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EHR Speed, Reliability Linked to Clinician Satisfaction, Patient Safety

EHR system response time can impact perceptions of patient safety and overall clinician satisfaction.

Organizations with greater clinician agreement that their EHR has the expected speed or reliability have significantly higher clinician satisfaction than organizations that lack this conformity, according to a KLAS Arch Collaborative report.

The Arch Collaborative is a group of healthcare organizations working to improve the EHR experience through surveys. Over 270 healthcare organizations have surveyed their end-users and more than 295,000 clinicians have responded.

Overall, almost half (44 percent) of clinicians surveyed said they do not agree that their EHR is fast enough. No organization had more than 90 percent of respondents report that the EHR has the response time they expect.

In terms of system reliability, 23 percent of clinicians surveyed do not agree that their EHR is available when they need it. Of the over 270 organizations, just 18 have more than 90 percent of clinicians reporting few or no difficulties with system availability.

The report also found that more than half (57 percent) of clinicians agree their EHR enables patient safety. Clinicians who strongly agree their system is reliable were much more likely to report the EHR supports patient safety.

This relationship is even more significant when it comes to system response time. Organizations with stronger clinician agreement that their EHR has the expected speed or reliability have significantly higher EHR satisfaction than organizations without this agreement.  

“Further, response time and reliability are not a common concern for the Collaborative organizations with the highest overall EHR satisfaction—almost all organizations in the 80th percentile for Net EHR Experience Score have fewer than 40 percent of their clinicians identify response time as an issue and fewer than 20 percent of clinicians identify reliability as an issue,” the report authors wrote.

Clinician perceptions of the EHR’s reliability do not depend solely on how often the platform is down. Even clinicians at organizations that experience very little downtime can report poor system reliability if the EHR is slow.

Response time is most closely correlated with clinician perceptions of system reliability compared to the various EHR aspects rated by clinicians in the survey, such as external integration, functionality, and EHR training.

“This is especially significant given that response time is also one of the aspects with which clinicians across the Collaborative report the lowest satisfaction,” the KLAS authors explained. “If an organization is experiencing high uptime but low satisfaction with system reliability, they may need to focus on increasing the system’s speed.”

Many clinicians who report dissatisfaction with their EHR’s response time or reliability also mention issues with IT equipment such as their computers, monitors, laptops, or workstations.

Compared to clinicians who strongly agree they have the response time and reliability they expect, clinicians who strongly disagree are 53 percent more likely to mention hardware issues organically. Clinicians who report that their EHR does not have the time or reliability they expect were also 67 percent more likely to report slow login times.

For example, one nurse respondent said that it takes 60 seconds for the system to load after entering their password.

“Given the frequency with which clinicians must log in during a shift, this nurse spends almost 10 percent of the workday waiting for the EHR to load,” the KLAS authors pointed out.

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