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Successful EHR Upgrades 2023
Mar 2023

Successful EHR Upgrades 2023


How to Maximize Impact and Prevent Clinician Frustration

Authored by:  Anna Beyer, 03/31/2023 | Read Time: 4 minutes

EHR upgrades are vital for continually improving technology, meeting regulatory requirements, expanding functionality, increasing user efficiency, and ultimately improving patient care. Arch Collaborative data shows EHR upgrades can be very challenging for clinicians. Clinicians are often frustrated and feel disconnected from the EHR when changes happen unexpectedly or appear to drive little improvement. To help healthcare organizations make upgrades smoother and more impactful for users, this report shares insights on the widespread phenomenon of user frustration with upgrades and recommends steps organizations and EHR vendors can take to improve.


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Ongoing Efforts to Improve EHR Upgrades:

To address the need for deeper insights on what factors correlate with upgrade success, the Arch Collaborative recently added a question to our end-user survey, asking respondents how the latest EHR upgrade has impacted their experience. In addition, we have begun surveying organizations in more detail about upgrades in the EHR education survey—which dives into education programs, trainers and educators, vendors and third-party education partners, and organizational processes for upgrades.

Investing in Positive Upgrade Experiences Pays Off in Clinician Trust 

Two key aspects of user trust in their organization/IT leadership are communication around upgrades and giving users input into EHR changes. Focusing on these areas can have strong dividends in organization-clinician relationships. As shown below, clinicians who strongly agree EHR changes are well communicated are 62.6 times more likely (compared to those who strongly disagree) to feel their organization/IT department delivers well. Those who strongly agree they have a voice in EHR changes are 29.5 times more likely to agree their organization/IT department delivers well. (Additional insights on trust in IT can be found here.)

odds of agreeing organization/it delivers well--by level of agreement ehr changes are well communicated
odds of agreeing organization/it delivers well--by level of agreement user has a voice in ehr changes

Plurality of Clinicians Are Indifferent about Impact of Recent EHR Upgrades

Just over one-fourth of clinicians agree or strongly agree recent changes have improved their EHR experience. A plurality express a neutral opinion of recent upgrades. While moving the needle will be challenging, organizations and EHR vendors have the opportunity to reverse the trend by listening to end-user feedback, clarifying what users need from upgrades, and partnering to better communicate the why behind EHR changes. (Read on for more recommendations.)

agreement that most recent ehr upgrade improved the ehr experience

Disruption, Communication Gaps, and Insufficient Education Are Common Themes of Upgrade Issues

The Arch Collaborative survey asks respondents to share details of their EHR experience, and the vast majority of respondents who mention upgrades share negative sentiments about the changes. Disruption is the top complaint—this includes downtime, slower system response times, and decreased efficiency from EHR changes. The next two most-common issues go hand in hand: lack of communication from the organization and insufficient education around upgrades (e.g., new functionality, workflow changes). Many clinicians share suggestions for how organizations can improve in this area, highlighting the opportunity for organizations and vendors to implement robust communication and education strategies around upgrades. Frustration with layout changes is also often mentioned by clinicians. Respondents feel some upgrades provide little to no apparent value or are redundant; these clinicians want to see fewer cosmetic changes to things like layout and more focus on improving the actual user experience.

sentiment of clinician comments about ehr upgrades common topics in clinician comments about ehr upgrades

Best Practices for Organizations to Improve EHR Upgrade Satisfaction

communication iconCommunicate early through various methods/tools: emails, posters in restrooms and hallways, newsletters, superuser communication, tip sheets, town hall meetings, etc.

end user iconAllow end-user testing of upgrades

nurse iconCreate role- or specialty-specific education, including in-person sessions (led by EHR trainers, superusers, clinician informaticists, etc.) and options like videos and tip sheets that teach users about upcoming EHR changes; leverage available education from your EHR vendor

notes iconCreate specialty-specific release notes for upgrades

clock iconPhase out outdated EHR education, tip sheets, and videos

mail iconRound or send out a survey after the upgrade to ask users for suggestions about the process (not necessarily the upgrade itself)

chat iconCommunicate in advance about any expected downtime from an upgrade, and monitor the actual downtime experienced by end users


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 have surveyed their end users and over 370,000 clinicians have responded. Impact 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.

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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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