Arch Collab

The Misalignment of IT and Clinical Perspectives



 This is an excerpt from a recent Arch Collaborative webinar featuring Adam Gale, President of KLAS Research and Taylor Davis, VP of Business Development and head of the Arch Collaborative.

Together they discuss insights uncovered from the more than 50,000 clinician responses the Arch Collaborative has gathered to date.








Taylor Davis

“I think all of us have somebody in our lives where maybe they are looking for love in the wrong places and you think, “Oh, that is not going to work out well for you.”

As we look at this data, we feel like we're seeing the very same experience with the EHR in terms of EHR success. So now that we have started to collect in mass, the voice of end user providers, we are working very closely with EHR vendors.

I had an hour call I did this morning with one of the leading EHR vendors in the industry. We talk all the time to provider organization leadership and IT leadership, and now we're collecting the voice of end users and we're here to tell you that these groups are saying different things.

So jumping into this, wanting to give you an example: We were just out in the West in the west coast meeting with a group. We had the chance to meet with about 20 from their IT and informatics group.

And we gave them four options. We said, “If your physicians could take a step forward with their EHR experience in one of the four ways, which way would they to move?”

And let me give you the four examples right here:

  • So for the first is incredible efficiency. If they could have faster-than-paper documentation, and just be able to move through the EHR incredibly quickly.
  • The second option, what if they could have control over the EHR so they could control how it is set up. How it works for them and their layout and some of the functionality. What if they didn't have to wait and go through a governance group and everything else?  
  • Third, what if you could click your fingers and everyone could become EHR masters so they fully understood all of the functionality that is available to them?
  • And the fourth option is: “What if we could really increase the patient insights that you're able to get out of the EHR? So the data's all there. What if we made it really easy for you to be able to get to the insights that you want to get to?”

So, Adam, you've already heard this story, but I have to admit we walked into this feeling a little bit nervous because we had thought that it would play out a certain way based on all these conversations that we've had. And Bob Cash and I walked in there, thinking, “Well, what if it doesn't play out that way?”

Luckily we didn't have to go to our plan B - it played out exactly like we expected.:

Adam Gale:

“Yeah. So what did they have to say? “

Taylor Davis:

“So the IT and informatics group - 15 people or so in the room - we had them all take votes and said, “you only get to choose one.” Seventy percent of them said we think it's incredible efficiency is what they'd want.”

Adam Gale:

“So, let me pause you there. As I talked to a lot of the leaders from these EHR vendors, they would agree with that. When I talk about EHR usability and, and success for the physicians, they go right to the UI. “How many clicks, how efficient can you be typically in documenting?” Their answer would map pretty closely to what I see the vendors doing today.”

Taylor Davis:

“Well, it's interesting because I actually walked through this exercise with the EHR vendor that I spoke to this morning and I said, “What do you think it would be?” They said, “we think it's efficiency.” So there's another data point that says that the IT and the informatics groups across the country from many EHR vendors believe that this is the top issue.

So, I asked this group, “why do you see this as the top issue?” And they responded, “Because of all of the discussions that we have where we're constantly getting feedback about too many clicks etc.” Or, “This needs to be streamlined. We don't like how you set this up.” and they said they give us feedback about that all the time.” I think that that's probably their greatest pain point.

You can see how those conversations happen. If I'm a physician and I sit down with an EHR vendor or with my IT team, I might just go right to efficiency and just say: “I think that this page could be laid out better.”

It's interesting though, we had a group of about 20 physicians in the room and we told the informatics team that we're going to ask them this same question. Overwhelmingly-above 80 percent-they chose patient insights. I think only one physician said, “I'd like to see better efficiency.”

The differences were very stark. It wasn't even very close. This was a really fun exercise for this organization. I think it identified to them, “hey, we may be on the wrong pages in terms of what we're doing.”

What's interesting is that this organization has a net experience score of over 35, so they're a high performing organization. But you still look at those who are supporting the EHR and those who are using the EHR and there's a disconnect in terms of what to fix.

So, we get really nervous as we see this. Obviously this is something that we're trying to call out. We get nervous as we see this disconnect because we think it creates a vicious cycle.”

Adam Gale:

“So, when you say we're “looking for love in all the wrong places,” we've spent a lot of time and money on the usability, the user interface specifically, and I don't think that's been a bad thing. I see the user interfaces on these systems and I always think, “well, that could be better.” But it's not the prioritized biggest bang for your buck.

Taylor Davis:

"That's exactly right. So if we could give you any takeaways today, and we've shared this with some of your groups, but if we could give you any takeaways today, it is: be careful about where you're putting your focus. The key to success with these clinicians is much deeper than just increasing their efficiency and decreasing the number of clicks that they have.”

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