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Finding the Right  Recipe for Documentation
Finding the Right Recipe for Documentation
Speech Recognition, Scribes & Other Methods—Impact Report


Based on the feedback of 37,718 physicians from 202 organizations, this report examines the impact of various documentation “recipes” on the following satisfaction and efficiency metrics:

Net EHR Experience Score (NEES) (EHR satisfaction rating)

Burnout rate (percent of physicians reporting burnout)

Self-reported ambulatory same-day chart-closure rate

Self-reported inpatient same-day chart-closure rate

Satisfaction with personal documentation quality

Satisfaction with peers’ documentation quality


Documentation Recipes

To determine how an organization’s documentation recipe is likely to impact EHR satisfaction and efficiency, each measured EHR deployment in the Arch Collaborative was sorted into one of eight groups depending on the organization’s average adoption level (as self-reported by physicians) of speech recognition, scribes, and dictation (adoption is considered high if it is above the median). While satisfaction and efficiency vary across these groups, not all variation is statistically significant. Overall, documentation method is a poor predictor of EHR experience and provider burnout (mathematically has only a limited impact). Statistically significant correlations are called out in future pages.


organization ehr satisfaction and efficiency by documentation recipe

Key Takeaways

Speech recognition works best when utilized on top of strong EHR proficiency. Speech recognition adoption must include strong change management and robust education.

While many physicians expect scribes to solve their documentation challenges, organizations that invest in scribes do not usually report significantly better outcomes. The few exceptions are organizations that ensure their scribes are well trained and that expect providers using scribes to be highly proficient with the EHR.

“A provider who does not know how to use the EHR will not know how to use speech recognition—or a scribe—to make the EHR easier to use.” —3M M*Modal Insights, pg. 7

“Done right, new technologies can alleviate administrative burdens for providers; done wrong, they may magnify administrative burdens, with the onus on organizational leadership for deployment, training, and support.” —Dr. Robert Budman, CMIO, Nuance Communications


Shifting the Paradigm

Surprised by the lack of impact that documentation method has on EHR satisfaction and clinician burnout? KLAS encourages organizations to consider that how these technologies and services are implemented can play a significant role in how well they move the needle.

As noted above, the success of scribes is often dependent on the quality of the training and the expectations set for providers. Similarly, use of speech recognition technology today is not always accompanied by sufficient user education and workflow redesign. Though the technology is likely to change drastically in coming years (thanks to the development of ambient intelligence), KLAS asserts that proper training and user assistance will still be important success factors.


Outcomes by Recipe

organization documentation recipe and outcomes

After controlling for the EHR in use, KLAS found the following correlations at the organizational level:

Organizations with higher use of dictation also have lower EHR satisfaction (p<.01).

There is no statistically significant correlation between documentation method and burnout rate.

Physicians at organizations with higher speech recognition adoption report higher same-day chart-closure rates (p<.01).

Physicians at organizations with higher dictation rates view their peers’ documentation as being of lower quality (p < .01).

Overall, the most effective organizations focus on only a couple of documentation methods (including personal entry and excluding dictation), likely because specializing in a couple of documentation methods allows for better support and training. Organizations with dictation or with many means of documentation see lower success.


Don’t Just Check the Box for Speech

Over 2,000 of the surveyed physicians commented on their speech recognition technology, with 45% reporting frustrations. The high number of positive comments indicates that the technology can be utilized well when accompanied by excellent EHR proficiency and speech recognition education. The quotes below are representative of the most common sentiments about speech recognition:

provider perceptions of speech recognition

“I LOVE the new [version of our speech recognition solution]. I feel like after just a few days, it knows me better than the other version did after years of me yelling at it.”

“My biggest complaint is with [our speech recognition solution]. It’s not reliable. It shuts down and crashes Epic on a daily basis. I expected this to be resolved with the latest Epic upgrade, but it was not. I usually stop using [the speech recognition solution] for the day if it crashes. The cycle repeats itself the next day. When it works smoothly, it makes the workflow more efficient.”

“Please provide the opportunity for ongoing, hands-on, at-the-computer training for both [our speech recognition solution] and Epic. I believe giving employed physicians the opportunity to observe Epic-savvy staff use and optimize the system would be a great financial investment for the corporation. Additionally, having an optimization-minded advocate from our organization looking at user problems and resolving them with Epic would really reduce job frustration and improve user efficiency.”


The data shows that the use of speech recognition technology does not guarantee documentation success—an organization can achieve very strong or very weak results depending on how the technology is implemented and how well users are trained. With how speech recognition technology is commonly implemented today, providers often report better efficiency, similar or lower EHR satisfaction, and sometimes lower confidence in their own documentation. In general, physicians report better outcomes when organizations make an all-in bet with speech recognition (i.e., don’t use scribes or dictation).

outcomes by recipe

Scribes

Among those using scribes, the differences are significant depending on how the data is analyzed.

The physicians who are given scribes are often the most frustrated, so it is not surprising that as a group, they report lower EHR satisfaction and worse chart-closure rates than their peers who use other documentation methods. However, the longitudinal data indicates that these metrics can improve with use of a scribe. Next year, KLAS will be able to show trends in how scribes impact physician burnout rates.

scribes

In Summary

It is increasingly clear that organizations looking for a quick fix to their EHR satisfaction challenges, either through scribes or speech recognition, are likely to be disappointed. Those that adopt these technologies and processes in tandem with strong change management and strong EHR proficiency will likely see efficiency gains.

It should be noted that the results achieved today could change as ambient intelligence supplements speech recognition technology, as organizations adopt better implementation and training programs for their technology environment, and as organizations improve how they implement scribe programs. As these technologies and services evolve, the Arch Collaborative will continue to monitor their impact and provide insights into how they can best be implemented and what results organizations can expect.

  • OrgType: 1
  • Topic Ids: 12
  • Topic Names: <a href="/archcollaborative/reports/clinical-outcomes/12"> Clinical Outcomes</a>
  • Cost: 0
  • Time: 0
  • OrgName: Bassett Healthcare System
  • OrgId: 1
  • EMRVendors: Bassett Healthcare System (1)
  • Regions: 2
  • Authors: Taylor Davis and Bryant Wood
  • Contacts:
Achieving EHR Satisfaction in Any Specialty
Achieving EHR Satisfaction in Any Specialty
Impact Report


† Pediatrics and cardiology are cited here and in later paragraphs instead of other, more extreme examples due to their larger sample sizes and to avoid overemphasis on potential outliers in Collaborative data.


One critical factor in the difference between specialties’ satisfaction is the quality of initial training. Collaborative data shows a correlation between high physician agreement that initial training prepared them well and high agreement that the EHR has functionality needed for
their specialty.

