Physician Satisfaction with Electronic Health Records – the Data Might Surprise You – Part 1

The following is a guest article by Heather Haugen from Atos and Mitchell Josephson from KLAS.

What factors predict physician satisfaction with clinical systems? As healthcare organizations select an EHR, they contemplate the best vendor, the breadth of functionality, integration across other applications, initial investment and maintenance costs, resources required to support the systems, and many other factors. While these factors have some influence on the adoption of an Electronic Health Record (EHR), none of them even make the “top 4” predictors of physician satisfaction.

Two independent research efforts have led to a better understanding of the most important variables in predicting long term satisfaction with EHRs. The Breakaway Group (now Atos) conducted several research studies that identified the factors that predict clinical systems adoption and overall satisfaction with the technology after implementation. They were able to compare many factors that impact EHR adoption across organizations at various levels of use and satisfaction. The outcomes from that research are published in a book titled Beyond Implementation: A Prescription for the Adoption of Health Information Technology.

Over the last three years, KLAS has collected insights and investigated what drives a clinician to be satisfied with their EHR. Aside from finding extreme variations in how users work with the same EHR platform, KLAS was able to validate a few key success indicators that highly satisfied users possess, and that those who are extremely frustrated with their EHRs do not. This body of research, which spans over 115,000 clinicians, is at the heart of the Arch Collaborative, and its outcomes provide critical guidance for healthcare organizations, especially as they focus on post-implementation outcomes.

Healthcare organizations can use these practical insights from the research to gain value from their technology investments.

In this two part series, we’ll share with you the four predictors of physician satisfaction based on the research.  In part one of the series you’ll learn the impact of Training & Education and Communication & Governance.

Training and Education: Training and education may be the most important long-term factor in achieving the expected value from an EHR. Many healthcare organizations commit to education and training leading up to go live, but very few continue to focus on educating their teams long-term. Doing so requires a disciplined post-implementation plan, along with the time and resources to support it.

  • Consider developing an education and training plan that reoccurs on a regular cycle. Some organizations have found success using “sprint teams” that come in and train on specific areas a few times per year.
  • Don’t underestimate the impact of upgrades and turnover. You need a plan for educating after upgrades are implemented (typically 4 times per year!) as well as for when key resources leave or move into new roles.
  • Develop role-based training. Generic training has no value to the end user. Always teach the workflow by role and task rather than showing the application’s functionality.
  • It’s important for each new clinician coming into an organization to receive at least 5-8 hours of EHR onboarding education. Ongoing education is also important to maintain high proficiency and satisfaction levels among clinicians. Physicians who are not new to the organization still need a minimum of 3-5 hours of ongoing education each year to maintain high levels of satisfaction with the EHR.
  • Trainer quality and content quality are also crucial. A simple litmus test for leaders to ask themselves is “Would I find the education valuable and is this trainer an expert who can effectively teach?” and “Is the education tailored to our workflows and to the needs of each role in our organization?”
  • Creativity is key. When engaging users, consider creative approaches. Messaging such as “Get the suck out of the EHR” will inspire more clinicians to attend versus “Mandatory EHR Training this Thursday”.
  • Consider the most effective mode of education: online learning, simulators, and sandbox activities are often the most effective and take less time away from patient care.

Communication and Governance: One of the most challenging aspects of leading the adoption of a new technology is transforming the project into a compelling and meaningful effort for everyone in the organization. The strategy, communication, tone, and processes are literally the on/off switch for adoption of your EHR. When leaders prioritize this effort, commit the required teams, and ensure sustainable processes after go-live, they achieve both clinical and financial goals. And if they don’t, the new EHR will become another poorly used technology that provides little value to the organization and its users.

  • Establish a clear set of goals and outcomes you expect to gain from using the EHR.
  • Commit the time and resources required to achieve those goals and outcomes.
  • Empathize with the level of change you are requiring from your employees. Use an enterprise system to provide the training and education they need for success.
  • Consider how to include all clinician types in the processes, decisions, and testing.
  • Leadership should be one of shared ownership. Organizations striving to create strong digital care environments include stakeholders from operations, IT, and the clinical side – all working together to help align the EHR with the organization’s vision.
  • Health systems that effectively optimize the EHR’s impact realize the effort is about change management as much as it is about integration, functionality, and efficiency. Consider using a change management model to align your efforts and make progress based on your needs.
  • How are you currently handling prioritization lists? Are they a mile long and growing? Consider an approach where department heads control the list. Take only the top one or two suggestions from each department and have them prioritize which items to include in the next sprint. Also consider creating a quick path for requests that don’t need to be bogged down by committee approval.

Join us next week for part 2 of this EHR Physician Satisfaction series where we’ll share the other two predictors of physician satisfaction.

About the Authors:

Mitchell Josephson is a senior analyst at KLAS Research as well as the VP of the Arch Collaborative, a KLAS initiative established to help healthcare organizations gain insight into and collaborate with one another on improving the current state of EHRs.

Heather Haugen PhD is the Chief Science Officer for Digital Health Solutions for Atos. Haugen holds a faculty position at the University of Colorado Denver- Anschutz Medical Center as the Director of Health Information Technology, where she mentors doctoral students and teaches courses. She is also the author of Beyond Implementation: A Prescription for the Adoption of Healthcare Technology.

About Atos Digital Health Solutions

Atos Digital Health Solutions helps healthcare organizations clarify business objectives while pursuing safer, more effective healthcare that manages costs and engagement across the care continuum. Our leadership team, consultants, and certified project and program managers bring years of practical and operational hospital experience to each engagement. Together, we’ll work closely with you to deliver meaningful outcomes that support your organization’s goals. Our team works shoulder-to-shoulder with your staff, sharing what we know openly. The knowledge transfer throughout the process improves skills and expertise among your team as well as ours. We support a full spectrum of products and services across the healthcare enterprise including Population Health, Value-Based Care, Security and Enterprise Business Strategy Advisory Services, Revenue Cycle Expertise, Adoption and Simulation Programs, ERP and Workforce Management, Go-Live Solutions, EHR Application Expertise, as well as Legacy and Technical Expertise. Atos is a proud sponsor of Healthcare Scene.

About KLAS

KLAS has provided accurate, honest, and impartial insight into the healthcare IT (HIT) industry since 1996. The KLAS mission is to improve the world’s healthcare by amplifying providers’ and payers’ voices. The scope of our research is constantly expanding to best fit market needs as technology becomes increasingly sophisticated. KLAS finds the hard-to-get HIT data by building strong relationships with our payer and provider friends in the industry.