Arch Reports: clinician-wellness-and-reducing-burnout

Mar 2023

Successful User’s Guide to High EHR Satisfaction
The goal of the Arch Collaborative is to help organizations understand not just how to make the EHR usable but how to help clinicians embrace it as a tool essential to their ability to deliver great care. To that end, this report examines the responses of over 3,000 highly satisfied EHR users to identify what they do differently from less satisfied peers. Their insights reveal specific areas that other users and organizations can focus on to improve their own satisfaction.

Amanda Wisner | Friday, March 24, 2023

Mar 2023

Key Drivers of Clinician EHR...

Key Drivers of Clinician EHR Satisfaction

Exploring the EHR Experience Metrics

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.

Lauren Manzione | Friday, March 3, 2023

Jan 2023

The Science of Improving the EHR...

The Science of Improving the EHR Experience

2023 Update

Since the Arch Collaborative was created in 2017, KLAS has had the opportunity to partner with almost 300 healthcare organizations to measure clinician perceptions of the EHR experience. These measurements represent over 340,000 clinician responses and have revealed key insights about common areas of satisfaction and frustration. Perhaps more importantly, by evaluating the lessons learned from organizations that have completed multiple measurements over time, we have identified a continuous improvement process that any organization can implement to help their clinicians better succeed with the EHR. Outlined below, this process relies significantly on the hard work of IT and informatics personnel, clinical leaders, and clinicians. Additionally, KLAS and the Arch Collaborative are there to help every step of the way.

Jacob Jeppson | Friday, January 6, 2023

Nov 2022

Provider Burnout and the EHR...

Provider Burnout and the EHR Experience
Following the COVID-19 pandemic, healthcare organizations have seen massive provider burnout, which ultimately leads to issues with staff shortages and quality of patient care. What can organizations do to alleviate and prevent provider burnout? Since 2018, the Arch Collaborative has conducted research on burnout, with particular focus on its intersection with the EHR. In the EHR experience survey, clinicians share their current level of burnout and which factors are contributing. Using this data and other measurements from the Arch Collaborative, this report details what organizations can do to combat provider burnout. Note that this report focuses on physicians, residents, fellows, and advanced practice providers—called “providers” throughout. Note: Data in this report comes from 181 unique provider organizations, some of which have measured provider burnout across multiple years.

David Evans | Friday, November 11, 2022

Sep 2022

Exploring EHR Satisfaction by...

Exploring EHR Satisfaction by Provider Specialty
KLAS Arch Collaborative Report Exploring EHR Satisfaction by Provider Specialty - Clinician Efficiency and Personalization

Anna Beyer | Friday, September 16, 2022

Aug 2022

Arch Collaborative Nursing...

Arch Collaborative Nursing Guidebook 2022
As the Arch Collaborative has grown, so has the voice of nurses. While past editions of the Arch Collaborative Guidebook primarily represented providers, this is the first to focus exclusively on nursing professionals. Insights come from 35 organizations who (1) surveyed nurses about their EHR experience (a total of 15,993 respondents across a breadth of organization types) and (2) completed as a leadership team the nursing section of the executive survey, sharing details about various organizational EHR practices and processes.

Jacob Jeppson | Tuesday, August 23, 2022

Jun 2022

Trust in Organization/IT Leadership...

Trust in Organization/IT Leadership 2022
Clinician perceptions of three key EHR stakeholders—their organization/IT leadership, their EHR vendor, and themselves as end users—impact their Net EHR Experience Score^†. However, this impact is strongest with the first group—organization/IT leadership. A number of factors play into whether clinicians trust their organization/IT leadership, including EHR satisfaction, clinician burnout, EHR training, and support. This report aims to answer the question: How can organizations most effectively build trust with clinicians and ultimately improve their EHR experience?

Anna Beyer | Friday, June 17, 2022

Jun 2022

Exploring EHR Satisfaction by...

