EHR Usability Scores and Benchmarks: How the Top Systems Compare (2026)

EHR Usability Rankings: The 2026 Scorecard

Epic leads across nearly every usability metric for enterprise EHRs, earning the top KLAS score for the 15th consecutive year. athenahealth dominates the ambulatory segment, winning Best in KLAS for Independent Physician Practice two years running.

Oracle Health's scores have dropped more than 10 points in vendor loyalty and relationship since the 2022 Cerner acquisition, though recent app developments have led to "cautious optimism" among some current customers.

The SUS Benchmark Gap: Vendor Claims vs. Clinical Reality

The 29-point gap between vendor-reported and clinician-reported SUS scores is the defining usability story in healthcare IT. Vendor testing is conducted in controlled environments with simplified scenarios that do not resemble actual clinical workflows.

A JAMA Network Open study found that among 27 widely-used EHR products, 67% met the average SUS benchmark in vendor testing. When actual physicians evaluated the same systems in real clinical settings, scores plummeted to the "not acceptable" range.

Task Efficiency Benchmarks: Clicks, Time, and Documentation Burden

Research shows that deep navigation hierarchies and non-intuitive menu labels double the clicks required for common tasks. In observed studies, wrong-field data entry occurred in 17% of tasks — a direct patient safety risk driven by poor interface design.

Physicians spend nearly as much time on EHR documentation and order entry (13 hours/week) as they do on administrative tasks and personal overhead combined. Systems with ambient AI documentation — like those from Epic, Nuance DAX, and NextGen — are cutting progress note time by 50% or more.

Usability by Specialty: One Size Does Not Fit All

KLAS Arch Collaborative data shows that specialty satisfaction varies dramatically. Only 49% of cardiologists and 47% of orthopedic surgeons report that their EHR has the functionality they need, compared to higher satisfaction rates in primary care.

The takeaway: general-purpose EHRs require significant configuration to serve procedural and image-heavy specialties. For specialty practices evaluating systems, test workflows specific to your clinical scenarios. See our specialty-specific guides for cardiology, orthopedics, and dermatology.

EHR Usability and Burnout: The Hard Numbers

The Mayo Clinic Proceedings study linking SUS scores to burnout is unambiguous: physicians who rate their EHR poorly are significantly more likely to report burnout symptoms. JAMA Network Open research confirmed that EHR-based alerts had the lowest usability scores of any EHR subsystem, and approximately one-quarter of family physicians reported being "somewhat or very dissatisfied" with their EHR.

The good news: physician burnout has improved from 53% in 2022 to 43.2% in 2024, and job satisfaction rose from 68% to 76.5% over the same period. AI-powered documentation tools and focused EHR optimization are contributing to this trend.

Nurse EHR Experience: The Documentation Crisis

A December 2025 KLAS report based on 80,147 acute care nurses found that reducing or streamlining documentation ranks as the number-one EHR enhancement request — cited twice as frequently as any other improvement. Nearly four in five nurses report losing time to unproductive charting each week.

The common thread across successful organizations: executive sponsorship, multidisciplinary governance teams, and direct engagement of frontline nurses through task forces, feedback surveys, and superuser programs. This is not a technology problem alone — it is an operational commitment.

ONC Usability Certification Criteria: What Vendors Must Meet

The 2025 HTI-1 rule significantly strengthened usability requirements. Vendors must now follow a named industry-standard User-Centered Design process — such as ISO 9241-210 or NISTIR 7741 — and provide the citation during certification.

Despite these requirements, the gap between certification-level usability testing and real-world clinician experience persists. This is because vendor-conducted tests use simplified scenarios that do not reflect the cognitive load, interruption frequency, and time pressure of actual clinical practice. Use these criteria as a baseline during your vendor evaluation, but always supplement with your own hands-on testing.

Usability Improvement ROI: Where to Invest

University of California data shows institutions saved up to $33,000 per provider per year after focused EHR optimization, primarily from administrative efficiencies and improved charge capture. Many practices recoup EHR optimization costs in under 2.5 years.

How to Evaluate EHR Usability During Vendor Selection

Vendor demos are choreographed. Published scores have limitations. Here is a practical framework for evaluating usability with your own data.

For a complete vendor evaluation framework, including scoring rubrics and reference check questions, see our EHR Selection Process guide and EHR Demo Evaluation Guide.

Frequently Asked Questions

The Bottom Line

EHR usability is not a soft metric — it directly drives clinician burnout, retention, patient safety, and organizational costs. The industry-wide SUS score of 45.9 is a failing grade that should be unacceptable. The good news is that usability is improvable, measurable, and increasingly a competitive differentiator among vendors.

When selecting an EHR, do not trust vendor-reported usability scores alone. Run your own hands-on evaluations with real clinical workflows, administer the SUS questionnaire, and reference KLAS Arch Collaborative data for your specialty. After implementation, invest in ongoing optimization: the organizations achieving the biggest NEES improvements share a common approach of executive sponsorship, frontline clinician engagement, and systematic documentation streamlining.