Benchmarking Clinician Satisfaction with Electronic Health Records

Have you heard your clinicians make either of these statements?

“I don’t like my health record! It takes me twice as long to do my work and it doesn’t improve the care I provide.”


“I love my health record! It gives me all the information I need to provide quality care to my patients.”

What appears to be a subjective difference in opinion, has objective and fully controllable variables. Would you have greater confidence in your healthcare system if your clinicians were happier with their tools? And if you had the opportunity to ensure your clinicians loved their health information system, would you take it?

The KLAS Arch Collaborative, an EHR usability-focused initiative, may provide us with that very opportunity. The Arch Collaborative has administered satisfaction surveys to over 100,000 clinicians in 200 hospital organizations internationally (though admittedly, Canada has not yet been a big participant). From these surveys, we’re learning that organizations with happy doctors have some similarities, many of which are highly reproducible.

You may think that the greatest predictor of satisfaction would be the electronic health record (EHR) vendor. Surprisingly, there are organizations using the same EHR at the top and the bottom of the satisfaction scale. Clearly there are factors beyond the software itself that lead to satisfaction.

Number one on the list of positive predictive factors is education. If providers don’t know how to use their system, they aren’t happy. This doesn’t seem like a stretch of the imagination, yet determining what is “adequate” education can be a mystery. It appears that providing e-learning, classroom training, and at-the-elbow support are routine practices at the top and the bottom of the satisfaction scale. Those organizations that succeed with education are going above and beyond the routine in ways that uniquely support their clinicians. Some successful organizations have adopted a robust change management philosophy woven into their communications, a skills development team, or mentoring system. There is a wonderful opportunity for further studies on a formula for successful education.

Next on the list is personalization. One size does not fit all clinicians and the ability and degree of customization of the system for these users greatly predicts their satisfaction. If the EHR can suit the clinician’s workflow, as opposed to the clinician trying to fit the EHR workflow, happiness ensues. Similar to how we are all happier when our clothes fit our bodies, than when we are trying to change our bodies to fit our clothes.

Another significant predictor is the degree of shared ownership of the system. If IT owns the EHR, clinicians are less satisfied. If clinicians are leading the way with excellent support of their IT partners, all is well. This shared ownership and responsiveness to user needs extends well beyond an implementation and can make or break the ongoing success and return on investment of an EHR.

With such a fantastic recipe for clinician satisfaction, and so much variability in implementation outcomes, it’s time to start benchmarking the success of our implementations to a quality standard. We would all benefit from increased Canadian participation in the Arch Collaborative and sharing best practices learned along the way.

For more information on the KLAS Arch Collaborative, check out their website:

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