However, while organizational efforts around training can help mitigate functionality issues, some specialties simply don’t have needed functionality in their EHR, even with great training. One common complaint is that the size or scope of the specialty does not match up with the EHR’s intended user base; for example, one dermatologist described the EHR as “overly bulky for outpatient specialty care.” Another issue is that the EHR does not support specialty-specific clinical workflows; one ophthalmologist said their EHR doesn’t meet the needs of clinicians who “need to be able to document with drawing or images.” Other physicians, notably orthopedists, have concerns with things like specialty-specific templates/order sets, slow response times, or an unintuitive user interface.

average net ehr experience score by specialty

To determine how much of the physician EHR experience is reliant on training compared to the product itself, the following charts compare Cerner and Epic users (the two largest customer bases in Collaborative data), showing how training impacts their EHR experience relative to meeting specialty-specific needs.


functionality vs. training epic cerner

Compared to Epic users, Cerner users tend to agree less that they have needed specialty-specific functionality, even when controlling for training quality. However, ophthalmology and dermatology stand out for lacking needed functionality regardless of EHR. This highlights EHR vendors’ responsibility to pay special attention to struggling specialties and ensure the EHR includes the functionality these specialties need to succeed.

While these findings may lead some less-satisfied physicians to believe that they can’t succeed with the EHR because of their specialty, trends within specialties debunk this assumption. In many cases, physicians in lower-scoring specialties who have had high-quality training report high overall EHR satisfaction. For example, cardiologists with strong initial EHR training have a Net EHR Experience Score of 58.3, well above the overall physician average. Conversely, physicians in higher-scoring specialties who receive poor training report low satisfaction; poorly trained pediatricians have a Net EHR Experience Score of -21.6.

While cardiology and pediatrics are vastly different specialties and use the EHR in different ways, this analysis
shows they are similarly susceptible to the positive effects of high-quality EHR training and the negative effects
of poor training.


vendor performance snapshotFor more insights on how other factors such as EHR personalization and organizational practices affect variation in EHR satisfaction, see the Expanded Insights section of this report, which examines several of the most- and least-satisfied specialties.

While there is variation in the typical experience of different specialties,
no specialty is immune to the effects that high-quality training, strong culture, and personalization can have on EHR satisfaction. The insights in this report show how physicians can rise above their specialty’s EHR limitations by learning effective methods of improving their EHR experience, regardless
of their specialty.

arch collaborative logo
  • OrgType: 1
  • Topic Ids: 5
  • Topic Names: <a href="/archcollaborative/reports/ehr-personalization/5"> EHR Personalization</a>
  • Cost: 0
  • Time: 0
  • OrgName: Bassett Healthcare System
  • OrgId: 1
  • EMRVendors: Bassett Healthcare System (1)
  • Regions: 2
  • Authors: Matt Brunken & Connor Bice
  • Contacts:
Clinician Training
Clinician Training

Why Provide EHR Training?

Clinicians are hungry for more information about the EHR. They want to be able to master it to make their lives easier and their patients’ lives safer. One of the earliest findings of the Arch Collaborative was that initial training makes a significant impact on clinicians’ EHR satisfaction. There is a 90-point difference in Net EHR Experience Score between clinicians who strongly agree their initial EHR training prepared them well and those who strongly disagree.


do clinicians want more ehr training

Who Should Be Involved in Training?



who

There are many options for who can effectively lead initial and ongoing training, but there is no single right answer for who can do it best. The key is rather to focus on the quality of trainers and where they can most effectively train.

How Much Training Is Needed?



how

Feedback from EHR users suggests that 5–8 total hours of initial training and 3–5 hours of ongoing training per year sets clinicians up for success. It is important to remember that training shouldn’t be so time-consuming that it contributes to clinician burnout. Instead, organizations should plan and communicate about training sessions ahead of time—this improves both attendance and overall clinician engagement in training.

What Methods of Training Are Most Effective?


what

Organizations can use a variety of types of training and classes for onboarding training or ongoing education to educate clinicians on the EHR. Having a rich mix of content-delivery methods appears to be most impactful on clinician’s overall EHR satisfaction. Some training practices are shown to be more helpful—for example, in-person training, rounding, and training on personalization tools and specialty-specific workflows.

Where Should Training Be Held?



where

Finding the most effective location to host training sessions can be difficult. Collaborative data shows that while some locations have been shown to support strong training, the location of training is less impactful than the quality of training. There has been evidence from a handful of organizations that holding trainings off-site can be highly effective, though this method can be more difficult to carry out.


arch collaborative logo
  • OrgType: 1
  • Topic Ids: 3
  • Topic Names: <a href="/archcollaborative/reports/follow-up-ehr-education-training/3"> Follow-up EHR Education/Training</a>
  • Cost: 0
  • Time: 0
  • OrgName: Bassett Healthcare System
  • OrgId: 1
  • EMRVendors: Bassett Healthcare System (1)
  • Regions: 2
  • Authors: Bryant Wood & Anna Beyer
  • Contacts:
Clinician Burnout
Clinician Burnout
An Arch Collaborative Impact Report 2019


the definition of burnout

physician burnout rates

Arch Collaborative data indicates that 28% of providers report some degree of burnout; this is a lower percentage than industry reports on burnout. One possible explanation for this is that organizations who participate in the Collaborative have already proved a willingness to measure their clinicians’ satisfaction and are therefore among the more progressive organizations in attempts to understand the daily experience of clinicians. This proactive approach and possible self-selection bias may make a difference in clinicians’ wellness experience.


A strong Net EHR Experience Score is correlated with lower burnout; the more satisfied providers in a certain organization are with their EHR, the less likely it is that many providers in that organization are experiencing burnout.

net emr experience score vs physician burnout rate

The second question asks, “What are the primary contributors to your feelings of burnout (if any)?” The most common contributor to provider burnout is too much time spent on bureaucratic tasks, followed by the impact of the EHR or other IT tools on efficiency, and then a heavy after-hours workload.

contributors to clinician burnout

Key Takeaway

burning match icon

There is a correlation between clinicians’ Net EHR Experience Scores and burnout, but the Arch Collaborative has not seen an R2 greater than 0.2, indicating that at most, the EHR experience explains only 20% of the variation in clinician burnout. The takeaway from this report should be that burnout extends beyond the EHR. Best practices that lead to higher EHR satisfaction may help, but focusing solely on the EHR is unlikely to eliminate burnout.


arch collaborative logo
  • OrgType: 1
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  • Topic Names: <a href="/archcollaborative/reports/clinical-outcomes/12"> Clinical Outcomes</a>,<a href="/archcollaborative/reports/clinician-it-relationships/8"> Clinician/IT Relationships</a>,<a href="/archcollaborative/reports/culture/9"> Culture</a>,<a href="/archcollaborative/reports/ehr-personalization/5"> EHR Personalization</a>,<a href="/archcollaborative/reports/follow-up-ehr-education-training/3"> Follow-up EHR Education/Training</a>,<a href="/archcollaborative/reports/inter-organization-collaboration/7"> Inter-organization Collaboration</a>
  • Cost: 0
  • Time: 0
  • OrgName: Bassett Healthcare System
  • OrgId: 1
  • EMRVendors: Bassett Healthcare System (1)
  • Regions: 2
  • Authors: Connor Bice
  • Contacts:
Arch Collaborative Guidebook 2019
Arch Collaborative Guidebook 2019

