KLAS Outlines Strategies to Improve Clinician EHR Satisfaction

Improving clinician satisfaction with the EHR is a continuous process that requires healthcare systems to continuously measure, implement, and evaluate EHR experience for more targeted interventions, according to a recent KLAS Arch Collaborative report sent to journalists. 

As a part of the survey, researchers collected response data from over 340,000 clinicians, revealing critical details about EHR areas of satisfaction and frustration to improve clinician EHR experience.

Ultimately, healthcare organizations should look to standardized organization-wide measurement as an initial first step in identifying challenges impacting EHR satisfaction.

Using data collected by the Arch Collaborative over the past five years, organizations can set benchmarks to understand the markers of high satisfaction.

Out of the 95 organizations that have completed several organization-wide measurements of clinician EHR satisfaction, 40 percent experienced an over 8 percentage-point increase in their net EHR experience score compared to their first measurement.

Additionally, organizations that measure EHR satisfaction more than once accomplish great experience scores of nearly 11 points higher.

“Historically, conclusions about clinician satisfaction with the EHR were often based on anecdotal data and feedback rather than formal measurement,” the KLAS researchers said. “Depending on the volume of this feedback (in terms of quantity or decibels), one could draw a variety of conclusions about the clinician EHR experience, some perhaps less accurate than others. To correctly identify—and then improve—the real issues your clinicians are experiencing with the EHR, the first step is standardized, organization-wide measurement.”

Secondly, KLAS recommended that organizations gain a greater understanding of what a poor EHR experience entails and its implications.

Poor EHR experience can result in employee turnover, with nurse turnover expenses as high as $1.9 to $3.4 million per organization and provider turnover costs reaching $25.6 million in some cases.

Survey findings indicated that 35 percent of respondents are likely to leave their organization if they are dissatisfied with EHR implementation and training. Low net EHR experience scores could also lead to over 30 percent of clinicians quitting.

KLAS researchers found that their analysis of “clinician EHR satisfaction, burnout, and turnover shows how much of this cost could be attributed to EHR dissatisfaction: $93,000–$170,000 per organization per year for nurses and $319,000–$1.3 million for physicians,” the researchers wrote. “These estimates illuminate the potential financial cost of not addressing clinician dissatisfaction with the EHR.”

Achieving greater EHR satisfaction requires organizations to identify specific departments, specialties, or clinical roles that need targeted interventions.

“The best candidates for intervention will be groups with strong leadership willing to engage in a change initiative,” the researchers stated. “Additionally, Collaborative data has identified several clinical backgrounds, specialties, and departments that generally haven’t seen much improvement over time and may therefore benefit from targeted intervention. For example, EHR satisfaction among allied health professionals has not improved over time and has in fact decreased slightly.”

The fourth step listed in the strategy guide is to evaluate improvement initiatives.

“Organizations looking to implement an improvement initiative will naturally wonder which are most worth the investment,” researchers wrote. “Organizations that have standardized to one EHR across their enterprise or have implemented a new EHR altogether have seen the highest increases in average net EHR experience score.” However, that approach may not be a feasible option for many organizations.”

Healthcare organizations should evaluate other improvement initiatives that have led to significant experience improvements, including third-party tools to improve usability. They also consider investing in clinical EHR functionality, implementing at-the-elbow training, and improving online training options.

The data from the Arch Collaborative shows that some of the greatest satisfaction improvements have yielded from EHR optimization or a new EHR implementation. This increased satisfaction following an EHR change can stem from a revitalized focus on EHR training and education.

Once an organization has selected an improvement initiative, it must determine ways for a successful implementation.

For example, Door County Medical Center used a one-on-one onboarding strategy to improve clinician satisfaction by 38 points. The organization provided new physicians with in-person EHR training lasting between two and four hours to ensure physicians were aware of the processes. Additionally, new physicians received two to five days of at-the-elbow support and ongoing training.

Lastly, KLAS encouraged organizations to remeasure satisfaction rates and repeat targeted interventions.

“While surveying your entire organization multiple times a year may not be feasible, the Arch Collaborative offers several options for interim measurements, including pre-and post-initiative surveys, which measure a subset of users before and after an intervention, and pulse surveys, which can be used to increase understanding of a specific group’s EHR experience,” the researchers stated.

“On average, organizations see significant improvement in NEES when they measure clinician satisfaction both before and after implementing an initiative targeting a specific department or goal.”