Insights from Arch Collaborative Impact Reports Published in 2019

Interested in what KLAS is learning from Arch Collaborative data? We were able to publish 10 impact reports surrounding key topics, including training, documentation, and more. We’ve summarized each of them for you below:

1. Are EMRAM Stage 7 Physicians More Successful? – In short, yes. Stage 7 EMRAM physicians report higher EHR satisfaction. Physicians who have the full tool set are more satisfied overall. They report having better tools to deliver care, better functionality, and better integration. Factors such as efficiency, usability, and analytics are still important to satisfaction, even with more advanced tools. Training is also still a major factor in EHR satisfaction; advanced tools make a difference only with the training on how to leverage them.
2. The Nurse EHR Experience – Nurses report higher satisfaction with the EHR compared to their physician peers. This difference in success can be attributed to the connection nurses attribute to EHR use and excellent patient care. Nurses also report stronger teamwork and openness in adopting changes to the EHR. However, the nursing experience is not flawless. Nurses report that the EHR has a high learning curve, regardless of clinical background. KLAS’ major finding is that nurses’ mastery and use of the EHR are as valuable as physicians’ and that nurses should be routinely included in discussions around the use of the EHR.
3. Successful Users’ Keys to EHR Satisfaction – What do physicians who report that their EHR use makes them as efficient as possible do differently from their peers? This report dives into the thoughts and trends of successful EHR users. It finds that EHR education, personalization, and experience are the three largest factors in EHR efficiency. More specifically, EHR education is absolutely key.
4. Can My EHR Get Me There? – This report analyzes the relationship between EHR vendor and EHR satisfaction. How much does your EHR vendor affect your team’s EHR satisfaction? While EHR vendors do contribute to some EHR satisfaction, more than half of EHR satisfaction variation is attributed to user practices; user mastery and training contribute far more than the EHR vendor and their software-building practices.
5. Improving EHRs Globally – We set out to understand the similarities and differences between US and non-US EHR users and health systems. Analysis of US and non-US data reveals that all EHR-using health systems score similarly on satisfaction measures related to reliability, internal integration, patient safety, and quality care. Experience differs in the fact that non-US health systems, not tethered to as stringent regulations as US health systems, find the EHR to far more efficient. Non-US EHR users need fewer personalizations because the out-of-the box implementations meet their needs. However, those non-US users that do leverage personalizations are able to get more efficiency and utility from their EHRs.
6. Arch Collaborative Guidebook 2019 – Though technically not an impact report, this long-form publication summarizes the evidence-based practices and leading practices in improving EHR satisfaction. It is not meant as a checklist of things to do to be successful but as a compendium of effective tactics that health systems can adapt to their unique situations, issues, and needs. The major topics the guidebook covers include clinical outcomes, EHR-enhancement governance, EHR personalization, and follow-up EHR education and training.
7. Clinician Burnout – The EHR is often brought up in cases of clinician burnout. While the EHR is not the root cause of burnout, the Arch Collaborative has found a correlation between EHR satisfaction and reduced reports of burnout. Those facing burnout often find that the EHR contributes to the feeling of burnout instead of alleviating it. Helping these clinicians make better use of the EHR can help reduce burnout.
8. Clinician Training – The majority of clinicians surveyed report that they want more EHR training. They know how continued mastery of the EHR improves their professional lives and the quality of the care that patients receive. However, training needs to be carefully arranged and implemented to be effective. Trainers should be effective communicators and peers to the physicians they train. Clinicians should spend 5–8 hours on initial EHR training and 3–5 hours on ongoing training yearly. Effective training methods vary, so having a mix of styles helps make the greatest impact. Location has not been found to be the most impactful factor in training programs.
9. Achieving EHR Satisfaction in Any Specialty – The Arch Collaborative has found that there is a wide variability in EHR satisfaction between clinicians in different specializations. Those in hospital medicine, pathology, and pediatrics report the highest satisfaction, and those in orthopedics, cardiology, and plastic surgery report the lowest. The reasoning for the variance largely has to do with initial training and whether the EHR has needed functionality for the specialty. Another issue brought to light is how some smaller specialties within larger facilities find themselves using workflows and tools that are not scoped for their specific needs.
10. Finding the Right Recipe for Documentation – How effective are dictation tools and scribes at improving EHR satisfaction? Your mileage may vary with these documentation tools. They do not replace EHR mastery; the Arch Collaborative found that using these tools without effective change management and strong EHR proficiency results in no EHR-satisfaction gains. However, as these tools develop and are well implemented and as people train with them, there is no reason to discount their effectiveness at entering documentation to the EHR.

To read more past impact reports from Arch Collaborative data, check out the Learning Center on the KLAS website. You can also find out more about our top 10 most visited Arch Collaborative case studies here.

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