Guidebook Participants

KLAS is grateful for the dedication and participation of several leaders who have given their time and insights to ensure that the information in this guidebook is accurate and helpful. We commend and thank the following individuals for their guidance:

Onboarding EHR Education Panel

  • David Niland, Medical Information Officer at Galway Clinic
  • Mike McNamara, CMIO at Kaiser Permanente Northwest
  • Heidi Garzo, EHR Training Manager at Petaluma Health Center
  • Sean Johnson, VP of Applications and Analytics at Sansum Clinic

Ongoing EHR Education Panel

  • H.C. Eschenroeder Jr., Orthopaedic Surgeon and CMIO at OrthoVirginia
  • Benjamin Suratt, Vice Chair of Medicine for Academic Affairs at University of Vermont College of Medicine
  • David Michael, CMIO at Vidant Health

Clinician Relationships & Communication Panel

  • Corey Joekel, CMIO at Children’s Hospital & Medical Center
  • David Kaelber, CMIO at The MetroHealth System

Shared Ownership & Governance Panel

  • Dhrumil Shah, CMIO at Compass Medical
  • John Lee, CMIO at Edward-Elmhurst Health
  • Jean Adams, CNIO and ACIO at Geisinger Health System
  • David Graham, CIO at Memorial Health System

Clinician Efficiency & Personalization Panel

  • Amy Chaumeton, Clinical Vice President and CMIO at Legacy Health
  • Keith Griffin, CMIO at Novant Health
  • Melissa Jost, Manager of Clinical Informatics at UC Davis Health
  • Eric Cheng, CMIO at UCLA Health

Clinician Wellness & Reducing Burnout Panel

  • Thomas Moran, VP and Chief Medical Information Executive at Northwestern Memorial Health Care
  • Paul Testa, CMIO at NYU Langone Health
  • Vicki Laurie, Consulting CIO at Tenet Healthcare
  • Neal Chawla, CMIO at WakeMed

Nursing EHR Success Panel

  • Ryan Zulkoski, Manager of Nursing Informatics at Children’s Hospital & Medical Center
  • Teresa Niblett, Director of Clinical Informatics at Peninsula Regional Medical Center
  • Ellen Pollack, CNIO at UCLA Health
  • Samantha Richards, VP and CNO at WVU Medicine

Opioid Abuse Prevention Panel

  • Laura Polito, Assistant Medical Director of Health Information Systems and Urgent Care Services at Sansum Clinic
  • Rob Schreiner, President at WellStar Medical Group
  • David Rich, CMIO at WVU Medicine

What Is the Arch Collaborative Guidebook?

The Arch Collaborative Guidebook is the result of thousands of hours of combined effort. Over 190 provider organizations around the world have measured the feedback of their clinicians, and the 100,000 clinicians who have participated by completing Collaborative surveys have dedicated an estimated 1,600 hours total to sharing their voices.

This incredible effort has allowed the Arch Collaborative to identify those organizations with the most successful EHR users. Leaders from these successful organizations have partnered with KLAS while also utilizing Arch Collaborative research findings to build this guidebook for EHR success.

There is no checklist for strong leadership; similarly, while this guide could be read as a checklist, it will be most effective when read as principles and opportunities for success meant to be skillfully applied according to an organization’s specific culture and circumstances.

This guidebook lays out the best practices identified in Collaborative data and shared by the most successful organizations in the Collaborative. If your organization is struggling with EHR satisfaction, start here!

It is expected that the principles in this guidebook will mostly remain consistent in future editions, but this guidebook may see significant additions over time as the Arch Collaborative continues to learn the science behind EHR success.

The principles in this guide come from two sources:


thumb print and key icons

Evidence-Based Practices: Best practices validated by Arch Collaborative research that differentiate the high-performing organizations or have been documented to help organizations improve.

Leading Practices: Commonly reported keys to success as identified by leading organizations, though not yet broadly validated or too unquantifiable to fully validate.

  • OrgType: 1
  • Topic Ids: 12,4,5,3
  • Topic Names: <a href="/archcollaborative/reports/clinical-outcomes/12"> Clinical Outcomes</a>,<a href="/archcollaborative/reports/ehr-enhancement-governance/4"> EHR Enhancement Governance</a>,<a href="/archcollaborative/reports/ehr-personalization/5"> EHR Personalization</a>,<a href="/archcollaborative/reports/follow-up-ehr-education-training/3"> Follow-up EHR Education/Training</a>
  • Cost: 0
  • Time: 0
  • OrgName: Bassett Healthcare System
  • OrgId: 1
  • EMRVendors: Bassett Healthcare System (1)
  • Regions: 2
  • Authors: Taylor Davis and Connor Bice
  • Contacts:
Improving EHRs Globally
Improving EHRs Globally
us and non us health systems ehr satisfaction

clinicial training satisfaction

While there are some key differences, like the impact of EHR personalizations, KLAS has confirmed that non-US health systems follow Arch Collaborative trends for two of the three pillars of success: EHR education and a culture of shared ownership.

When it comes to initial training, US and non-US clinicians have very similar experiences. Just over half of the clinicians in each group agree initial training prepared them well; US clinicians are just slightly more likely to strongly agree.

This trend persists for ongoing training, which US and non-US clinicians agree is sufficient in equal numbers (53% in each group). Again, US clinicians are slightly more likely to strongly agree ongoing training is sufficient.

