EHR Vendor, Organizational Relationship Key to EHR Satisfaction

EHR satisfaction and success are possible with any EHR system after improved organizational and vendor teamwork, according to a recent KLAS Impact Report.

Physician respondents noted the importance of their respective EHR vendors to enable quality care and how well the organization implemented, supported, and trained on the EHR system.

Nurse respondents valued their respective EHR vendor’s ability to implement the EHR, deploy health IT support, and initiate EHR training.

Through past research and surveys, KLAS described three pillars that create a successful EHR user:

• EHR user mastery
• Sense of shared ownership
• EHR functionality meeting specialty-specific needs

“The importance of this last pillar in particular is highlighted in this report as an important predictor of EHR satisfaction for both inpatient and ambulatory physicians,” explained KLAS. “EHR functionality depends on both the vendor and the organization—has the vendor built needed tools, and do users know how to leverage them to support care?”

KLAS surveyed over 35,000 inpatient physicians, over 56,000 ambulatory physicians, and over 70,000 nurses to identify the combined provider and EHR vendor partnership role in EHR success.

Inpatient physicians noted organization and IT delivery as the leading satisfaction variable for EHR success. Respondents also said EHRs that have functionality catering to specialty care, that help achieve quality healthcare, that have quick system response time, and that can create internal integration also led to success.

Ambulatory physicians reported similar EHR needs, saying that tools that provide functionality for a specific specialty area, that can enable quality care, and that have fast system response time were successful. Additionally, ambulatory clinicians said organization and IT delivery led to EHR satisfaction

The leading EHR satisfaction indicator among nurses was organization and health IT delivery.

“Part of the reason for this factor’s high impact is likely the role of nurse leadership—when these leaders effectively address frontline nurses’ EHR needs, perceptions of the EHR’s value are much higher,” KLAS explained.

“KLAS has found high variation in nurse EHR satisfaction (even among nurses using the same EHR), suggesting that with the right approach, it is possible for organizations to use their own resources to improve nurse EHR satisfaction without having to implement a whole new system.”

Nurse respondents also noted system response time, enabled quality care, needed specialty functionality, EHR training, and end-user mastery as other key EHR success variables.

“The EHR is stable and reliable,” wrote a satisfied hospitalist respondent. “We used to have a lot of unexpected downtime, and that was untenable. I would appreciate having more options within the patient summary tabs to follow certain categories of conditions.”

“Some excellent accordions include VAP, diabetes, and pain. There is a very efficient method to quickly follow medications, vitals, and labs. There are similar accordions for cardiovascular (BP medications), renal, and alcohol withdrawal. . . . In the past, we might end up with a patient who is put on IV fluids unnecessarily by the second or third day of hospitalization. But now it is very easy to screen for that,” the hospitalist continued.

On the other hand, several hospitalist respondents experienced overall EHR dissatisfaction.

“I firmly believe this EHR makes important information difficult to find and interpret, and it is very inefficient,” said an anonymous dissatisfied hospitalist. “It creates superfluous and difficult-to-navigate notes and information that are not centralized. That makes it easy for care providers to disregard notes, and they often do. That affects patient safety. . . . It is difficult and arduous to document in the EHR, and providers’ efforts to do so still yield subpar results with erroneous, irrelevant information.”

“When it comes to functionality and how easy it is to learn, the EHR is a highly unintuitive system. . . . Integration is nonexistent, downtime is frequent, and safety seems to be the lowest priority, if it is a priority at all,” the dissatisfied hospitalist added.

KLAS interviewed two health IT professionals at OrthoVirginia, a Virginia-based orthopedics facility, after reporting a 31-point increase in EHR vendor delivery satisfaction with its Epic Systems EHR.

OrthoVirginia recommended organization leaders work directly with the EHR vendor after gaining feedback from users. The organization also recommended the EHR vendor work directly with the organization, and the end-user communicate her EHR needs.

Organizational leaders can leverage superusers, provide additional training, and teach personalization to help users take advantage of the EHR and its new features. The EHR vendor can develop new features based on client needs and provide training materials. The professionals recommended end-users participate in training and make additional efforts to master the EHR. 

The two health IT leaders also said the increased focus on mastery, culture, and training could help change EHR expectations for the better.

“OrthoVirginia’s success is the result of taking advantage of every new enhancement Epic offers,” KLAS concluded.