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How KLAS’s Arch Collaborative is Improving Clinician EHR Satisfaction: Q&A with Memorial Health System's Dr. David Graham

Published on 10/22/2018

Accurate, honest and impartial feedback from EHR users is critical for health care organizations. Yet more than 90 percent of providers do not have recent user-satisfaction data. KLAS Research created The Arch Collaborative to address this issue. The annual, provider-led effort helps its network of more than 55 members measure feedback, collaborate around best practices, and improve the EHR experience for clinicians. Through the Collaborative’s detailed eight-minute survey, members gain insights into clinicians’ thoughts on training, culture, governance, personalization and informatics. 

Dr. David Graham, CMIO and CIO at Memorial Health System in Springfield, Illinois, sat down with us to share how his organization has benefited from The Arch Collaborative’s robust data collection and global benchmarking capabilities. 

Measuring EHR efficiency and usability

What are some examples of how The Arch Collaborative has benefited your organization?

Dr. Graham: My learning and my involvement with the Collaborative has allowed me to see several different ways that we can approach the theme of usability with our physicians. First, we were pleasantly surprised to see that we were scored so highly among Cerner users around the country in how we do our initial education and training and in how we support our physicians. We were pleasantly surprised to see that what we thought was “just how we do things” was scored very highly on a national scale within the Collaborative and was something different that people could learn from. It was exciting to get that affirmation. We realized that we were doing some things right, and that we knew the best way to implement and support the tools. 

On the specifics around education and training, one interesting piece came when we were scored relatively lower on personalization and customization. This surprised us greatly, because we spent a lot of time in our initial trainings setting up the physicians with their preferences and their favorites, and the templates and tools they would be using most. That feedback from the Collaborative has helped us to be more explicit with the physicians about how and what we are doing with the system for their benefit and their needs. 

We’ve also been able to take the raw data from the survey, analyze it on multiple levels and use it to help develop action plans with our physicians for three months, six months and one year. We based the plans specifically on analytics that we pull out of the system; the physicians can use these plans in near-real time to help them interact with the system. This allows our organization to look at different workflow models. It has also proved the efficacy of tools like dynamic documentation and voice recognition platforms, as well as the use of templating to give physicians a more seamless and efficient data input and output mechanism, which leads to improved patient care. 

Improving physician communication and satisfaction 

How has the feedback from the Collaborative impacted broader strategy at your organization? 

It allowed us to prioritize our strategies based on what the physicians were telling us, and that is a powerful tool. We could go to our physicians and say, “We are going to resolve this issue, not only because it is what we want to do, but also because it is what you told us you need from us.” 

It’s also changing our timelines around prioritizing certain tools that we’ve wanted to implement, which will allow physicians to have greater usability in the system. 

Rather than changing our strategy specifically, the feedback has allowed us to reprioritize the things we thought were most important to go after. It has elevated the physician voice for us, and I absolutely think it will translate into greater physician satisfaction and appreciation for what we do here at Memorial. It will also improve communication with physicians. The data gives us a razor-sharp focus to be able to say, “Here is what you told us, and here is what we did, and here is the outcome.” We are just finishing up our nursing survey, and we have several hundred responses already. We are going to use that information to drive forward with changes from the employee satisfaction and engagement line.

A step toward interoperability

What does the Arch Collaborative mean in the context of the industry as a whole? Is this a model that you think other organizations and health care leaders can learn from?

I think the Collaborative provides a new model of how we need to be thinking about things. It is going to expand and improve the whole theme of interoperability. One of the challenges that we’ve found in the last 10 years is that things have become more isolated or health IT provider-centric, and we have forgotten all the lessons we can learn from people in a broader context. I am hearing about high-level things – such as tools, educational patterns, follow-up patterns and tactics for governing decision making with our physicians – that are less about what health IT providers can do for us than they are about how we manage our relationships and operations. Learning from those things is valuable, and it is nice to get validations and ideas from a larger community that helps us think about how to approach things. 

I’ve been thinking differently about some of the analytical solutions that Cerner has to offer for us as far as physician usage and physician time and assistance that I didn’t realize were there. When I heard about some of these tools in other health IT providers, it made me think and ask about what might exist within Cerner that we just didn’t know about, and that would give us the opportunity to do more interactive work with our physicians. The beauty of getting a broad view of physician and nurse interactions is that it allows us to see a bigger picture. I can see how it might guide us toward interoperability. 

The more we can understand what is possible on an interoperability level and a communication level, the better we are going to be as an organization.  Looking at common issues and practices from a higher level across the broad global health community allows us to see what we really need for the best communication and the best outcomes. 

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