Determinants of Electronic Health Record Satisfaction among Advanced Practice Providers
Bears, Jake Silverman, Matthew Sandoval,MD, MD Jacobs, Alicia McEntee, Rachel
Bears, Jake
Silverman, Matthew
Sandoval,MD, MD
Jacobs, Alicia
McEntee, Rachel
Citations
Altmetric:
License
License
Abstract
Background: Previous research has shown that Advanced Practice Providers (APPs) use the Electronic Health Record (EHR) differently from physicians, suggesting that the current EHR configuration may not be well optimized for their role. There is a notable gap in the medical literature examining EHR satisfaction among APPs, as well as how satisfaction correlates with EHR efficiency and user comfort in this group. In the 2024 KLAS Arch Collaborative EHR Satisfaction survey (KLAS), APPs within the UVM Health Network (UVMHN) placed in a much lower percentile nationally compared to their physician counterparts in overall EHR satisfaction scores.
Objective: This study aims to identify specific factors contributing to APPs within the UVMHN having lower EHR satisfaction compared to national peers and to assess areas in which APPs and physicians differ in EHR satisfaction and efficiency.
Methods: Quantitative data from Epic’s Signal analytics (July 2025), utilization metrics from an ambient artificial intelligence (AI) documentation tool (July 2025), and KLAS 2024 were compiled and analyzed. Efficiency was measured using an internal time-in-system metric that compares actual to expected EHR time. Proficiency was evaluated based on use of key EHR features. Active use of the ambient documentation tool was determined by note volume. Statistical analyses compared APP and physician performance and assessed differences between primary care and non-primary care settings.
Results: APPs and physicians demonstrated similar levels of EHR efficiency and proficiency, and ambient AI documentation utilization did not differ between groups. Differences in EHR satisfaction could not be explained by these performance metrics. Proficiency differed by practice context, with primary care providers in all roles showing higher scores than those in non-primary care settings. In contrast, efficiency was similar across all settings. KLAS 2024 responses indicated high interest in additional EHR training among APPs, with team-based optimization sessions and support from experienced peer users rated as the most valuable training methods.
Conclusions: Lower EHR satisfaction among APPs does not appear to stem from measurable differences in efficiency, proficiency, or ambient AI documentation use. Variation in proficiency by practice setting and strong demand for EHR training highlight the need for targeted, role-specific, and site-specific optimization efforts.
References
Rotenstein LS, Apathy N, Edgman-Levitan S, Landon B. Comparison of Work Patterns Between Physicians and Advanced Practice Practitioners in Primary Care and Specialty Practice Settings. JAMA Netw Open. 2023;6(6):e2318061. doi:10.1001/jamanetworkopen.2023.18061
Simpson JR, Lin C-T, Sieja A, Sillau SH, Pell J. Optimizing the electronic health record: An inpatient sprint addresses provider burnout and improves electronic health record satisfaction. J Am Med Inform Assoc. 2021;28(3):628-631. doi:10.1093/jamia/ocaa231
Watson MD, Elhage SA, Scully C, Peterson S, Gulledge M, Cunningham K, Sachdev G. Electronic health record usage among nurse practitioners, physician assistants, and junior residents. J Am Assoc Nurse Pract. 2021;33(3):200-204. doi:10.1097/JXX.0000000000000466
Description
Poster presented by Jake Bears at Northern New England CO-OP Practice & Community Based Research Network, January 23-25, 2026
Date
2025