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Clinician Governance, EHR Training May Boost EHR User Satisfaction

A KLAS Arch Collaborative report found governance structure and EHR training have the greatest impact on user EHR user satisfaction.

High-quality EHR training and clinician-led governance structure are key components to improving EHR user satisfaction for clinicians, according to the most recent KLAS Arch Collaborative report.

The survey of over 250 healthcare organizations and 240,000 clinicians examined EHR user satisfaction for various organizations with different sizes, focuses, patient demographics, EHR systems, and leadership structures.

According to Arch Collaborative data, clinicians in community hospitals had the lowest overall EHR satisfaction, with an average NET EHR Experience Score of 19.

However, this lower satisfaction can be tied to the EHRs typically used by community hospitals, which often have fewer resources. Strong EHR satisfaction is still possible for community hospitals, regardless of the EHR used, KLAS researchers stated.

Past reports have shown that the EHR in use only contributes to 33 percent of a clinician’s EHR experience. By improving user mastery through ongoing EHR training and fostering an organization-wide sense of shared ownership, community hospitals can significantly enhance the EHR experience.

Compared to their peers, midsize health systems had the second-lowest average Net EHR Experience Score of 25.9. Delivering EHR support across multiple locations, maintaining multiple EHR systems, and navigating the layers of communication between EHR decision-makers and end-users made achieving greater EHR satisfaction difficult for them.

In addition, clinicians at midsize health systems reported the lowest satisfaction with their own efforts to learn the EHR. Clinicians were also unsatisfied with their organizational and IT leadership, the report discovered.

Midsize health systems should focus on improving user proficiency and creating higher trust in organizational leadership, KLAS researchers mentioned.

Children’s hospitals received an average Net EHR Experience Score of 29.8. Children’s hospitals are unique in their need to document things such as immunizations, well-child visits, and patient growth, but their EHRs often don’t support these special needs.

These EHR systems are often not optimized to support pediatric care, causing clinicians to regularly have difficulty finding or documenting needed patient information, the report stated.

Additionally, clinicians at children’s hospitals gave the lowest levels of self-reported charting efficiency, and nearly 29 percent of reported burnout.

As reported by organization executives, one-third of children’s hospitals have insufficient EHR training or education, which is their biggest barrier to higher EHR satisfaction. Clinicians at these facilities are also the least likely to have ongoing training; they lack trainers and superusers needed to guide users.

Academic health systems are another organization with unique needs that lead to longer charting times, as patient records in academic health systems often require a higher level of detail. What is particularly concerning is that clinicians at academic health systems have reported some of the highest levels of burnout compared to clinicians at other types of organizations, the report mentioned.

Clinicians at large health systems reported the second-highest satisfaction with the EHR, with an average Net EHR Experience Score of 35.4. The few challenges clinicians face at large health systems are often because of the organization’s size, making it difficult for clinicians to communicate with each other across the organization.

When large health system executives were asked to identify the top factors that contributed to their EHR success, 17 percent of them stated that having a good EHR system or vendor relationship is helpful. Additionally, 25 percent cited clinician-inclusive governance as the factor that had contributed the most to their EHR success, and 23 percent stated user training.

The highest reported EHR satisfaction belongs to community health systems, which hold an average Net EHR Experience Score of 40.3. Community health systems lead out in satisfaction with EHR stakeholders, IT rounding, and charting efficiency.

Sixty percent of community health system executives attributed their success to having clinician-led governance structures and fast internal support.

The Collaborative report found that strong user mastery, an organization-wide sense of shared ownership, and having an EHR technology that meets users’ unique needs can impact 70 percent of clinicians’ EHR satisfaction.  By focusing on these critical areas, executives significantly improve the EHR experience, the report concluded.

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