Exploring EHR Satisfaction by Organization Type
The various healthcare organizations in the Arch Collaborative differ widely in terms of size, focus, patient demographics, EHR systems, and leadership structures. These differences can affect end users’ EHR satisfaction, particularly when it comes to key indicators like training and governance. This report examines organization-specific trends uncovered by the Collaborative data and highlights opportunities and strategies for improvement.

Ruirui Sun | Wednesday, June 8, 2022

Jun 2022

EHR Response Time & Reliability

Foundational to Satisfaction Yet Far from Sufficient

In the early days of the Arch Collaborative, clinician feedback revealed three fundamental factors key to EHR satisfaction: (1) strong user mastery, (2) an organization-wide sense of shared ownership, and (3) EHR technology that meets users’ unique needs (personalization). Much about an individual’s or organization’s EHR satisfaction can be understood through the lens of these three pillars. However, further research has demonstrated that industry-wide issues with system response time and reliability are creating significant barriers to clinician satisfaction. If efforts to improve EHR satisfaction are to be truly successful, organizations must first address these two foundational factors.

Jacob Jeppson | Wednesday, June 1, 2022

May 2022

Global EHR Satisfaction 2022

Global EHR Satisfaction 2022
In 2019, KLAS published early findings on EHR satisfaction outside the United States. Since then, additional non-US organizations have participated in Arch Collaborative measurement, revealing new insights on the state of EHR satisfaction around the globe. Based on 28 Collaborative measurements from 23 health systems in Asia/Oceania, Europe, and the Middle East, this report seeks to help healthcare organizations in regions outside the US better understand the factors that contribute to clinician satisfaction with the EHR. On average, clinicians in the Middle East report the highest EHR satisfaction, but there are highly satisfied users in each global region, and we can learn helpful information from each.

Anna Beyer | Wednesday, May 11, 2022

Apr 2022

Clinician Turnover and the EHR...

Clinician Turnover and the EHR Experience
Two years into the COVID-19 pandemic, healthcare organizations in the US are dealing with multiple repercussions—including major staffing shortages. Clinician turnover is high, staffing costs have risen, and even when organizations are able to hire new providers and staff, the need to train them can strain existing employees. These challenges result in overburdened clinicians, millions of additional dollars spent by healthcare organizations, and, ultimately, a diminished capacity for patient care.

Lauren Manzione | Friday, April 8, 2022

Jan 2022

EHR Satisfaction in Providers with...

EHR Satisfaction in Providers with Complex Work Arrangements
72% of acute care providers in Arch Collaborative research deal with complex work arrangements—meaning they work in multiple locations or additional care settings. For reasons ranging from differences in the EHR system and workflows to differences in the level of EHR support provided by their organization, providers who have complex work arrangements generally have higher burnout, lower EHR efficiency, and lower EHR satisfaction compared to peers who work solely in a single hospital. This report details these findings and uses the Arch Collaborative’s Keys to Success to share what organizations can do to support providers in complex work arrangements. (Providers who work solely in ambulatory care are not included in this research.)

Ruirui Sun | Friday, January 7, 2022

Dec 2021

Clinician Burnout 2021

COVID-19 Increasingly Cited in Rising Burnout

The Arch Collaborative’s first look at clinician burnout after the start of the COVID-19 pandemic revealed levels of nurse and physician burnout to be only slightly elevated. However, these numbers have continued to rise as the pandemic has trudged on and healthcare professionals have had to face challenges such as the Delta variant, vaccine reluctance and misinformation, and hostility from patients and their families. This report examines key findings regarding clinician burnout and how it is being impacted by the COVID-19 pandemic.

Jacob Jeppson | Friday, December 3, 2021

Nov 2021

Allied Health Professionals

What Drives Their EHR Experience?

Allied health professionals (also often called ancillary care providers) are a group of EHR users that have—until now—received less focus in Arch Collaborative reports. This study shares core findings about this group of users and their EHR experience.

