- KLAS recently published a list of best practices for EHR optimization to reduce provider burden as part of a study conducted through its Arch Collaborative initiative.
“The Arch Collaborative, in an effort to stem the tide of EMR-related clinician burnout, brings together organizations from community facilities to large IDNs under a standardized user-satisfaction survey,” stated KLAS on its website.
Launched in late 2016, the Arch Collaborative was an attempt by KLAS researchers to team up with provider organizations to create a common end-user satisfaction survey. One year later, the collaborative now includes insights from 15,535 physicians and 55 healthcare organizations.
Participating organizations include Rush Health, Geisinger Health, Mayo Clinic, Tufts Medical Center, and others.
As part of its most recent survey, researchers collected data from 7,609 physicians and EHR users to benchmark, share best practices, and indicate successful hospital and clinic cultures. Forty-three percent of surveyed providers reported overall dissatisfaction with their EHR experience.
“The story of their dissatisfaction is not simply one of too many clicks,” clarified researchers. “Rather, their dissatisfaction stems from a perception of having lost control over the care they were trained to deliver as well as a perception that they cannot improve their current situation.”
Ultimately, KLAS researchers named education, personalization, and culture as the three keys to EHR optimization among successful healthcare organizations.
First, researchers indicated that successful organizations consistently recognize the impact of both initial and ongoing EHR education.
“These organizations require newly hired physicians to spend six or more hours in training classes taught by other clinicians,” stated researchers. “This ongoing training leverages the power of peer pressure to engage users rather than relying on at-the-elbow training or classroom training not taught by a fellow clinician.”
Specifically, user satisfaction among physicians that reported feeling well-prepared following initial training was more than 50 percent higher than user satisfaction among those who reported feeling unprepared following initial training. This discrepancy in user satisfaction between those who felt their EHR system training had been sufficient and those that did not remained consistent more than 5 years after implementation.
Survey results revealed initial EHR training is the number one predictor of EHR user success.
“The effects of poor initial training remain with users for years after they come live,” stated researchers.
Additionally, organizations that require newly trained hired physicians to complete more than six hours of training generally reported higher levels of provider satisfaction.
Regarding personalization, KLAS stated successful organizations generally maintain personalization settings are the key to making a one-size-fits-all EHR system work for all physicians and hospital staff.
“Personalizations that allow clinicians to quickly retrieve data or review a chart are the most powerful in improving clinician satisfaction,” stated researchers.
Survey results showed a direct positive correlation between personalization setting use and organization EHR experience score.
Additionally, healthcare organization leadership from high-performing organizations reported good EHR governance was the key to their success.
“The Epic Physician Builder program, which essentially makes EMR governance more responsive to the needs of users, enables higher EMR satisfaction and can be copied by other EMR customer bases,” noted researchers. “Users need to invest about 6 hours per year into better learning the EMR.”
Finally, KLAS researchers revealed that organization culture matters more than which EHR an organization has implemented, according to surveyed providers.
“While culture is the most difficult key to replicate, it is clear that successful organizations have built a culture of IT service and user empowerment,” wrote researchers. “These organizations show the deep care they have for clinician success through their sincere efforts to listen and resolve clinician challenges. They also empower problem solving by not blaming all problems on the EMR vendor.”
Along with highlighting behaviors that tend to drive success, KLAS also indicated actions that are associated with inhibiting EHR user satisfaction.
Most notably, researchers found spending money on IT seems to have no impact on improving end user experience. Additionally, secure messaging capabilities and voice recognition use in clinical documentation have almost no effect on EHR satisfaction rates.
Despite previous study findings suggesting medical scribes may ease provider burden, researchers found no association between the use of medical scribes and higher rates of EHR satisfaction.
Overall, 85 percent of surveyed physicians either agreed or strongly agreed that they find fulfillment in their work as physicians. While EHR use may add stress to the provider workload, most physicians still find joy in practicing medicine.