Clinicians’ relationships with and trust in IT leadership are similar throughout the world. Building a symbiotic relationship and creating shared ownership between the clinicians who use the EHR and the IT and informatics personnel who support the EHR is essential for achieving EHR satisfaction, no matter the geography.

clinician trust in it leadership

adoption of ehr personalization tools

The biggest difference between US and non-US health systems is in adoption of EHR personalization tools. In the US, personalization tools help clinicians get data in and out of the EHR more quickly in the face of stringent documentation requirements. Outside the US, these requirements are less burdensome, so clinicians need less EHR personalization to be efficient. However, if the global community were to see increased regulatory burdens similar to those in the US, the use of EHR-personalization tools would likely have a significant impact on EHR satisfaction.


key takeaways

arch collaborative logo

  • OrgType: 1
  • Topic Ids: 5,3,2
  • Topic Names: <a href="/archcollaborative/reports/ehr-personalization/5"> EHR Personalization</a>,<a href="/archcollaborative/reports/follow-up-ehr-education-training/3"> Follow-up EHR Education/Training</a>,<a href="/archcollaborative/reports/new-clinician-ehr-education/2"> New Clinician EHR Education</a>
  • Cost: 0
  • Time: 0
  • OrgName: Bassett Healthcare System
  • OrgId: 1
  • EMRVendors: Bassett Healthcare System (1)
  • Regions: 2
  • Authors: Connor Bice
  • Contacts:
2019 Summit Slides - Arch Collaborative Learnings Part 1
2019 Summit Slides - Arch Collaborative Learnings Part 1
  • OrgType: 1
  • Topic Ids: 12,8,9,4,5,3,2
  • Topic Names: <a href="/archcollaborative/reports/clinical-outcomes/12"> Clinical Outcomes</a>,<a href="/archcollaborative/reports/clinician-it-relationships/8"> Clinician/IT Relationships</a>,<a href="/archcollaborative/reports/culture/9"> Culture</a>,<a href="/archcollaborative/reports/ehr-enhancement-governance/4"> EHR Enhancement Governance</a>,<a href="/archcollaborative/reports/ehr-personalization/5"> EHR Personalization</a>,<a href="/archcollaborative/reports/follow-up-ehr-education-training/3"> Follow-up EHR Education/Training</a>,<a href="/archcollaborative/reports/new-clinician-ehr-education/2"> New Clinician EHR Education</a>
  • Cost: 0
  • Time: 0
  • OrgName: Bassett Healthcare System
  • OrgId: 1
  • EMRVendors: Bassett Healthcare System (1)
  • Regions: 2
  • Authors: Taylor Davis and Hailey Tate
  • Contacts:
2019 Summit Slides - Arch Collaborative Learnings Part 2
2019 Summit Slides - Arch Collaborative Learnings Part 2
  • OrgType: 1
  • Topic Ids: 10,12,8,9,4,1,5,13,3,7,6,2,11
  • Topic Names: <a href="/archcollaborative/reports/analytics/10"> Analytics</a>,<a href="/archcollaborative/reports/clinical-outcomes/12"> Clinical Outcomes</a>,<a href="/archcollaborative/reports/clinician-it-relationships/8"> Clinician/IT Relationships</a>,<a href="/archcollaborative/reports/culture/9"> Culture</a>,<a href="/archcollaborative/reports/ehr-enhancement-governance/4"> EHR Enhancement Governance</a>,<a href="/archcollaborative/reports/ehr-go-live/1"> EHR Go-Live</a>,<a href="/archcollaborative/reports/ehr-personalization/5"> EHR Personalization</a>,<a href="/archcollaborative/reports/financial-investment/13"> Financial Investment</a>,<a href="/archcollaborative/reports/follow-up-ehr-education-training/3"> Follow-up EHR Education/Training</a>,<a href="/archcollaborative/reports/inter-organization-collaboration/7"> Inter-organization Collaboration</a>,<a href="/archcollaborative/reports/it-informatics-hiring/6"> IT/Informatics Hiring</a>,<a href="/archcollaborative/reports/new-clinician-ehr-education/2"> New Clinician EHR Education</a>,<a href="/archcollaborative/reports/nursing/11"> Nursing</a>
  • Cost: 0
  • Time: 0
  • OrgName: Bassett Healthcare System
  • OrgId: 1
  • EMRVendors: Bassett Healthcare System (1)
  • Regions: 2
  • Authors: Taylor Davis and Hailey Tate
  • Contacts:
2019 Summit Slides - Committee Meetings
2019 Summit Slides - Committee Meetings
  • OrgType: 1
  • Topic Ids: 9
  • Topic Names: <a href="/archcollaborative/reports/culture/9"> Culture</a>
  • Cost: 0
  • Time: 0
  • OrgName: Bassett Healthcare System
  • OrgId: 1
  • EMRVendors: Bassett Healthcare System (1)
  • Regions: 2
  • Authors: Taylor Davis and Hailey Tate
  • Contacts:
2019 Summit Slides - Individual Organization Presentations
2019 Summit Slides - Individual Organization Presentations
  • OrgType: 1
  • Topic Ids: 8,9,13,3,2,11
  • Topic Names: <a href="/archcollaborative/reports/clinician-it-relationships/8"> Clinician/IT Relationships</a>,<a href="/archcollaborative/reports/culture/9"> Culture</a>,<a href="/archcollaborative/reports/financial-investment/13"> Financial Investment</a>,<a href="/archcollaborative/reports/follow-up-ehr-education-training/3"> Follow-up EHR Education/Training</a>,<a href="/archcollaborative/reports/new-clinician-ehr-education/2"> New Clinician EHR Education</a>,<a href="/archcollaborative/reports/nursing/11"> Nursing</a>
  • Cost: 0
  • Time: 0
  • OrgName: Bassett Healthcare System
  • OrgId: 1
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  • Regions: 2
  • Authors: Taylor Davis and Hailey Tate
  • Contacts:
2019 Summit Slides - Keynote and Conference Welcome
2019 Summit Slides - Keynote and Conference Welcome
  • OrgType: 1
  • Topic Ids: 12,8,9,1,13
  • Topic Names: <a href="/archcollaborative/reports/clinical-outcomes/12"> Clinical Outcomes</a>,<a href="/archcollaborative/reports/clinician-it-relationships/8"> Clinician/IT Relationships</a>,<a href="/archcollaborative/reports/culture/9"> Culture</a>,<a href="/archcollaborative/reports/ehr-go-live/1"> EHR Go-Live</a>,<a href="/archcollaborative/reports/financial-investment/13"> Financial Investment</a>
  • Cost: 0
  • Time: 0
  • OrgName: Bassett Healthcare System
  • OrgId: 1
  • EMRVendors: Bassett Healthcare System (1)
  • Regions: 2
  • Authors: Taylor Davis and Hailey Tate
  • Contacts:
2019 Summit Slides - Moving the Needle Presentations
2019 Summit Slides - Moving the Needle Presentations
  • OrgType: 1
  • Topic Ids: 8,9,4,5,3,7,2
  • Topic Names: <a href="/archcollaborative/reports/clinician-it-relationships/8"> Clinician/IT Relationships</a>,<a href="/archcollaborative/reports/culture/9"> Culture</a>,<a href="/archcollaborative/reports/ehr-enhancement-governance/4"> EHR Enhancement Governance</a>,<a href="/archcollaborative/reports/ehr-personalization/5"> EHR Personalization</a>,<a href="/archcollaborative/reports/follow-up-ehr-education-training/3"> Follow-up EHR Education/Training</a>,<a href="/archcollaborative/reports/inter-organization-collaboration/7"> Inter-organization Collaboration</a>,<a href="/archcollaborative/reports/new-clinician-ehr-education/2"> New Clinician EHR Education</a>
  • Cost: 0
  • Time: 0
  • OrgName: Bassett Healthcare System
  • OrgId: 1
  • EMRVendors: Bassett Healthcare System (1)
  • Regions: 2
  • Authors: Taylor Davis and Hailey Tate
  • Contacts:
2019 Summit Slides - Organization Type Meetings
2019 Summit Slides - Organization Type Meetings
  • OrgType: 1
  • Topic Ids: 8,9,4,5,13,3,7,2,11
  • Topic Names: <a href="/archcollaborative/reports/clinician-it-relationships/8"> Clinician/IT Relationships</a>,<a href="/archcollaborative/reports/culture/9"> Culture</a>,<a href="/archcollaborative/reports/ehr-enhancement-governance/4"> EHR Enhancement Governance</a>,<a href="/archcollaborative/reports/ehr-personalization/5"> EHR Personalization</a>,<a href="/archcollaborative/reports/financial-investment/13"> Financial Investment</a>,<a href="/archcollaborative/reports/follow-up-ehr-education-training/3"> Follow-up EHR Education/Training</a>,<a href="/archcollaborative/reports/inter-organization-collaboration/7"> Inter-organization Collaboration</a>,<a href="/archcollaborative/reports/new-clinician-ehr-education/2"> New Clinician EHR Education</a>,<a href="/archcollaborative/reports/nursing/11"> Nursing</a>
  • Cost: 0
  • Time: 0
  • OrgName: Bassett Healthcare System
  • OrgId: 1
  • EMRVendors: Bassett Healthcare System (1)
  • Regions: 2
  • Authors: Taylor Davis and Hailey Tate
  • Contacts:
2019 Summit Slides - Panel Discussions
2019 Summit Slides - Panel Discussions
  • OrgType: 1
  • Topic Ids: 8,9,4,5,3,2,11
  • Topic Names: <a href="/archcollaborative/reports/clinician-it-relationships/8"> Clinician/IT Relationships</a>,<a href="/archcollaborative/reports/culture/9"> Culture</a>,<a href="/archcollaborative/reports/ehr-enhancement-governance/4"> EHR Enhancement Governance</a>,<a href="/archcollaborative/reports/ehr-personalization/5"> EHR Personalization</a>,<a href="/archcollaborative/reports/follow-up-ehr-education-training/3"> Follow-up EHR Education/Training</a>,<a href="/archcollaborative/reports/new-clinician-ehr-education/2"> New Clinician EHR Education</a>,<a href="/archcollaborative/reports/nursing/11"> Nursing</a>
  • Cost: 0
  • Time: 0
  • OrgName: Bassett Healthcare System
  • OrgId: 1
  • EMRVendors: Bassett Healthcare System (1)
  • Regions: 2
  • Authors: Taylor Davis and Hailey Tate
  • Contacts:
2019 Summit Slides - Vendor Breakouts
2019 Summit Slides - Vendor Breakouts
  • OrgType: 1
  • Topic Ids: 7
  • Topic Names: <a href="/archcollaborative/reports/inter-organization-collaboration/7"> Inter-organization Collaboration</a>
  • Cost: 0
  • Time: 0
  • OrgName: Bassett Healthcare System
  • OrgId: 1
  • EMRVendors: Bassett Healthcare System (1)
  • Regions: 2
  • Authors: Taylor Davis and Hailey Tate
  • Contacts:
Can My EHR Get Me There?
Can My EHR Get Me There?
An Arch Collaborative Impact Report


