Factors That Influence Clinician Experience with Electronic Health Records

Objectives: To report quantitative and qualitative analyses of features, functionalities, organizational, training, clinical specialties, and other factors that impact electronic health record (EHR) experience based on a survey by two large healthcare systems. Materials and Methods: A total of 816 clinicians-352 (43 percent) physicians, 96 (12 percent) residents/fellows, 177 (22 percent) nurses, 96 (12 percent) advanced practice providers, and 95 (12 percent) allied health professionals-completed surveys on different EHRs. Responses were analyzed for quantitative and qualitative factors. The measured outcome was calculated as a net EHR experience. Results: Net EHR experience represents overall satisfaction that clinicians report with the EHR and its usability. EHR experience for Virginia Commonwealth University Medical Center and University of Chicago Medicine was low. There were noticeable differences in physician and nursing experiences with EHRs at both universities. EHR personalization, years of practice, impact on efficiency, quality of care, and satisfaction with EHR training contributed significantly to the net EHR experience. Satisfaction of certain specialty practitioners such as endocrinology, family medicine, infectious disease, nephrology, neurology, and pulmonology was noted to be especially low. Ability to use a split-screen function to view labs, follow-up training from other providers rather than vendors, reduced documentation time burden, fewer click boxes, more customizable order sets, improved messaging, e-prescribing, and improved integration were the most common desired EHR improvements requested on qualitative analysis. Discussion: EHR experience was low regardless of the system and may be improved by better EHR training, increased utilization of personalization tools, reduced documentation burden, and enhanced EHR design and functionality. There was a difference between provider and nursing experiences with the EHR. Conclusion: Designing better EHR training, increasing utilization of personalization tools, enhancing functionality, and decreasing documentation burden may lead to a better EHR experience.