physicians discussing their work

Who Is in Control of EHR Satisfaction?

On the surface, the Arch Collaborative data set isn’t always rosy. For example, we have analyzed the results of over 100,000 clinician responses and have uncovered at least one insight that might raise some eyebrows:

Nearly 80% of the variability in EHR satisfaction comes from the provider organization and the clinical end user.

Making the Difference

The overwhelming majority of variation that drives up EHR satisfaction comes from the health system and its users. Of course, that sounds an awful lot like victim blaming when you consider that clinicians often have EHRs foisted onto them without so much as a second thought. Still, I see that insight as the most empowering news KLAS could give to clinicians who are feeling frustrated, stuck, and maybe even a little harassed by their EHR. It means that health systems and their clinicians have the very real ability steering their EHR satisfaction forward.

Before I get much further, I do think it’s important to note that the data isn’t giving a free pass to EHR vendors. Clearly, there are many improvements that companies in the EHR market need to make, and the last thing Arch Collaborative data should be used for is helping EHR vendors shirk their responsibility to innovate and improve within the market.

Still, a large portion of control over the baseline satisfaction of EHRs lies with health systems and their clinical end users. If those two groups can align themselves with best practices, they can seriously improve their experiences with the EHR.

Clinician Relationships and Communication

KLAS recently published the Arch Collaborative Guidebook, which compiles data-validated best practices from various organizations who have measured within the Collaborative. Overwhelmingly, a critical component of successful EHR instances is the relationship an organization maintains between their IT department and clinical leadership.

Among the most effective methods mentioned in the guidebook, one sticks out as particularly useful: Proactively seek out your most frustrated clinicians and convert them into EHR promoters.

Recently I was at the HCI Healthcare Summit in Denver, Colorado, and had the opportunity to hear CT Lin, the CMIO of UC Denver, speak.

He has spent much of his career championing IT transformation for clinicians. He mentioned during the panel discussion that he began his crusade for improving the EHR began in 1997 as the self-appointed “chief complainer” at the University of Colorado. While there, he often found himself complaining the loudest about the inefficiencies in their digital systems. Eventually, his informaticist leadership brought him in and empowered him to help improve their EHR.

It’s important to remember that those who are passionately angry about the EHR are just that—passionate. Often, helping those passionate individuals become empowered to enact change converts them from obstacle to advocate.

When “No” Means “Let’s Talk About It”

To further improve the communication and relationship between the IT and clinical staffs, best practices suggest that frontline IT analysts shouldn’t be expected to say no to clinicians. Instead, they should escalate issues or find alternative, acceptable solutions. They should operate under a yes or alternative-solution mentality. All of us can relate to the frustration of calling customer service and being told by tier-one support that nothing can be done, especially when we get that nagging sense that if we could just peek behind the curtain, we could talk to someone that would actually solve our problem.

It’s important then to have IT people who understand their role as communicators between the IT department and the clinical teams. In cases where no is the only possible option for a disgruntled doctor, the IT senior peers (who share in ownership of the EHR) should deliver the news. By speaking the clinicians’ language and helping them understand the reasons behind the no, they can help diffuse those frustrations.

Whenever possible, organizations should strive to collaborate with clinicians on a solution in order to build trust between the IT and clinical staffs.

Additionally, many of the highly successful organizations within the Collaborative’s data set have identified and internalized a change management philosophy. We’ve seen that it’s less important to pick the “right” change management philosophy from among the several popular methods and more important to wholly adopt a framework. Leaders who understand change management know not to be disappointed when communications need to be sent multiple times.

Where Does It Lead?

Ultimately, clinician satisfaction is less about the tools and more about how they’re being used. Organizations looking to move the needle for their clinicians should focus on creating a transparent, trust-based relationship. Sure, that sounds like the absolute pinnacle of an easier-said-than-done solution, but thankfully, there are data-validated practices that can help health systems plan out their next steps toward EHR optimization.




     Photo cred: Shutterstock, Dragon Images