability & response time

Ask yourself the following questions:

  1. Do we comply with our vendor’s infrastructure recommendations?
  2. Do we adhere to a hardware inventory schedule?
  3. How does the Wi-Fi perform in our clinics and hospitals?
  4. Do our single sign-on and EHR vendors work together to improve the user experience?
  5. Do we know how long it takes a user to get into the system?
  6. Do we know how long it takes to shift between windows or tabs in the EHR?
  7. Are we on the latest version of our vendor’s EHR?

Functionality

  • Be transparent and communicative about what functionalities are available to your clinicians by using effective marketing and training.
  • Listen to the functionality needs of your clinicians and consider a third-party option when needed. (Though also consider how integration might impact third-party functionality.)

Efficiency

  • Streamline and simplify charting as much as possible to remove unnecessary clicks and too many ways to complete the same workflow
  • Provide workflow-specific education for providers to help them be more efficient.
  • Empower clinicians to take personal responsibility over their EHR experience.

Patient safety & patient-centered care

  • Ensure alerts function as important, effective reminders.
  • Assess whether system alerts are optimized to avoid alert fatigue.
  • Focus on recommendations for functionality and efficiency improvement, which are closely tied to patient safety and patient-centered care.

Individual Clinicians

System reliability & response time

  • Follow the hardware and software recommendations of your healthcare organization and vendor.
  • Ensure that you are up to date with software and hardware updates on all the devices you use.
  • Report any problems to your organization.

Functionality

  • Take time to learn about the functionality of your EHR through training and working with superuser peers and others with strong EHR expertise.
  • If there is functionality you feel you are missing, ask about it. It might already exist in your system.

Efficiency

  • Take advantage of training offered by your organization to help you be more efficient. Time spent on training that improves your efficiency can pay dividends in time saved.
  • Take personal responsibility for your EHR experience.

Patient safety & patient-centered care

  • Provide feedback about the effectiveness of alerts.
  • Focus on recommendations for functionality and efficiency improvement, which are closely tied to patient safety and patient-centered care.

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 klasresearch.com/arch-collaborative.

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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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