Lauren Manzione | Friday, November 5, 2021

Oct 2021

EHR Vendor Initiatives

EHR Vendor Initiatives
The Arch Collaborative examines many factors in trying to understand an end user’s EHR satisfaction. Some of these factors—such as training or user support—are the responsibility of the healthcare organization. Some—like self-directed mastery and time spent in the EHR—are in the hands of end users. The EHR vendor also plays a significant role: they can provide service, functionality, or enhancements that make the EHR experience better. For this report, KLAS asked Cerner and Epic to share what initiatives they have recently implemented to support strong EHR satisfaction. (No other EHR vendors have enough clients participating in the Collaborative for the effects of any improvement initiatives to be measured.)

Anna Beyer | Friday, October 15, 2021

Oct 2021

Improving EHR Satisfaction in...

Improving EHR Satisfaction in Ambulatory Settings

Optimization Sprints Show Early Promise

Reporting significant benefits, including increased EHR satisfaction and more effective teamwork, four Arch Collaborative organizations have implemented EHR optimization sprints^† in their ambulatory clinics. Based on pre- and post-intervention surveys from over 400 clinicians that participated in these sprints, this report seeks to (1) evaluate the effectiveness of the sprint methodology by examining changes in participants’ overall EHR satisfaction, degree of burnout, and satisfaction with ongoing training and (2) share overarching principles and best practices for successfully implementing your own optimization sprint.

Jacob Jeppson | Friday, October 15, 2021

Aug 2021

Individual Repeat Measurements

What High-Improvement Clinicians Teach Us about Advancing EHR Satisfaction

To date, over 45 Arch Collaborative organizations have used the EHR Experience Survey to measure their clinicians’ EHR satisfaction at least twice, capturing the repeat scores of over 30,000 clinicians. Between measurements, these organizations have implemented changes to training, technology, governance, and other areas in hopes of improving their end users’ EHR satisfaction. While previous Arch Collaborative reports (click here for the latest) have explored the impact of these changes at the organizational level, this report examines how the satisfaction of individual clinicians has improved or declined from measurement to measurement and what we can learn from clinicians who have seen the biggest increases.

Cole Duda | Friday, August 20, 2021

Jul 2021

Clinician Training 2021 Update

Clinician Training 2021 Update
Training is the backbone of user mastery (one of the three pillars of EHR satisfaction outlined in the Arch Collaborative 2020 Guidebook). The COVID-19 pandemic highlighted potential vulnerabilities for healthcare organizations as clinicians had to quickly adapt to new methods of care delivery, often without sufficient training.

Lauren Manzione | Friday, July 16, 2021

Jul 2021

The Science of Improving the EHR...

The Science of Improving the EHR Experience 2021 Update
A total of 46 Arch Collaborative member organizations have now measured clinician EHR satisfaction at least twice. These organizations understand that improvement is an iterative process, with repeat measurements serving to gauge the efficacy of implemented interventions. This report is based on findings from these repeat measurements and offers an update on our understanding of how organizations best support, implement, and educate on the EHR.

Jacob Jeppson | Friday, July 9, 2021

May 2021

Arch Collaborative Nursing Summit...

Arch Collaborative Nursing Summit White Paper 2021
On February 10, 2021, 78 people from 10 health systems and 4 vendor organizations convened virtually for KLAS’ Arch Collaborative Nursing Workshop to discuss improving nurses’ EHR experience. High-performing nurse faculty members presented their approach to onboarding, ongoing EHR education, burnout, trust in IT, and nurse efficiency.

After the event, each attendee was asked to rate on a 1–9 scale their response to the following statement: “Our organization will change how we approach EHR delivery because of this workshop.” The average response across all responses (n=19) was 7.8, and no organization gave an average score less than 7.0. Each organization foresees the way they approach their EHR delivery to change as an outcome of KLAS’ workshop.

Connor Bice | Friday, May 28, 2021

May 2021

Clinician Trust in Organization/IT...

