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High-Impact Methods to Achieve Clinician EHR Satisfaction with Few Additional Resources
Healthcare organizations are continually looking for ways to improve clinician EHR satisfaction despite tight budgets and staffing shortages. According to Arch Collaborative data, organizations who spend more of their budget on their EHR don’t necessarily realize a higher Net EHR Experience Score†. In contrast, those who prioritize and reallocate resources toward high-impact interventions can often see improved clinician EHR satisfaction—proving that high satisfaction is possible despite budget and staffing constraints. Drawing from Arch Collaborative case studies, this report provides examples of high-performing organizations or those with improved performance who have made small but effective efforts to increase clinician EHR satisfaction.
As Arch Collaborative members recognize the positive impact that robust training and education can have on clinicians’ EHR satisfaction, they are looking for ways to scale their education programs quickly with limited staff and budgets. Organizations are increasingly turning to eLearning—both to scale clinician education efforts with small budgets and to meet the demand of recent graduates from medical and nursing schools, who often prefer this format. This report provides examples of how eLearning can be implemented strategically as a convenient, cost-effective training method that complements traditional instructor-led training.
Tyler Hendricks & Jenifer Gordon |
Monday, October 23, 2023
Arch Collaborative Provider Guidebook 2023 Arch Collaborative Provider Guidebook2023—Creating EHR Mastery: Onboarding EHR Education; Creating EHR Mastery: Ongoing EHR Education; Creating Shared Ownership: Provider Relationships and Communication; Creating Shared Ownership: Governance; Creating Provider Efficiency: Personalization; Creating Provider Wellness: Reducing Burnout; Building a Technological Foundation: System Reliability and Response Time
Since the Arch Collaborative’s early days, analysis of clinician feedback has identified three pillars 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). This last pillar is the focus of this report. While it is important for physicians to have the flexibility to care for patients and document in a way that fits their workflow, too much freedom to change the EHR can hinder efficiency and patient safety. This report identifies the benefits of personalization as well as best practices for leveraging it.
With limited budgets and resources, Arch Collaborative members frequently ask KLAS which of their EHR vendor’s education initiatives and system features are most effective at improving EHR efficiency and satisfaction. Because Epic users make up over 60% of respondents in the Arch Collaborative’s data sample, this report evaluates several Epic-specific initiatives and features to help Epic customers determine whether they are worth the investment. While not an exhaustive list of all Epic offerings capable of improving EHR efficiency and satisfaction, the initiatives and features examined in this report are those that Epic users have identified as top of mind.
Streamlining the Clinician Experience through Services & Software Offerings
Arch Collaborative research has highlighted EHR efficiency as one of the most impactful factors to the clinician EHR experience. However, it is one of the metrics with which clinical staff are least satisfied—only 46% of respondents agree their EHR enables efficiency. Further, lack of efficiency is the NEES* metric most correlated with clinician burnout. Healthcare organizations are looking to services firms and software vendors to help drive EHR efficiency and improve the EHR experience. This report specifically highlights services offerings and software solutions that can support healthcare organizations in their EHR efficiency efforts. The report is part of a series aimed at exploring firm and vendor offerings in a variety of areas that impact EHR satisfaction.
Arch Collaborative research shows that education is one of the most impactful factors to the clinician EHR experience. KLAS recently invited vendors and firms to provide information on their offerings that can augment healthcare organizations’ efforts to improve clinician EHR education. For this report, KLAS interviewed 75 healthcare organizations to validate these vendor and firm offerings and provide guidance for others who are looking to supplement their EHR education programs.
Since the early days of the Arch Collaborative, feedback from clinicians has shown training to be a key pillar of EHR success. The importance of education became even more apparent as methods for delivering training shifted throughout the pandemic. As a collaborative, we continue to ask questions and work with our member organizations—both healthcare organizations and vendors—to identify best practices for EHR education and share success stories that that illustrate them (see recent Collaborative report on vendors who offer EHR education solutions).
Augmenting EHR Education Initiatives through Software and Services Offerings
Arch Collaborative research has validated education as one of the most impactful factors to the clinician EHR experience. With staffing shortages and limited resources aggravated by the COVID-19 pandemic, healthcare organizations are looking to software vendors and services firms to help improve clinician EHR education. This report specifically examines services offerings and software solutions that can support healthcare organizations in their EHR education efforts.
This report is a compilation of vendor and firm claims about their services and software offerings. See KLAS’ follow-up report for customer validations of these offerings.
How to Maximize Impact and Prevent Clinician Frustration
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.
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.
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.
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.
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.
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.
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.
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
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.
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.
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.
