Recommendations for Improving EHR Transitions: Nursing Perspectives From Three Healthcare Systems

Transitions from one electronic health record (EHR) to another are increasingly common yet can be enormously disruptive, affecting patient care and health care worker well-being. Nurses are especially impacted as the largest group of EHR users, and their perspectives are vital for understanding and improving transitions.

To identify actionable recommendations for supporting nurses during EHR transitions by learning from nurse experiences at health care systems that have completed EHR-to-EHR transitions.

Semistructured interviews were conducted with nurses from 3 health care systems in the United States between September 2023 and March 2024. We used rapid qualitative analysis to understand the nursing experience and actions taken during the EHR transition and identify recommendations for process improvement.

We interviewed n=15 participants, including frontline nurses and nurse informaticists across 3 health care systems.

We identified ten recommendations across 3 categories: training and support, workflow and usability, and EHR governance. Organizations consistently found that successful transitions required moving beyond vendor-provided support to develop institution-specific guidance, with nurses often taking key roles in developing and disseminating this guidance. Key recommendations included building internal training capacity, staging education to match user readiness, proactively redesigning workflows with nurse input, and establishing shared governance structures for EHR optimization.

EHR transitions are challenging and can have a significant and, in some cases, detrimental impact on nursing staff. Input from nurses is critical for improving the transition process and reducing potential negative effects.