Clinician Trust in Organization/IT Leadership
A clinician’s trust in their organization and IT leadership can greatly impact their EHR experience. To measure this trust, the Arch Collaborative EHR Experience Survey asks end users whether they agree their organization and IT leadership have done a great job of implementing, training on, and supporting the EHR. A number of factors—for example, training, burnout, and EHR governance structure—affect how clinicians answer this question. The Executive Insights section of this report examines the outcomes of clinician trust and shares a high-level view of what drives it. The Expanded Insights section dives deeper into the relative importance of various factors on clinician trust and what practices help end users feel supported by their organization when it comes to the EHR experience.

Anna Beyer | Friday, May 21, 2021

Apr 2021

Role of Healthcare IT in...

Role of Healthcare IT in COVID-Related Burnout
After a year of packed ICUs, PPE shortages, and other COVID-19 related stressors, there is hopefully light at the end of the tunnel, with vaccines becoming widely available and COVID-19 case numbers declining. However, the pandemic has certainly had significant impacts on the healthcare community. This report explores the impact on clinician burnout and examines whether healthcare technology has played a role in current levels of burnout.

Lauren Manzione | Wednesday, April 14, 2021

Apr 2021

Role of Provider/Vendor Partnership...

Role of Provider/Vendor Partnership in EHR Success
KLAS’ Arch Collaborative research has found that success is possible with any EHR—the Collaborative includes organizations from a variety of EHR customer bases who feel their vendor has delivered a high-quality solution. This report shares what factors most affect end users’ EHR perceptions (these factors often require the organization and vendor to work in tandem) and how EHR stakeholders can better the EHR experience.

Jacob Jeppson | Friday, April 2, 2021

Feb 2021

Why Invest in Measurement?

Why Invest in Measurement?
KLAS Arch Collaborative Report

Cole Duda and Bob Cash | Friday, February 12, 2021

Dec 2020

Immediate Chart-Closure Rates

Immediate Chart-Closure Rates
The percentage of charts closed immediately after patient interactions is a simple measure of a complex idea: a provider’s ability to keep up with their workload, which is influenced by time, efficiency, and many other factors. Comparing immediate chart-closure rates to other indicators suggests that providers who report higher chart-closure rates also have higher Net EHR Experience Scores and lower levels of burnout. Furthermore, closure rates also correlate with factors such as a provider’s perception of the quality of their initial EHR education and the degree to which a provider has personalized the EHR.

Lauren Manzione | Friday, December 18, 2020

Oct 2020

Arch Collaborative Guidebook 2020

Arch Collaborative Guidebook 2020
A product of the October 2020 Arch Collaborative Summit, the Arch Collaborative Guidebook lays out the best practices identified in Collaborative data and shared by the most successful organizations in the Collaborative.

Connor Bice | Thursday, October 22, 2020

Sep 2020

Nurse Burnout 2020

Clinician burnout is an important problem facing the healthcare industry. While previous Arch Collaborative research has explored the issue across all clinicians, this report narrows the focus specifically to nurses, one-quarter of whom report some degree of burnout. What are some of the most commonly reported causes of this burnout, and can any EHR-satisfaction best practices also help reduce burnout?

Matt Brunken | Friday, September 18, 2020

Aug 2020

Healthcare Executives’ COVID-19...

Healthcare Executives’ COVID-19 Experience

Insights on Technology Challenges & Solutions

In the midst of the COVID-19 crisis, healthcare organizations are eager to learn from peers and find fast solutions to top-of-mind technology challenges. 19 executives from 18 healthcare organizations shared their status in addressing these challenges. The overarching theme? While healthcare organizations have found stopgaps in many areas, few have successfully implemented permanent solutions that serve a long-term strategy. This report details how organizations are faring against technology challenges today and—in acknowledgment that the future of healthcare is hazy for everyone—also provides links to technology-performance resources you may find useful and asks you to help peers make informed decisions by sharing your technology experiences.