variability of satisfaction in all ehr users for all solutions

How Much Does the Software Matter?

For 73% of measured organizations, KLAS has found at least one instance in the organization of two physicians of the same specialty using the same EHR software who gave diametrically opposite responses to whether the EHR enables them to deliver high-quality care (one physician strongly agreed and the other strongly disagreed).

where does variation in ehr experience come from

key insight control ehr success through clinician users

The Impact of the EHR

Organizations who participate in the Arch Collaborative are self-selected, so they do not represent a random sampling of user experience, but they can show what is possible.

While stable, functional, integrated software is obviously a foundational requirement for success, a focus on the people and processes around an EHR is what separates the successful organizations from the unsuccessful ones.

Collaborative organizations using Epic have shown the greatest consistency in achieving high satisfaction, but it is unclear how much of that success is driven by the EHR. Even in measured areas that tend to be more technical in nature, such as system response time or reliability, Epic has generally been much more prescriptive than other vendors, requiring specific system configurations or processes.

Before an organization switches EHR solutions, it is critical (and dramatically less costly) for efforts to focus on the following:

organization satisfaction by ehr vendor
user mastery shared ownership meeting unique needs

  • OrgType: 1
  • Topic Ids: 8,9,1
  • Topic Names: <a href="/archcollaborative/reports/clinician-it-relationships/8"> Clinician/IT Relationships</a>,<a href="/archcollaborative/reports/culture/9"> Culture</a>,<a href="/archcollaborative/reports/ehr-go-live/1"> EHR Go-Live</a>
  • Cost: 0
  • Time: 0
  • OrgName: Bassett Healthcare System
  • OrgId: 1
  • EMRVendors: Bassett Healthcare System (1)
  • Regions: 2
  • Authors: Taylor Davis
  • Contacts:
Successful Users' Keys to EHR Satisfaction
Successful Users' Keys to EHR Satisfaction
An Arch Collaborative Impact Report



overall trends icon
Across clinician types, EHR education is the most common differentiator—27% of responding clinicians say their successful use of the EHR can be traced back to their efforts in obtaining EHR education. Another standout factor is whether users personalize the EHR to fit their individual workflow needs.

providers icon
Among providers (physicians, residents, and APPs) who answered this question, personalization and EHR education are still the top two factors supporting high satisfaction, though for providers, personalization was credited more often than education.


all clinicians keys to ehr satisfaction
providers keys to ehr satisfaction




nurses iconFor nurses, doubling down on time spent learning the EHR is far and away the most important key to success: 44% cite this as the main factor that drives their successful use of the EHR. The second most mentioned category is experience with the EHR; it appears that the more time nurses spend in the EHR, the better equipped they are to be successful with it. Personalization was mentioned less by nurses largely because of the fact that personalization tools for nurses are absent from most EHR builds.

nurses keys to ehr satisfaction

1 While clinicians can find success using many EHRs, most of this data comes from clinicians who use Epic. This is primarily due to the high number of Epic customers who have participated in the Arch Collaborative so far.