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
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
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.
Taylor Davis and Hailey Tate |
Friday, May 24, 2019
2019 Summit Slides - Individual Organization Presentations Many organizations have shared their keys to successful EHR use. These slides highlight seven organizations and their best practices. OrthoVirginia's Road to Dramatic ImprovementMemorial Health System's Driving to Success with Cerner Clinicals and FinancialsKaiser Permanente Northwest Region's Trust and TrainingRoyal Children's Hospital's Creating a Service CultureUCLA Health's Keys to Nursing SuccessPetaluma Health Center's Educating for SuccessMetroHealth Medical Center's Success on a Small Budget
Taylor Davis and Hailey Tate |
Friday, May 24, 2019
2019 Summit Slides - Moving the Needle Presentations Organizations are beginning to remeasure their clinician's experience with the EHR. Here are some organizations who have seen significant increases in their Net EHR Experience Scores.
Taylor Davis and Hailey Tate |
Friday, May 24, 2019
2019 Summit Slides - Organization Type Meetings Part of the benefit of the Arch Collaborative is seeing how similar organizations manage their clinicians' EHR experience. The 2019 Arch Collaborative Summit provided the opportunity for comparably sized organizations to meet together and talk about common problems and potential solutions for those problems.
Taylor Davis and Hailey Tate |
Friday, May 24, 2019
2019 Summit Slides - Panel Discussions One of the primary goals of the 2019 Arch Collaborative Summit was to create a Best Practices Guidebook that lists out many of the successful principles for effective EHR management. KLAS partnered with some of the most successful organizations in the Collaborative to compile a list of best practices and then discussed these principles at the Summit to ensure that these concepts are widely applicable. Learn principles on Onboarding training, EHR personalization, ongoing training, physician wellness, preventing opioid abuse, how to successfully round and build clinician/IT relationships, how to build a governance with shared ownership and how to ensure that nurses voices are heard.
Taylor Davis and Hailey Tate |
Friday, May 24, 2019
In October 2018, the Arch Collaborative added an open-ended question to the end of our clinician-experience survey for those who report high satisfaction and efficiency: What do you believe that you do differently from some of your peers that enables you to be highly successful with the EHR? This question only appears for those clinicians who agree or strongly agree that the EHR enables them to deliver high-quality care and that the EHR makes them as efficient as possible. Arch Collaborative data has indicated that the keys to EHR success lie with EHR education, EHR personalization, and the organization’s culture. But what do the clinicians themselves cite? The following report highlights what the first 1,261 clinicians to answer the question above do differently to be successful, and what other clinicians who may not be using the EHR quite as successfully can learn from their peers.
Since nurses work widely with the EHR, it is crucial to measure their experience with it so that opportunities for improvement can be found. And since, on average, nurses report significantly higher EHR satisfaction than physicians, it is also important to understand their successes; doing so provides vital information about how to improve EHR satisfaction for all clinicians.
Taylor Davis & Connor Bice |
Thursday, March 28, 2019
The last 10 years have seen a dramatic rise in the adoption of health information technology—as well as a dramatic rise in physician frustration with this technology. What about the organizations that have reached the peak of EHR adoption: HIMSS EMRAM Stage 7? Are their physicians more or less frustrated? To answer this question, KLAS (in cooperation with HIMSS Analytics) has used the public reporting of Stage 6 & 7 hospitals in the US to see whether there is a correlation between HIMSS EMRAM stage and EHR user satisfaction.
2018 Arch Collaborative Summit Slides In May 2018, KLAS hosted the first ever Arch Collaborative Summit for health systems to share their ideas on how to achieve clinician satisfaction with the EHR. Various health systems, using various EHRs, presented their results and their programs that led to high satisfaction while others listened and asked questions. The collaboration resulted in shared concepts and new ideas to help all parties involved be better prepared to improve their clinicians' EHR satisfaction.
Taylor Davis and Hailey Tate |
Friday, May 18, 2018
We built EMRs to help clinicians deliver dramatically bettercare and to be more efficient in that care. If clinicianseverywhere consistently praised EMRs for revolutionizingthe practice of medicine, wouldn't that be an indication thatthe EMR was a success?
But that is not happening.
In late 2016, in an effort to turn the tide of EMR frustration,KLAS gathered with a handful of provider organizationswith the idea of creating a common end-user satisfactionsurvey to be used as a means of establishing satisfactionbenchmarks and enabling provider organizations to learnfrom each other’s successes and failures. Today, this effort—called the Arch Collaborative—has collected 15,535 userperspectives from 55 organizations.
Taylor Davis |
Wednesday, December 6, 2017
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