Jacob Jeppson & Connor Bice | Thursday, August 27, 2020

Jul 2020

The Nurse EHR Experience 2020

The Nurse EHR Experience 2020
Nurses are the lifeblood of healthcare, keeping organizations running while balancing the needs of patients and physicians. Though they are on average more satisfied with the EHR than their physician counterparts, nurses have unique EHR needs that may be overlooked when clinician EHR satisfaction is examined as a whole. Accordingly, this report focuses specifically on the EHR satisfaction feedback shared by the more than 70,000 nurses (from 189 unique organizations) who have completed the Arch Collaborative survey. These findings can help organizations pinpoint ways to better support nurses in their crucial roles.

Lauren Manzione and Anna Beyer | Friday, July 31, 2020

Jul 2020

EHR Satisfaction for Recent Go-Lives

How Does Time with an EHR Affect Satisfaction?

KLAS’ Arch Collaborative, which has collected EHR-satisfaction data from thousands of clinical end users from hundreds of health systems, has identified and documented three best practices that lead to increased EHR satisfaction. Dubbed the Three Pillars of EHR Satisfaction, these best practices include strong user mastery, an EHR’s ability to meet users’ unique needs, and an organizational sense of shared EHR ownership. This report shows that these best practices are applicable for any acute/ambulatory care organization—regardless of how recently (or not) they implemented their EHR.

Connor Bice and Cole Duda | Friday, July 10, 2020

May 2020

Is There a Relationship between EHR...

Is There a Relationship between EHR Satisfaction and Hospital Quality Ratings?
A common question KLAS hears from organizations participating in the Arch Collaborative is whether there is any correlation between EHR satisfaction and an organization’s performance in other measures of hospital quality. To answer this question, KLAS looked at the Net EHR Experience Score (NEES) of Arch Collaborative members who appear in at least one of five key hospital quality ratings:

CHIME’s Most Wired (levels 8–10)
CMS Star ratings (5-star organizations)
Healthgrades (America’s 100 Best Hospitals list)
Leapfrog (Top Hospitals list)
US News and World Report (Best Hospitals list)

Jacob Jeppson and Anna Beyer | Friday, May 22, 2020

May 2020

Providing High-Quality Care: The...

Providing High-Quality Care: The EHR Factors at Play
One of the biggest promises of EHRs is that they will help healthcare providers deliver higher-quality care to their patients—the main measure of healthcare success. But do they? This report shares frontline clinicians’ feedback on how well their EHR is living up to the promise of enabling high-quality care.

Matt Brunken | Friday, May 1, 2020

Apr 2020

What Can Epic's Signal Data Tell Us...

What Can Epic's Signal Data Tell Us About EHR Satisfaction and Burnout?
Through the Signal tool, organizations using Epic have easy access to a wealth of user-level Physician Efficiency Profile (PEP) data, including in-depth data on how physicians use In Basket, orders, notes, and clinical review. Provider executives use this data to inform their informatics strategies and identify how users compare to peers in the Epic community. Leaders looking to improve EHR satisfaction and reduce burnout among their clinicians may wonder, Can this data be used to identify individual physicians who are struggling with the EHR?

Jacob Jeppson | Friday, April 17, 2020

Mar 2020

The Science of Improving the EHR...

The Science of Improving the EHR Experience

An Arch Collaborative Impact Report

Theories are proven (or disproven) through application. Technologies from the ham radio to the microprocessor were successful applications that ended the debate about theoretical principles. Similarly, today’s EHR experience pioneers prove that they understand the science of EHR success by measuring the feedback of their clinical staff, making improvements, and then measuring again. This report details the experiences of the first organizations in the Arch Collaborative to measure their clinicians' EHR satisfaction, make changes to improve, and then measure again.

Taylor Davis & Connor Bice | Friday, March 6, 2020

Feb 2020

Are EMRAM Stage 7 Nurses More...

Are EMRAM Stage 7 Nurses More Successful?