  • OrgType: 1
  • Topic Ids: 8,5,3,2,11
  • Topic Names: <a href="/archcollaborative/reports/clinician-it-relationships/8"> Clinician/IT Relationships</a>,<a href="/archcollaborative/reports/ehr-personalization/5"> EHR Personalization</a>,<a href="/archcollaborative/reports/follow-up-ehr-education-training/3"> Follow-up EHR Education/Training</a>,<a href="/archcollaborative/reports/new-clinician-ehr-education/2"> New Clinician EHR Education</a>,<a href="/archcollaborative/reports/nursing/11"> Nursing</a>
  • Cost: 0
  • Time: 0
  • OrgName: Bassett Healthcare System
  • OrgId: 1
  • EMRVendors: Bassett Healthcare System (1)
  • Regions: 2
  • Authors: Connor Bice
  • Contacts:
The Nurse EHR Experience
The Nurse EHR Experience
An Arch Collaborative Impact Report 2019


nurse net ehr experience score
physician net ehr experience score



successes icon

While nurses are more satisfied than physicians in every category measured by the Arch Collaborative EHR satisfaction survey, some of the strongest satisfaction points for nurses are those related to patient care. The majority of the care-delivery support that occurs in the EHR is completed by nurses. While this time spent in the EHR reduces the amount of time nurses have to spend on direct patient care, nurses still spend more time with patients than physicians do, and Arch Collaborative data shows that the majority of nurses agree that the EHR benefits patients.


1 Some estimate that 75% of chart use can be attributed to nurses.

2 Linda W. Higgins et al., “Hospital Nurses’ Work Activity in a Technology-Rich Environment: A Triangulated Quality Improvement Assessment,” Journal of Nursing Care Quality 32, no. 3 (July/September 2017): 208–17, https://journals.lww.com/jncqjournal/Fulltext/2017/07000/Hospital_Nurses

__Work_Activity_in_a.6.aspx.


agreement that the emr keeps patients safe
pain points icon

Despite the successes highlighted above, a large percentage of nurses report pain points in other, equally important metrics. Regardless of a user’s clinical background, an EHR can be difficult to learn, and nurses generally report room for improvement when it comes to factors related to EHR usability.


agreement that the emr provides the analytics quality measures and reporting they need

Nursing leaders at many organizations tell KLAS that their departments are driven by a culture of teamwork and openness to adopting changes that will help them achieve better patient outcomes and patient safety. This anecdotal evidence is corroborated by Collaborative data. The EHR satisfaction survey asks participants to rate the performance of three groups of key EHR stakeholders: (1) the clinical end users, (2) the EHR vendor, and (3) the organization’s leadership and IT groups. Nurses rate themselves as the highest-performing group (and rate their leadership/IT groups the lowest). This indicates that nurses put the bulk of EHR-mastery responsibility on themselves.

agreement that stakeholder delivers well nurses only

When organizations discuss EHR issues—whether related to training, usability, governance, or change management—they must make sure they seek out the opinions of their nurses. At too many organizations, nurses have been left to utilize their own teams and peers to master the EHR. Organizations can increase EHR satisfaction among their nurses—and likely other clinicians too—by working to amplify the nurse voice in EHR matters.

  • OrgType: 1
  • Topic Ids: 9,3,2,11
  • Topic Names: <a href="/archcollaborative/reports/culture/9"> Culture</a>,<a href="/archcollaborative/reports/follow-up-ehr-education-training/3"> Follow-up EHR Education/Training</a>,<a href="/archcollaborative/reports/new-clinician-ehr-education/2"> New Clinician EHR Education</a>,<a href="/archcollaborative/reports/nursing/11"> Nursing</a>
  • Cost: 0
  • Time: 0
  • OrgName: Bassett Healthcare System
  • OrgId: 1
  • EMRVendors: Bassett Healthcare System (1)
  • Regions: 2
  • Authors: Taylor Davis & Connor Bice
  • Contacts:
Are EMRAM Stage 7 Physicians More Successful?
Are EMRAM Stage 7 Physicians More Successful?
A 2019 KLAS-HIMSS Analytics Collaboration


key findings
physician satisfaction with ehr

himss analytics logo

HIMSS Analytics is a global healthcare information and technology standards organization assisting regulatory bodies and healthcare providers in making lasting improvements in efficiency, performance, and care outcomes. Offering a suite of Maturity Models led by flagship model EMRAM, HIMSS Analytics provides prescriptive frameworks to healthcare organizations allowing for global comparability, benchmarking, and strategic clinical and financial improvement. HIMSS Analytics' Certified Consultant Program offers professional training for vendors to educate and build strategy around the Maturity Models. HIMSS Analytics is a wholly owned subsidiary of HIMSS (Healthcare Information and Management Systems Society). For more information, visit www.himssanalytics.org.

arch collaborative logo

The Arch Collaborative is a global, provider-led effort to improve EHR usability and satisfaction through consistent measurement, benchmarking, and collaboration around best practices. To date, over 150 provider organizations have measured the feedback of their clinical EHR users and have begun to take steps to improve the EHR experience. If your organization is interested in maximizing the value of your EHR, learn more at https://klasresearch.com/arch-collaborative or email us at archcollaborative@klasresearch.com.



  • OrgType: 1
  • Topic Ids: 10,5,3,2
  • Topic Names: <a href="/archcollaborative/reports/analytics/10"> Analytics</a>,<a href="/archcollaborative/reports/ehr-personalization/5"> EHR Personalization</a>,<a href="/archcollaborative/reports/follow-up-ehr-education-training/3"> Follow-up EHR Education/Training</a>,<a href="/archcollaborative/reports/new-clinician-ehr-education/2"> New Clinician EHR Education</a>
  • Cost: 0
  • Time: 0
  • OrgName: Bassett Healthcare System
  • OrgId: 1
  • EMRVendors: Bassett Healthcare System (1)
  • Regions: 2
  • Authors: Taylor Davis
  • Contacts:
Improving the EHR Experience Through Personalization
Improving the EHR Experience Through Personalization
A Path Toward Excellence

EHR personalization can be divided into three overarching categories: data input, data output, and EHR workflows. Each personalization within these three categories has an immense impact on providers’ Net EHR Experience scores, and on average, providers who report high personalization have Net EHR Experience scores more than 30 points higher than those who don’t.


difference in net ehr experience score by personalization tool category


Unfortunately, instead of investing their own resources into making providers aware of how personalization tools can improve usability and efficiency, many organizations are waiting on EHR vendors to make dramatic improvements to the EHR user interface. But if organizations want to see improvement, all they have to do is focus training and follow-up education on data input, data output, and EHR workflows.

Why Wait?

The biggest issue to overcome? Adoption. 66% of providers have little to no personalization in place. This means two-thirds are losing out on potential efficiency and satisfaction gains. Let’s help clinicians personalize the EHR just as smartphone vendors encourage personalization of their devices.


level of ehr personalizationmost and least used personalizations



Where to Start

Helping providers adopt any one personalization can have an immediate impact, but the following three personalizations appear to make the biggest splash:


Layouts Providers who use layouts and find them very useful have a Net EHR Experience score 38.7 points higher than those who do not use layouts.

