The Power Of Ehr Design: Staff Satisfaction, Improved Care

In collaboration with the American Seniors Housing Association (ASHA), August Health recently published a survey of clinical leaders from senior living operators across the nation. The report included findings on gaps in clinical reporting, strategies for fall reduction, and new care models and technologies. One recurring theme though, was that of the challenges around staffing — hiring, retaining, training and improving the quality of senior living professionals. 

It is unsurprising that clinical leaders report so many issues around staffing. Caregivers face an environment that can be stressful, frustrating and demoralizing, as they shoulder the burden of demanding resident needs, increased compliance and legal scrutiny and antiquated technology systems that add day-to-day friction. 

This isn’t just anecdotal. Though there aren’t many studies examining the experience of caregivers in senior living, that of their counterparts in acute care spaces is well-documented, and studies report nurse burnout as a pervasive issue across healthcare. 

System strife

In particular, dissatisfaction with antiquated electronic health record (EHR) systems is a major contributor to this trend. According to the KLAS Arch Collaborative Nursing Guidebook 2024, of the nurses experiencing burnout, 32 percent cite the EHR as a factor. Within that group, 40 percent report that they will likely leave their organization within the next two years. Another study finds that nurses working in settings with poor EHR usability have higher incidences of burnout and job dissatisfaction. Even more damning, poor EHR usability actually has led to significantly higher odds of inpatient mortality and hospital readmission within 30 days, according to a paper published by Wolters Kluwer Health. 

Why is the EHR causing such strife? Continuing to look at the data, frequently cited issues include lack of user-friendliness, confusing terminology, difficulty of finding or retrieving information and system complexity, according to another study. The same study describes how counterintuitive design of EHRs can break a user’s natural flow, cost extra time and effort, and contribute to medical errors. 

The consequences of poor EHR design go beyond staff satisfaction and burnout. Poorly designed systems, by pushing users away, can result in important tasks being completed inadequately, late or not at all. When considering critical tasks like resident care assessments, this can lead to worse care outcomes and missed revenue. In a recent case study, this cost a large operator millions of dollars. Overly complex systems can also lead to incomplete incident reports and errors in medication records — common reasons for citations and lawsuits. And when critical data for making strategic corporate decisions becomes too difficult to access, management can be left guessing. 

Desirable design

So, what can we do about it? There is no silver bullet, but investing in well-designed, easy-to-use EHR systems can make a significant impact. Systems with better EHR usability lead to higher EHR adoption rates, fewer medical errors, less clinician burnout, lower costs and improved patient safety. This is the core idea behind August Health: building an EHR for senior living that caregivers love. 

Good design goes further than just pretty colors and rounded corners. A prerequisite to a well-built system is a deep understanding of the user’s workflow — and even their worldview. It means asking “why” until you really understand a user’s problem, rather than just providing a slightly better solution. It means iteration after iteration and going through countless bad ideas before arriving at the right one. 

This takes both time and a good deal of determination. There’s immense pressure, especially when growing quickly, to offer short-term solutions to customers. In most cases, there’s a quick and dirty solution, a new button or yet another setting, that would provide immediate relief to a user’s problem. But without first considering the big picture and the upstream implications, this is a slippery slope. Too many quick fixes and you’ll be working on a product with a lack of user-friendliness, where complexity of the system is making life worse for your staff. Maintaining the bar for quality requires steadfastness in the midst of pressure for a quick win. 

But the investment is worth it. When equipped with the right tools, caregivers have the power to transform lives and build communities. They are the heart and soul of our commitment to compassion and dignity for elders. It’s time we matched their dedication with tools that empower them. They deserve nothing less.

— Erez Cohen, co-founder and co-CEO, August Health 

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