Variation in Family Physicians’ Experiences Across Different Electronic Health Record Platforms: a Descriptive Study

Background Electronic health records (EHRs) have been connected to excessive workload and physician burnout. Little is known about variation in physician experience with different EHRs, however. Objective To analyze variation in reported usability and satisfaction across EHRs. Design Internet-based survey available between December 2021 and October 2022 integrated into American Board of Family Medicine (ABFM) certification process. Participants ABFM-certified family physicians who use an EHR with at least 50 total responding physicians. Measurements Self-reported experience of EHR usability and satisfaction. Key Results We analyzed the responses of 3358 physicians who used one of nine EHRs. Epic, athenahealth, and Practice Fusion were rated significantly higher across six measures of usability. Overall, between 10 and 30% reported being very satisfied with their EHR, and another 32 to 40% report being somewhat satisfied. Physicians who use athenahealth or Epic were most likely to be very satisfied, while physicians using Allscripts, Cerner, or Greenway were the least likely to be very satisfied. EHR-specific factors were the greatest overall influence on variation in satisfaction: they explained 48% of variation in the probability of being very satisfied with Epic, 46% with eClinical Works, 14% with athenahealth, and 49% with Cerner. Conclusions Meaningful differences exist in physician-reported usability and overall satisfaction with EHRs, largely explained by EHR-specific factors. User-centric design and implementation, and robust ongoing evaluation are needed to reduce physician burden and ensure excellent experience with EHRs.