Templates Providers who use templates and find them very useful have a Net EHR Experience score 38.0 points higher than those who do not use templates.

Filters Providers who use filters and find them very useful have a Net EHR Experience score 37.6 points higher than those who do not use filters.

  • OrgType: 1
  • Topic Ids: 5
  • Topic Names: <a href="/archcollaborative/reports/ehr-personalization/5"> EHR Personalization</a>
  • Cost: 0
  • Time: 0
  • OrgName: Bassett Healthcare System
  • OrgId: 1
  • EMRVendors: Bassett Healthcare System (1)
  • Regions: 2
  • Authors: Taylor Davis & Connor Bice
  • Contacts:
Organization Culture: The X-Factor of EHR Success
Organization Culture: The X-Factor of EHR Success
An Arch Collaborative Impact Report

  • OrgType: 1
  • Topic Ids: 9
  • Topic Names: <a href="/archcollaborative/reports/culture/9"> Culture</a>
  • Cost: 0
  • Time: 0
  • OrgName: Bassett Healthcare System
  • OrgId: 1
  • EMRVendors: Bassett Healthcare System (1)
  • Regions: 2
  • Authors: Taylor Davis and Connor Bice
  • Contacts:
How to Approach EHR Change Management
How to Approach EHR Change Management
An Arch Collaborative Impact Report

  • OrgType: 1
  • Topic Ids: 4
  • Topic Names: <a href="/archcollaborative/reports/ehr-enhancement-governance/4"> EHR Enhancement Governance</a>
  • Cost: 0
  • Time: 0
  • OrgName: Bassett Healthcare System
  • OrgId: 1
  • EMRVendors: Bassett Healthcare System (1)
  • Regions: 2
  • Authors: Taylor Davis and Connor Bice
  • Contacts:
EHR Success Doesn't Have to Be High Cost
EHR Success Doesn't Have to Be High Cost
An Arch Collaborative Impact Report

  • OrgType: 1
  • Topic Ids: 13
  • Topic Names: <a href="/archcollaborative/reports/financial-investment/13"> Financial Investment</a>
  • Cost: 0
  • Time: 0
  • OrgName: Bassett Healthcare System
  • OrgId: 1
  • EMRVendors: Bassett Healthcare System (1)
  • Regions: 2
  • Authors: Taylor Davis and Connor Bice
  • Contacts:
EHR Mastery—The Impact of Training
EHR Mastery—The Impact of Training
Don't Go Chasing Waterfalls


Good Training, Bad Training

EHR satisfaction begins with initial training, and providers are more satisfied in the long run when they start off with a good experience. In fact, how clinicians rate the quality of their initial EHR training explains nearly 50% of the variation in their EHR satisfaction.


Impactful Practices1

What makes for good training? Here are three practices that could positively impact your organization.

  • Focus on the who, not the what. The quality of the trainer matters more than the structure of the training.
  • Expect engagement from clinicians in mastering the EHR—at least 7 hours of initial EHR education and at least 3 hours of annual follow-up education.
  • Deliver training that adds value and yields high demand. A few organizations have achieved this through off-site training.

[1] Supporting data can be found in the full report, “EHR Mastery: The Impact of Training”


Self-Assessment

  • Would I enjoy going through our existing training programs?
  • Do we expect all new clinicians to go through 7+ hours of initial training?
  • Are our training opportunities in high demand?

good training and bad training


Less Impactful Practices

Often, organizations will institute one of the following programs with aspirations of immediate improvement in EHR satisfaction. While some organizations find success with these options, on average they are not proven to have a significant impact.



Requiring Ongoing Training2

  • Requiring ongoing training rather than making it voluntary increases EHR satisfaction by only 3.9%.

Insisting That Clinicians Teach Clinicians

  • 55% of satisfied organizations have primarily non-clinicians EHR instructors.

Offering a Test-Out Option

  • Epic customers3 see a .76 (.3%) increase in EHR satisfaction when providers can test out of some training and a 3.6 (1.8%) point increase when they can test out of all training.


[2] Although requiring ongoing education has very little impact, offering it and encouraging participation should still be a priority.

[3] Sample sizes for other vendors’ client bases were too small for findings to be shown.


net ehr experiance score by instructors clinical background

  • OrgType: 1
  • Topic Ids: 10
  • Topic Names: <a href="/archcollaborative/reports/analytics/10"> Analytics</a>
  • Cost: 0
  • Time: 0
  • OrgName: Bassett Healthcare System
  • OrgId: 1
  • EMRVendors: Bassett Healthcare System (1)
  • Regions: 2
  • Authors: Taylor Davis and Connor Bice
  • Contacts:
2018 Arch Collaborative Summit Slides
2018 Arch Collaborative Summit Slides
  • OrgType: 1
  • Topic Ids: 10,12,8,9,4,1,5,13,3,7,6,2
  • Topic Names: <a href="/archcollaborative/reports/analytics/10"> Analytics</a>,<a href="/archcollaborative/reports/clinical-outcomes/12"> Clinical Outcomes</a>,<a href="/archcollaborative/reports/clinician-it-relationships/8"> Clinician/IT Relationships</a>,<a href="/archcollaborative/reports/culture/9"> Culture</a>,<a href="/archcollaborative/reports/ehr-enhancement-governance/4"> EHR Enhancement Governance</a>,<a href="/archcollaborative/reports/ehr-go-live/1"> EHR Go-Live</a>,<a href="/archcollaborative/reports/ehr-personalization/5"> EHR Personalization</a>,<a href="/archcollaborative/reports/financial-investment/13"> Financial Investment</a>,<a href="/archcollaborative/reports/follow-up-ehr-education-training/3"> Follow-up EHR Education/Training</a>,<a href="/archcollaborative/reports/inter-organization-collaboration/7"> Inter-organization Collaboration</a>,<a href="/archcollaborative/reports/it-informatics-hiring/6"> IT/Informatics Hiring</a>,<a href="/archcollaborative/reports/new-clinician-ehr-education/2"> New Clinician EHR Education</a>
  • Cost: 0
  • Time: 0
  • OrgName: Bassett Healthcare System
  • OrgId: 1
  • EMRVendors: Bassett Healthcare System (1)
  • Regions: 2
  • Authors: Taylor Davis and Hailey Tate
  • Contacts:
Creating the EMR Advantage
Creating the EMR Advantage
EMR Best Practices Study

Making EMR Success a Science

Of the 7,609 physicians who participated in this research, 43% report overall dissatisfaction with their EMR experience. The story of their dissatisfaction is not simply one of too many clicks. Rather, their dissatisfaction stems from a perception of having lost control over the care they were trained to deliver as well as a perception that they cannot improve their current situation.

