Key Drivers of EHR Improvement 2025

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Using a track-and-field analogy, this report clarifies how to leverage your EHR Experience Level to focus on the areas that will be most impactful for your organization. It also explores how the EHR House of Success correlates with this framework to guide leaders on how to achieve their set goals.

Voices of Healthcare Organizations

“We already get the data review report, and it highlights the things we need to work on. It just feels like generic information, and we want more information and direction on the route we should take to address and improve the gaps.” —Healthcare executive

“It can be hard to make a decision on what to do first, and sometimes getting a few of those easy wins launches us into a mindset that we can do some of these things.” —Healthcare executive

Setting Targets for Progress

Visualizing the Levels: From Hurdles to Vaults

Think of this journey like a track-and-field competition: At any given time, many events are taking place, each demanding something different of the athlete—precise technique, targeted training, and sometimes collaboration or specialized equipment. Through it all, athletes work toward their own goals and personal records, whether measured in speed, distance, or height.

Just as a coach surveys the field to decide how best to train their athletes for success, a healthcare organization seeking to improve clinician EHR satisfaction can take a similar approach. Without first assessing your current position, it can be overwhelming to look at the data and know where to begin or how much improvement is needed. Standard benchmarks can show where you stand among peers, but each organization faces different hurdles and heights that they must clear. The EHR Experience Levels provide additional clarity by showing you how your own metrics compare to those at the next level—revealing where you should focus your energy and how far you need to stretch to progress. By examining where the largest gaps in satisfaction exist, you can pinpoint the metrics that will most help your organization advance and make the greatest impact on clinician satisfaction.

To illustrate how metrics tend to vary in impact and what effort is required to improve them, we have grouped them into three categories—hurdles, relay races, and pole vaults.

Framework for EHR Progress: A Track-and-Field Comparison

When running hurdles, you cannot quickly finish the race unless you cleanly clear them. They are essential barriers that no organization can skip when seeking to improve the EHR experience. These metrics often show the largest gaps between below-average (Level 1) and exceptional (Level 6) performers, so focusing here can have the greatest impact on overall satisfaction.

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Success in relay races requires teamwork and timing, hinging on both individual performance and seamless handoffs. Efforts here may require preparation and collaboration across multiple teams and infrastructure (e.g., servers, badges, Wi-Fi) but are achievable with the right coordination and focus.

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The pole vault is a technically demanding event, requiring a combination of speed, strength, agility, timing, and balance. These are challenges the entire industry is still working to solve. The pole vault isn’t impossible to clear, but success requires broad external collaboration and remains a pain point even for Level 6 organizations.

The Metrics That Matter Most for Physicians & Nurses

Across Arch measurements, three NEES metrics consistently emerge as the hurdles, relay races, and pole vaults that organizations should work on to make meaningful EHR improvement. For both physicians and nurses, efficiency is often the first hurdle to clear, and external integration is the pole vault that remains most difficult to solve. The relay race differs between clinical roles—for physicians, it is response time, and for nurses, it is patient-centered care.

Taking the Next Steps

Few athletes begin with the pole vault, and few healthcare organizations start at Level 6. Progress comes from identifying the metrics that will make the most impact to your organization through your EHR Experience Level and then making consistent, intentional efforts to improve those areas. Luckily, no organization has to make this journey alone. While this report focuses on goal setting, the Arch Collaborative offers a range of resources with both strategic guidance and practical tools to help leaders tackle the metrics they have decided on and reach new EHR Experience Levels. Some of these resources include:

Sustaining Progress: Leadership & the EHR House of Success

While an organization works to improve their highest-impact metrics, the pillars of the EHR House of Success—education, governance, and personalization—remain essential. The metrics in the previous section show an organization where to focus; the EHR House of Success guides leaders on how to achieve those goals, whether through technical upgrades, workflow optimization, or cultural alignment.

Healthcare leaders play the role of coach on this journey. Their job is to provide both strategy and support—setting clear targets, ensuring accountability, and reinforcing the pillars of the EHR House of Success. When leaders consistently emphasize education, governance, and personalization, they create conditions where their clinicians can thrive.

The following charts illustrate how these pillars correlate with the EHR Experience Levels. As organizations progress from Level 1 to Level 6, consistent gains can be seen in each area, reinforcing that these principles—and the leaders who sustain them—are critical to sustaining improvement.

The Pace of Improvement Varies

Improvement looks different for every organization, and both steady and rapid progress can lead to meaningful results. At the 2025 Arch Collaborative Learning Summit, Franciscan Health shared how intentional, incremental work over multiple years led to lasting gains in satisfaction, climbing three EHR Experience Levels and representing one of the most substantial improvements observed in the Collaborative. With a different approach, UTHealth Houston showed that focused initiatives with nurses can drive measurable improvements, rapidly elevating their NEES and EHR Experience Level over just two years.

Together, these examples highlight that there is no single timeline for success. What matters most is committing to the work—whether through steady refinement or rapid, focused change—and using the Levels and House of Success as guides along the way.

Practice & Perfection: Steps to Take

Examples of Setting Effective Goals with EHR Experience Levels 

To tangibly illustrate the principles in this report, the following exercises demonstrate the potential benefits of using your EHR Experience Level in conjunction with standard benchmarking when setting goals. Better Care Health is a real Arch Collaborative member organization that has been anonymized for use in data visualizations. This proxy organization serves as an example to illustrate how organizations can interpret and act on their EHR satisfaction data.

Better Care Health Physicians—NEES 42.5, Level 4

At first glance, Better Care Health’s benchmarking results for physicians suggest that “enables quality care” should be the primary focus for improvement, as it is the only metric below the upper quartiles. While that insight is valuable, the organization’s EHR Experience Level provides a clearer picture of where improvement will have the most impact. When comparing their current Level 4 results to the average Level 5 organization, quality care remains an area of opportunity (9% gap), but the largest differences appear in external integration (17%) and patient-centered care (12%). Continued efforts in areas like quality care will support progress toward Level 6, but focusing on external integration and patient-centered care will drive the most significant gains.

Better Care Health Nurses—NEES 67.2, Level 5

Better Care Health can perform a similar exercise for their nurses, who report higher overall satisfaction than the physicians. The nurses benchmark in the upper quartiles across all metrics, making it less clear at first where the organization should focus on improvement. Comparing their Level 5 results to the average Level 6 organization reveals the largest opportunities: efficiency (16% gap), patient-centered care (13% gap), and quality care (12% gap). While maintaining high-performing metrics such as reliability—already on par with Level 6—will support ongoing progress, concentrating on these three areas is most likely to accelerate the nurses’ advancement to Level 6.