Successful EHR Upgrades 2023

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.)

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.)

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.

Best Practices for Organizations to Improve EHR Upgrade Satisfaction

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

Allow end-user testing of upgrades

Create 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

Create specialty-specific release notes for upgrades

Phase out outdated EHR education, tip sheets, and videos

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

Communicate 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.