Trust in Health IT Leadership Key to Provider EHR Experience

Trust in organizational health IT leadership has a significant impact on providers’ overall EHR experience, according to a KLAS Arch Collaborative report.

The KLAS Arch Collaborative is a group of healthcare organizations working to improve the EHR experience through surveys.

KLAS calculates net EHR experience score (NEES) by measuring clinician perceptions of three key EHR stakeholders—their organization/IT leadership, their EHR vendor, and themselves as end-users. However, the impact on NEES is strongest for organization/IT leadership.

Several factors play into whether clinicians trust their organization/IT leadership, including EHR satisfaction, clinician burnout, EHR training, and support.

Since the Arch Collaborative research began in 2017, participating organizations have seen improvements in some areas and declines in others. Despite an overall uptick in the average NEES (by 16 points), clinician satisfaction with organizational EHR delivery has decreased by about four percent.

The difference in clinicians’ NEES is significant depending on how they rate their organization/IT leadership. On average, there is a difference of 124.1 points in NEES between providers who strongly agree their organization/IT leaders deliver well and those who strongly disagree.

“This is especially important because clinician burnout is on the rise—fewer clinicians (by about nine percentage points) report no burnout compared to four years ago,” the authors noted. “Organizations that have earned high trust from their clinicians are uniquely set up to address burnout.”

Some Collaborative organizations have measured clinician satisfaction before and after implementing an initiative targeting a specific department or goal. On average, these organizations saw significant improvement in NEES.

Typical focus areas for these initiatives include training and implementing new health IT such as EHRs and other supporting technology.

In these measurements, the NEES of repeat respondents increases an average of 22 points. In contrast, repeat respondents whose organizations have measured multiple times but not for a specific improvement initiative see an average NEES increase of about 7 points.

In addition to seeing an increased NEES, repeat respondents for organizations that conduct pre/post surveys also report higher satisfaction with their organization/IT leadership, their EHR vendor, and themselves as end-users.

A Boruta analysis (an algorithm used to determine what variables are most important to a particular metric) shows that the factors most important to clinicians’ perception of their organization/IT leadership are initial and ongoing EHR training.

Organizations often use EHR superusers in efforts to improve satisfaction with ongoing training. The report found that organizations that leverage superusers deeply embedded in their various departments see higher ratings for trust in organization/IT leadership.

Arch Collaborative case studies point to best practices of organizations with high EHR satisfaction. Recommendations include:

• Assign a superuser for every department/specialty
• Prior technical expertise isn’t necessarily needed
• Protected or paid time for superusers can be beneficial
• Superusers are best deployed as a peer-to-peer aid resource to teach best practices and support the adoption of personalization tools
• Superusers are crucial to developing effective EHR education materials
• Superusers are highly effective members of EHR governance boards

“The EHR is supposed to be a tool that helps clinicians deliver high-quality care to patients,” the authors said. “When clinicians feel the EHR doesn’t support high-quality, patient-centered care, they are much less likely to be satisfied with their EHR and their organization.”

About 44 percent of Arch Collaborative respondents disagree or are indifferent that their EHR enables patient-centered care.

The Collaborative organizations that rate highest for the agreement that the EHR supports patient-centered care also have much higher consensus (by 20 percentage points) that the organization and IT leadership deliver well, compared to organizations who score lower on this measure.