More than just calling out the problems with the EMR, their feedback reveals how provider organizations can help make the EMR consistently successful for their clinicians.

net emr experience score by organization

Three Keys of Successful Organizations

1. Education

Successful organizations recognize the incredible impact of initial and ongoing EMR education. These organizations require newly hired physicians to spend six or more hours in training classes taught by other clinicians. This ongoing training leverages the power of peer pressure to engage users rather than relying on at-the-elbow training or classroom training not taught by a fellow clinician.

user satisfaction after less than 12 months and 5 plus years

correlation between satisfaction and use of personalization settings

2. Personalization

Successful organizations understand that personalization settings are the key to making a one-size-fits-all EMR work for everyone. Personalizations that allow clinicians to quickly retrieve data or review a chart are the most powerful in improving clinician satisfaction.


3. Culture

While culture is the most difficult key to replicate, it is clear that successful organizations have built a culture of IT service and user empowerment. These organizations show the deep care they have for clinician success through their sincere efforts to listen and resolve clinician challenges. They also empower problem solving by not blaming all problems on the EMR vendor.

organization culture matters more than the emr implementation

Key Learnings of This Report

With over 600,000 data points collected, the full Arch Collaborative report has many findings. Full findings are available only to Arch Collaborative members, but key learnings are shared below to help all organizations improve.


Drivers of Success

  • Initial EMR training is the top predictor of EMR user success. The effects of poor initial training remain with users for years after they come live. (see page 15)
  • Organizations that require newly hired physicians to complete more than six hours of training see significantly higher satisfaction. Requiring a test for new physicians is correlated with slightly higher satisfaction. (see page 18)
  • Use of personalization settings has a dramatic effect on the user experience, yet fewer than half of the personalization options that users have are actually being utilized. (see page 20)
  • Personalization settings that help users get data out of the EMR improve satisfaction more than those that help users get data into the EMR. (see page 22)
  • Leadership from high-performing organizations report that good EMR governance is key to their success. (see page 25)
  • The Epic Physician Builder program, which essentially makes EMR governance more responsive to the needs of users, enables higher EMR satisfaction and can be copied by other EMR customer bases. (see page 25) Users need to invest about 6 hours per year into better learning the EMR. 54% of EMR users report engaging in no ongoing EMR training. (see page 27)
  • Incorporating EMR training into departmental meetings is one of the most effective training methods; on average, organizations that do this have a 30-point higher Net EMR Experience score. (see page 36)
  • Survey participants are asked to rate three EMR stakeholders: the end users (themselves), the EMR vendor, and the organization’s leadership/IT groups. Organizations where the users rate themselves lower than their EMR vendor and leadership/IT groups have a Net EMR Experience score 40 points higher than those who rate their vendor the lowest. This trend appears to be in part indictive of a culture in which users possess feelings of selfawareness and enablement regarding their own power to improve their EMR experience. (see page 38)
  • A multiple regression model of user feedback, allowing for the isolation of separate factors, highlights the importance of organization culture and its impact on EMR success. (see page 102)

Actions That Lack Impact or Inhibit Success

  • Organizations spending a higher percentage of their operating budget on IT see almost no increase on average in the user experience. (see page 65)
  • The ratio of support individuals to physicians at an organization matters to EMR success at the extremes but is not a good predictor of EMR success. (see page 67)
  • Secure messaging solutions have nearly no effect on EMR satisfaction. (see page 69)
  • Organizations with higher adoption of voice recognition as users’ primary documentation method report no increase in satisfaction. (see page 70)
  • The use of scribes is not tied to higher EMR satisfaction (see page 71) and is not tied to stronger physician fulfillment. (see page 72)
  • Automated EMR-monitoring tools do not provide a satisfaction boost for those organizations that have invested time into them. (see page 74)
  • Organizations with higher documentation efficiency rates report only slightly higher satisfaction. (see page 75)

Other Trends

  • Organization type doesn’t seem to be a factor in EMR satisfaction, except for community hospitals, which struggle to support a quality user experience. (see page 12)
  • Specialties in which procedures are performed in-clinic (e.g., otorhinolaryngology) and specialties that have very demanding documentation needs tend to have the lowest satisfaction. The user experience for specialists varies widely depending on the EMR. (see page 29)
  • There is no correlation between years of experience with an EMR and user satisfaction, highlighting the lack of ongoing investment that organizations and users make in EMR success. (see page 31)
  • While organization culture is the top predictor of user EMR success, a close second is which EMR is in use. This report details Collaborative performance by vendor, including organization Net EMR Experience scores, average personalization levels, and most/least successful user groups. (see pages 40–63)
  • Clinicians reporting significant amounts of after-hours charting report much lower EMR satisfaction. (see page 78)
  • Younger clinicians might be the proverbial canary in the coal mine for EMR success. Older clinicians report lower satisfaction than their younger counterparts, but mostly in very high satisfaction organizations. In lower satisfaction organizations, it is most often the younger clinicians who are the least satisfied. (see page 80)
  • 85% of physicians agree or strongly agree that they find fulfillment in their work as a physician. (see page 82)
  • Those clinicians who do not find fulfillment in their work are not necessarily less satisfied with their EMR. Physicians who are burned out (do not find fulfillment) often feel unempowered. (see page 83)
  • Physicians consistently report lower satisfaction than nurses and advanced practice providers, with ease of use being a greater concern among physicians. (see page 96)
  • In addition to achieving a more positive user experience, clinicians that take advantage of EMR-personalization tools also report better ambulatory documentation efficiency. (see page 99)

Getting Involved in the Arch Collaborative

  • What is your organization’s Net EMR Experience score?
  • What areas should you be targeting for improvement?
  • What can you learn from the most successful EMR deployments in the world?
  • How will you know whether you are improving if you are not measuring your progress?

For more information about joining the Arch Collaborative, or to gain access to the full report, email ArchCollaborative@klasresearch. com. So that all organizations can participate, first-time measurement participation is free of charge.

We call upon all provider organizations to measure their performance, learn from industry leaders, and make the improvements that will enable EMR success.

  • OrgType: 1
  • Topic Ids: 8,4,5,3,2
  • Topic Names: <a href="/archcollaborative/reports/clinician-it-relationships/8"> Clinician/IT Relationships</a>,<a href="/archcollaborative/reports/ehr-enhancement-governance/4"> EHR Enhancement Governance</a>,<a href="/archcollaborative/reports/ehr-personalization/5"> EHR Personalization</a>,<a href="/archcollaborative/reports/follow-up-ehr-education-training/3"> Follow-up EHR Education/Training</a>,<a href="/archcollaborative/reports/new-clinician-ehr-education/2"> New Clinician EHR Education</a>
  • Cost: 0
  • Time: 0
  • OrgName: Bassett Healthcare System
  • OrgId: 1
  • EMRVendors: Bassett Healthcare System (1)
  • Regions: 2
  • Authors: Taylor Davis
  • Contacts:
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