Arch Collab Bright Idea

The Arch Collaborative: A Light Goes On For EMR Usability

My “Aha” Moment

When I married my wife nearly 22 years ago, my father-in-law told me that I’d need to learn to golf if I were to make a suitable businessman and husband. He helped me pick out a driver and everything else I would need, including the most uncomfortable shoes I’d ever worn in my life. I remember thinking, “No wonder golfers use carts to get around!” But I figured the footwear was part of the game, so I shrugged and suffered in silence.

Then, recently, I had the chance to get a new pair of golf shoes. Imagine my surprise when a pair of Nike golf shoes I tried on instantly became the favorite pair of shoes in my closet. They’re so comfortable that I even wear them to the office! I rejoiced in my “aha” moment but also mourned for how late it had come. For over 20 years, I’d limped around in miniature torture chambers simply because I hadn’t known how good golf shoes could really be.

Today, healthcare providers all over the world struggle with EMR usability problems even more painful than my first pair of golfing shoes. Many providers realize that their experience should be better but aren’t convinced that they can do anything to fulfill their EMR dreams. My KLAS colleagues and I feel differently. We believed and are now certain that provider organizations have enormous power to improve their EMR experience. That’s why we created the Arch Collaborative.

Some “Aha” Moments from the Collaborative

Many participants in the Arch Collaborative—including us at KLAS—began with some long-held and oft-repeated assumptions about the EMR, its usability, and its users. But as survey results from thousands of end users trickled in, most of these assumptions were heartily debunked. Here are just a few falsehoods paired with contrasting truths from the Collaborative data:

  • “Organizations that spend the most money on improving their EMRs have the happiest users.” - There was only a marginal improvement in satisfaction for organizations that spent more than 4% of their operating budget on IT.
  • “The most experienced clinicians will be more satisfied with the EMR.” - On average, we saw a zero-point difference in the satisfaction scores of experienced EMR users versus brand-new users.
  • “The best way to increase EMR satisfaction is by reducing clicks.” - There was only a slight correlation between EMR satisfaction and charting efficiency.

It soon became clear that the biggest factors in EMR satisfaction had little to do with the technical details of the EMR. Instead, the vast majority of the Collaborative findings pointed to things like culture, relationships, and mindsets (put into practice through governance, training and personalizations). While we were a little surprised to see so many of our original beliefs blown out of the water, KLAS became excited to share our “aha” moments with our friends in the Collaborative and the industry. These desires, along with the desires of Collaborative members to learn from each other, led to one of KLAS’ most greatly anticipated events.

The Arch Collaborative Summit

On May 22nd and 23rd, KLAS gathered with our healthcare friends in Salt Lake City for the first Arch Collaborative Summit. Our goal? To share some of our “aha” moments and help the attendees kindle their own. You can imagine my delight at the number and variety of committed and passionate organizations represented:

  • 50 health systems who have been participating in the Arch Collaborative
  • 4 EMR vendors (Allscripts, Cerner, Epic, and MEDITECH)
  • 2 speech recognition vendors (MModal and Nuance)
  • 3 consulting firms (Impact Advisors, Nordic, and The Chartis Group)
  • CHIME
  • The Scottsdale Institute
  • The ONC

Our morning included several breakout sessions led by health systems who had found success in specific EMR-related areas. For instance, Tim Niacaris of JPS Health System led a session on combating physician burnout, and David Graham recounted how Memorial Health had built trust between their clinicians and IT.

After lunch, attendees attended what we called our “science fair”. Dozens of Collaborative organizations—such as Mayo Foundation, Sutter Health, and Salford Royal UK—set up booths and shared some of their secrets to boosting EMR satisfaction. Attendees from many health systems even got to meet with representatives from their respective EMR vendors to discuss future collaboration and improvement efforts.

As I ambled between the breakout sessions and booths, my smile grew bigger and bigger. Hearing health system representatives talk about the specifics of setting up governance programs, transforming culture, and engaging clinicians confirmed to me the importance of the Collaborative, the Summit, and the unconquerable spirits of the providers around me.

More “Aha” Moments to Come

While the Summit lasted only a day and a half, KLAS hopes for the spirit of the Collaborative to become a way of life. In our efforts to spread the “aha” moments around, KLAS has created two resources for subscribing Collaborative members: the Collaborative Learning Center and the Collaborative Directory.

The Learning Center includes dozens of case studies from health systems with the best performance in areas like provider EMR personalization and provider engagement. The Collaborative Directory will help health systems participating in the Collaborative to do just as the title suggests: collaborate.

KLAS also wants to share principles of success and even a few details from the Arch Collaborative case studies with everyone. With that desire in mind, we’ll be publishing more blog posts and other publications in the near future, so stay tuned!

I’m not sure exactly what the next year will bring for the Arch Collaborative, but I’m confident and thrilled that the collaboration that began at the Summit will improve the lives of providers all over the US and beyond. We hope you’ll join our cause and come ready to learn the truths that can solve healthcare’s toughest problems.