Health systems that chase cost reduction above all else pay a steep price — and clinicians bear the brunt of it. New research from KLAS confirms what many informatics leaders have long suspected: when financial priorities crowd out workforce well-being, burnout rates climb sharply and retention suffers.
What the KLAS Research Reveals
The April 2026 KLAS report draws on interviews with 42 CMIOs and CNIOs across 39 US healthcare organizations. The sample ranges from critical access hospitals to large academic medical centers. Each respondent ranked their organization’s commitment across the four Quadruple Aim goals: patient experience, population health, cost reduction, and clinician well-being.
The results are striking. Nearly four in ten organizations placed cost reduction at the top. Meanwhile, only 17% prioritized clinician experience first. That imbalance shows up directly in burnout data — and the numbers make a strong argument for rethinking priorities.
The Real Cost of Putting Cost First
Burnout Rates Tell the Story
At health systems that rank cost reduction as their primary goal, clinician burnout hits 35%. Furthermore, at organizations where cost reduction falls lower in the priority order, burnout drops to as low as 26%. That nine-point gap is not an abstraction. It represents nurses and physicians walking out the door — or burning out at their desks.
A Cycle That Compounds Itself
KLAS describes a self-perpetuating loop that cost-first organizations struggle to escape. Burned-out clinicians leave. Staffing gaps grow wider. Colleagues under greater pressure burn out next. Then more turnover follows. Beyond workforce strain, this cycle carries direct financial costs and steadily erodes the patient experience. Therefore, organizations that cut first often find the financial math catches up with them in the worst possible way.
Why EHR Satisfaction Drives Retention
Scores That Separate Stayers from Leavers
Organizations that place clinicians at the top of their priority list report a Net EHR Experience Score of 65.0 — more than ten points above the Arch Collaborative’s three-year average of 54.5. Higher EHR satisfaction correlates clearly with lower burnout and reduced turnover. In other words, the clinician experience delivers measurable returns across every other organizational goal.
The Retention Gap Is Enormous
Retention data shows the stakes in sharp relief. Physicians who plan to leave healthcare post a Net EHR Experience Score of -14.7. Those who intend to stay score 32.7. For nurses, the gap runs from 7.8 among those leaving the industry to 53.1 among those who remain. Consequently, clinicians who feel genuinely supported by their EHR choose to stay — and those who do not, leave.
What CMIOs and CNIOs Are Seeing
A Shared Set of Challenges
CMIOs and CNIOs approach the clinician experience through a systemic lens. Their top reported hurdles include clinician burnout (55%), staffing shortages (52%), internal misalignment (50%), and patient message burden (40%). Frontline physicians and nurses name the same underlying problems. However, they experience these as daily friction — slow documentation, poor integration, and limited data visibility.
Different Roles, Similar Pain Points
For nurses, documentation burden tops the list of requested EHR improvements at 31%. Physicians, by contrast, rank integration first at 22%, with documentation close behind at 20%. Although the specifics differ, the theme is consistent: clinicians want tools that work with them, not against them.
Ambient AI Leads the Fix — But Nursing Gets Left Out
The Dominant Improvement Strategy
Ambient speech and AI documentation tools have emerged as the leading response. In fact, 52% of surveyed CMIOs and CNIOs named ambient AI as the single most important improvement underway at their organizations. Training upgrades ranked second at 13%, followed by infrastructure investment at 9%.
A Blind Spot Worth Correcting
KLAS flagged a significant gap in how ambient AI rolls out. CNIOs report that most ambient AI initiatives target providers first. Nurses — the largest segment of the clinical workforce — receive far fewer dedicated solutions. Yet nurses work at the bedside in greater numbers and shape the patient experience directly. As a result, KLAS concluded that nursing-focused ambient tools deserve equal investment and urgency.
What High-Performing Organizations Do Differently
The KLAS report highlights practices common among organizations that reduce costs without harming clinician satisfaction. These include accessible training and ongoing support, active clinician participation in decision-making, and consistent feedback loops between leadership and the frontline. Additionally, KLAS spotlights several low-cost, targeted initiatives among Arch Collaborative members that produced measurable gains in clinician well-being. The takeaway is clear: technology investments succeed when strong culture and governance already exist beneath them.
Key Takeaways
- Cost-first strategies correlate with higher clinician burnout and greater turnover risk
- EHR satisfaction tracks closely with retention for both nurses and physicians
- CMIOs and CNIOs cite burnout, staffing shortages, and internal misalignment as their top challenges
- Frontline clinicians feel those same issues as daily documentation and integration pain
- Ambient AI leads current improvement efforts, with 52% of informatics leaders naming it the top fix underway
- Nursing-focused ambient applications deserve equal weight in any deployment plan
Improving the clinician experience, KLAS concludes, is the highest-leverage move available for achieving workforce stability and financial health simultaneously.
