Doctors with high electronic health record satisfaction are nearly five times more likely to report they'll stay at their organization, according to KLAS researchers. The group with the highest EHR satisfaction score is hospital medicine and also of note, anesthesiology's enthusiasm has declined.

WHY IT MATTERS

The Exploring EHR Satisfaction by Provider Specialty report from the KLAS Arch Collaborative reveals that hospital medicine, pediatrics, family medicine and internal medicine are the physician specialties with the highest EHR experience scores, compared to peers using the same EHR, while orthopedics and cardiology had some of the lowest EHR satisfaction scores.

Common frustrations experienced include EHR functionality, ability to deliver quality care and vendor delivery of quality.

The Arch Collaborative EHR Experience Survey looked at core EHR satisfaction factors – system efficiency, functionality, impact on care and more, aggregating results into an overall net EHR experience score. KLAS used Cerner and Epic EHR data because only they offer a large enough representation of specialty data for such a study, according to the report.

The specialty scoring the highest EHR satisfaction (compared to each vendor’s average) is the same for Cerner and Epic – hospital medicine providers scored over 10 points higher than the average for their respective EHRs. 

These providers are satisfied with their workflow training, EHR functionality and ease of learning how to use the system – 70% agreed their EHR had the needed functionality while only 49% of doctors in cardiology and 47% in orthopedics reported feeling that way. 

There were similar findings among these groups for agreement that EHR was efficient and enabled patient care.

The survey also found that some organizations that recently measured EHR satisfaction found abnormally high satisfaction scores in anesthesiology, cardiology, gynecology and obstetrics – and orthopedics. 

Though anesthesiologists generally have an overall EHR satisfaction in the middle of the range, this specialty had the largest decrease in satisfaction over time of any specialty examined in this research. 

KLAS then conducted in-depth interviews with the anesthesiologists who reported abnormally high satisfaction to glean insights into what makes them different from their less-satisfied peers. The best practices that emerged from the analysis are:

• Involve individuals in EHR governance to better understand EHR changes and the reasoning behind them

• Enable providers to ask the IT department, EHR analysts or their peers for help with quick fixes and recommendations for being more efficient with the EHR

• Provide significant use of EHR personalization tools to enhance EHR use and make documentation easier

• Implement EHR education, including required organization trainings and self-learning opportunities, to increase EHR knowledge and understanding

"I am engaged in the change process. I have seen several of my suggestions implemented in our version of Epic. I feel as though I have more control over my work when I can influence my daily workflow," said one anesthesiologist who participated in the deeper analysis.

THE LARGER TREND

For several years researchers are finding that EHR usability and clinician burnout are connected, and that EHR satisfaction is a factor in doctors' decisions to leave the profession.

But with physician support, one organization in Virginia managed to turn things around across 25 clinics with what they say is a scalable, replicable EHR satisfaction solution.

OrthoVirginia increased provider satisfaction with its EHR by providing more documentation options and one physician support specialist for every 40 providers. The specialists handled short-term individual support and then expanded to teaching.

"We realized we didn't have enough active engagement with the physicians. We knew we had to come up with a way to engage our physicians other than once a month sitting on a phone call," said Terri Ripley, OrthoVirginai's CIO, during a HIMSS20 presentation.

ON THE RECORD

"Though it may take significant time and effort to build specialty-specific workflow training, providers who strongly agree their training was specialty-specific are almost 25 times more likely to agree that the EHR has the functionality they need," said researchers. "Both organizations and EHR vendors can help all providers find success with the EHR by ensuring that initial and ongoing education are tailored to the needs of different specialties."