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Individual Repeat Measurements
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
Clinician Training
Jul 2021
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
The Science of Improving the EHR Experience
Jul 2021
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
Arch Collaborative Nursing Summit White Paper 2021
May 2021
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
Clinician Trust in Organization/IT Leadership
May 2021
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
Role of Healthcare IT in COVID-Related Burnout
Apr 2021
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
Role of Provider/Vendor Partnership in EHR Success
Apr 2021
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
Why Invest in Measurement?
Feb 2021
Why Invest in Measurement?
KLAS Arch Collaborative Report
Cole Duda and Bob Cash | Friday, February 12, 2021
Immediate Chart-Closure Rates
Dec 2020
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
Arch Collaborative Guidebook 2020
Oct 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
Nurse Burnout 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
Healthcare Executives’ COVID-19 Experience
Aug 2020
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
The Nurse EHR Experience 2020
Jul 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
EHR Satisfaction for Recent Go-Lives
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
Is There a Relationship between EHR Satisfaction and Hospital Quality Ratings?
May 2020
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
Providing High-Quality Care: The EHR Factors at Play
May 2020
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
What Can Epic's Signal Data Tell Us About EHR Satisfaction and Burnout?
Apr 2020
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
The Science of Improving the EHR Experience
Mar 2020
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
Are EMRAM Stage 7 Nurses More Successful?
Feb 2020
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
Finding the Right Recipe for Documentation
Dec 2019
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
Achieving EHR Satisfaction in Any Specialty
Oct 2019
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
Clinician Training
Sep 2019
Clinician Training
KLAS Arch Collaborative Report Clinician Training - Follow-up EHR Education/Training
Bryant Wood & Anna Beyer | Friday, September 6, 2019
Clinician Burnout
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
Arch Collaborative Guidebook 2019
Jul 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
Improving EHRs Globally
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
2019 Summit Slides - Arch Collaborative Learnings Part 1
May 2019
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 - Arch Collaborative Learnings Part 2
May 2019
2019 Summit Slides - Arch Collaborative Learnings Part 2
The second part of the Arch Collaborative learnings is a continuation from part 1.
Taylor Davis and Hailey Tate | Friday, May 24, 2019
2019 Summit Slides - Committee Meetings
May 2019
2019 Summit Slides - Committee Meetings
KLAS organized committees to help guide the direction of the Arch Collaborative in key areas. These areas include: the general survey, the executive survey, nursing research, media & outreach, academic research and physician wellness.
Taylor Davis and Hailey Tate | Friday, May 24, 2019
2019 Summit Slides - Individual Organization Presentations
May 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 - Keynote and Conference Welcome
May 2019
2019 Summit Slides - Keynote and Conference Welcome
Kick off the 2019 Arch Collaborative Summit learnings with insights from Liz Johnson from Tenet Healthcare Corporation.
Taylor Davis and Hailey Tate | Friday, May 24, 2019
2019 Summit Slides - Moving the Needle Presentations
May 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
May 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
May 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
2019 Summit Slides - Vendor Breakouts
May 2019
2019 Summit Slides - Vendor Breakouts
One of the greatest opportunities in the Arch Collaborative is the potential partnership between vendor and health system to jointly improve the EHR experience for clinicians everywhere. Clinicians, vendors and the KLAS team all met together to talk about their unique needs and how they could mutually benefit each other.
Taylor Davis and Hailey Tate | Friday, May 24, 2019
Can My EHR Get Me There?
May 2019
Can My EHR Get Me There?
An Arch Collaborative Impact Report

The KLAS Arch Collaborative has collected the feedback of over 80,000 clinicians at 180+ organizations across 9 countries and found that which EHR vendor they use does not determine satisfaction on its own.
Taylor Davis | Tuesday, May 14, 2019
Successful Users' Keys to EHR Satisfaction
May 2019
Successful Users' Keys to EHR Satisfaction
An Arch Collaborative Impact Report

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.
Connor Bice | Monday, May 13, 2019
The Nurse EHR Experience
Mar 2019
The Nurse EHR Experience
An Arch Collaborative Impact Report 2019

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
Are EMRAM Stage 7 Physicians More Successful?
Feb 2019
Are EMRAM Stage 7 Physicians More Successful?
A 2019 KLAS-HIMSS Analytics Collaboration

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.
Taylor Davis | Thursday, February 28, 2019
Improving the EHR Experience Through Personalization
Nov 2018
Improving the EHR Experience Through Personalization
A Path Toward Excellence

If there were a yellow brick road that led to higher EHR satisfaction, that path would be EHR personalization. Personalization leads to better EHR efficiency, better physician agreement that the EHR enables quality care, more provider trust that the EHR vendor has built a quality tool, and higher overall EHR satisfaction.
Taylor Davis & Connor Bice | Friday, November 9, 2018
Organization Culture: The X-Factor of EHR Success
Nov 2018
Organization Culture: The X-Factor of EHR Success
An Arch Collaborative Impact Report

Enacting cultural change is one of the most challenging obstacles an organization can face. In fact, it is so difficult that dozens of books are published every year to teach successful culture principles and remind leaders of the importance of workplace culture. Because culture issues can be so hard to overcome, organizations often look to other solutions that are quicker or easier to implement. When it comes to clinician EHR satisfaction, these quick fixes include implementing voice recognition technology, hiring scribes, switching to a different EHR, or making training mandatory. Unfortunately, these are just Band-Aids that hide the real issue and postpone the heavy lift of solving EHR challenges.
Taylor Davis and Connor Bice | Friday, November 2, 2018
How to Approach EHR Change Management
Oct 2018
How to Approach EHR Change Management
An Arch Collaborative Impact Report

EHR governance does not need to be a roadblock to provider organizations’ EHR improvement strategies. Many organizations use governance to effectively improve the EHR and as an avenue for explaining to physicians the EHR’s limitations, whether those are caused by regulations, technical architectures, or organizational capacity.
Taylor Davis and Connor Bice | Friday, October 26, 2018
EHR Success Doesn't Have to Be High Cost
Oct 2018
EHR Success Doesn't Have to Be High Cost
An Arch Collaborative Impact Report

In today’s healthcare market, budgetary decisions are becoming more and more challenging as profit margins become increasingly thin for a majority of hospitals. To examine how tightening the purse strings affects providers and their EHR satisfaction, KLAS asked more than 50 organizations about the various ways they invest in their EHR(s) and also surveyed these organizations’ end users regarding their EHR satisfaction. KLAS’ analysis of the two data sets reveals two interesting findings about how EHR spending impacts EHR satisfaction: (1) the percentage of the overall budget allotted to IT and the EHR does not need to be large for providers to be successful with the EHR; and (2) the number of physician and IT personnel that are committed to IT responsibilities has a substantial impact on provider satisfaction.
Taylor Davis and Connor Bice | Friday, October 19, 2018
EHR Mastery—The Impact of Training
Oct 2018
EHR Mastery—The Impact of Training
Don't Go Chasing Waterfalls

Organizations occasionally look for a magical solution that will fix clinician dissatisfaction with the EHR. Unfortunately, because education is a human experience, there isn’t any one training program that will magically solve this dilemma. But what has been made clear—by analyzing survey responses from over 40,000 end users—is that good training has a profound and lasting impact on a clinician’s satisfaction with the EHR.
Taylor Davis and Connor Bice | Monday, October 8, 2018
2018 Arch Collaborative Summit Slides
May 2018
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
Creating the EMR Advantage
Dec 2017
Creating the EMR Advantage
EMR Best Practices Study

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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