A 2020 KLAS-HIMSS Analytics Collaboration

Health information technology is a commonly cited source of clinician frustration and burnout. But what about clinicians at organizations that have reached the peak of EHR adoption—HIMSS EMRAM Stage 7? Do their clinicians report more or less EHR frustration? In 2019, KLAS (in cooperation with HIMSS Analytics) examined this question as it relates to physicians. This 2020 follow-up explores how an organization’s EMRAM stage impacts EHR satisfaction among nurses.To conduct the analysis, KLAS analyzed the Arch Collaborative survey responses of over 34,000 nurses from hundreds of individual hospitals. Throughout this report, responses from the nurses are grouped by organization, with each organization designated as either Stage 7, Stage 6, or Stage Not Validated, depending on the publicly available information from HIMSS Analytics.

Bryant Wood and Connor Bice | Thursday, February 6, 2020

Dec 2019

Finding the Right Recipe for...

Finding the Right Recipe for Documentation

Speech Recognition, Scribes & Other Methods—Impact Report

Many healthcare organizations wonder what recipe will lead them to EHR documentation success. Are scribes a cure-all? What factors lead to success with speech recognition? And should organizations still use dictation?

Taylor Davis and Connor Bice | Wednesday, December 4, 2019

Oct 2019

Achieving EHR Satisfaction in Any...

Achieving EHR Satisfaction in Any Specialty

Impact Report

Insights shared by over 30,000 physicians reveal that EHR satisfaction is highly variable across specialties. For example, pediatrics physicians have an average Net EHR Experience Score (a measurement of overall satisfaction similar to a net promoter score) of 24.0, but other specialties report much lower satisfaction (e.g., cardiology ^† with a score of 1.6).

Matt Brunken & Connor Bice | Wednesday, October 23, 2019

Sep 2019

Clinician Training

Clinician Training
KLAS Arch Collaborative Report Clinician Training - Follow-up EHR Education/Training

Bryant Wood & Anna Beyer | Friday, September 6, 2019

Aug 2019

Clinician Burnout

An Arch Collaborative Impact Report 2019

The Arch Collaborative’s primary focus is improving the EHR experience, and this experience involves the wellness of the clinician. Therefore, included in this study are two questions derived from the American Medical Association’s (AMA) Mini Z study. These two questions are correlated with the Maslach Burnout Inventory, which helps to properly identify when a clinician is burning out. All burnout findings in this report are shared through the lens of the impact of burnout on EHR satisfaction.This report is not a comprehensive analysis of the causes of clinician burnout, nor are its recommendations intended to be the primary solutions for this complex problem. Instead, this report is intended to show the developing relationship between burnout and EHR dissatisfaction. KLAS hopes the following insights add to a broader solution for taking care of those who continually offer care to others.

Connor Bice | Friday, August 2, 2019

Jul 2019

Arch Collaborative Guidebook 2019

Arch Collaborative Guidebook 2019
A product of the May 2019 Arch Collaborative Summit, the Arch Collaborative Guidebook lays out the best practices identified in Collaborative data and shared by the most successful organizations in the Collaborative.

Taylor Davis and Connor Bice | Thursday, July 25, 2019

Jun 2019

Improving EHRs Globally

Today, achieving EHR satisfaction is a global endeavor as digitization of patient records becomes more and more common throughout the world. This report aims to increase awareness of the similarities and differences in EHR challenges faced by US and non-US health systems. To date, 189 organizations across the globe have measured the feedback of their clinicians (totaling >90,000 responses) and have received benchmarking data comparing them to similar organizations. 13 of these organizations are outside the United States. Do non-US health systems have a different perception of their EHR compared to US organizations? And if there are differences, what can each group learn from the other?

In most ways, US and non-US health systems have similar experiences with their EHRs. For both groups, system reliability and internal integration are the two aspects of the EHR generating most satisfaction. The areas where more significant differences appear are efficiency (non-US health systems

Connor Bice | Friday, June 28, 2019

May 2019

2019 Summit Slides - Arch...

2019 Summit Slides - Arch Collaborative Learnings Part 1
With more responses from over 100,000 clinicians from more than 190 organizations, KLAS and the Arch Collaborative team have learned a ton! So much that we had to split the findings into two sessions. Here is part 1.